By Dave Andrusko
Fox News will air an hour-long special on what District Attorney Seth Williams has called Gosnell’s “House of Horrors.” The program airs tonight– Friday, May 3, at 9pm Eastern Standard Time. As of this writing, the jury is still contemplating the charges against Kermit Gosnell, which include four counts of first degree murder—babies allegedly aborted alive and then killed—and one count of third degree murder—the death of a 41-year-old woman because, according to the prosecution, Gosnell’s untrained, unlicensed employees gave her too much Demerol.
The Philadelphia Health Department’s Environmental Engineering Section failed to follow through after receiving a complaint in 2003 about aborted fetuses stored in an employee refrigerator.
Years earlier, in August 2003, another branch of the city’s health department had received an anonymous complaint about Women’s Medical Society. Mandi Davis, a sanitation specialist in the environmental engineering section, wrote a memo to a colleague at the department, Ken Gruen, with a copy to then-Assistant Health Commissioner Izzat Melhem. She informed them that she had received a “rather disturbing” complaint of aborted fetuses stored in paper bags in an employee refrigerator at Gosnell’s clinic.
Davis requested that a site visit be conducted to assure that proper infectious waste handling and disposal practices were in place. Davis further instructed Gruen: “I am not expecting a ‘wild goose chase’ for aborted fetuses.” Current Philadelphia Health Commissioner Donald Schwarz testified that notations on the memo seem to indicate that a site visit was, in fact, made.
The city health department, however, could not produce any report of that site visit. Nor is there evidence that the department took any action against Gosnell for his dangerous handling of medical waste, or for his failure to have an approved infectious waste plan, as is required by the city Health Code.
A year later, Gosnell still had no approved disposal plan. On March 28, 2004, Davis sent Gosnell a letter stating that a “plan” he had submitted was “incomplete.” In fact, it was completely blank, except for the name and address of the clinic, some contact information, and an indication that it was a medical facility. On May 3, 2004, Davis sent another letter. This one was a form letter. Davis wrote:
Several years ago all Doctors practicing in Philadelphia received a letter from former Health Commissioner Estelle B. Richman explaining the need for the Department to have an infectious waste handling and disposal plan from your practice. The Commissioner’s letter explained the necessity for infectious waste to be properly containerized, stored, transported, and disposed in a manner to preclude any hazard to you, your staff, and patients, the community or the environment.
The letter noted that the city had never received a plan or a fee from the clinic.
On May 7, 2004, a city health department inspector was sent to the clinic. His report stated that proper labels were missing from areas where waste was stored; that red bag containers for infectious waste were not lidded; that marked boxes of infectious waste were sitting on the basement floor – not raised as they should be; that red bags for pick-up were not properly stored in the basement; and that the clinic did not provide a contract with a disposal company.
Gosnell subsequently produced some more paperwork, including a copy of a contract for disposal. However, he never paid his fee. The city never approved his medical waste plan. And he never cleaned up the infectious waste. Yet five years later, he was still operating. When the Grand Jurors toured the facility in 2010, boxes of waste were still sitting on the basement floor. Gosnell still stored aborted fetuses in plastic containers in the freezer. Employees described a stench emitted by bags of fetal tissue that piled up in the clinic.
Commissioner Schwarz tried, unsatisfactorily, to explain why the city never enforced the regulations that purport to protect staff, patients, the community, and the environment. Protection of the public, according to Dr. Schwarz’s testimony, was not the real intent behind the regulations. The impetus for requiring doctors to have infectious waste plans approved by the city was not public health; it was revenue.
The city regulations required the city’s 10,000 providers to pay $100 for individuals, $250 for clinics, and $500 for institutions such as hospitals, schools, and nursing homes. But the regulations provided no guidance as to what the health department was supposed to do to enforce the plans once submitted. Dr. Schwarz related to the Grand Jury what he heard from people who were in the health department at the time:
The department was told, apparently, to collect the money, make sure the plan came in, get the fee, and not enforce, that is don’t take action against people but remind them. This is a revenue generating activity.
The department would only inspect or take action when there was a complaint about a provider’s infectious waste handling or disposal.
Then, according to what Dr. Schwarz was told, sometime in 2004 or 2005 – shortly after Davis sent to the clinic the form letter reminding delinquent medical providers to submit their waste plans and pay their fee – the department stopped trying to enforce the regulation against those who had not complied. The health commissioner’s testimony might explain why the department did not pursue Gosnell for his failure to submit an adequate infectious waste plan or pay his fee.
But it does not explain the department’s inaction after an inspector observed and reported Gosnell’s perilous storage and disposal of infectious waste in May 2004 (and probably in 2003, though we did not see that report).
There is no record to indicate that the health department ever checked to see if the dangerous conditions in the clinic had been remediated. It is clear from our investigation that they never were.