NOTE: This article is the second of a two-part series on two Ohio abortion facilities. This article will focus on the pending closure of the Center for Choice in Toledo. The first article, on the closing of the Capital Care facility in Cuyahoga Falls, is here.
Pro-lifers praying during 40 Days for Life outside Center for Choice abortion facility in Toledo, Ohio [Photo courtesy of Pro-Life Connection]
On April 8th through 10th, officials with the Ohio Department of Health paid a visit to the Center for Choice abortion facility in Toledo.
Now, mind you, Center for Choice isn’t just any run-of-the-mill abortion clinic; rather, it’s a member of the National Abortion Federation (NAF), which styles itself as the gold standard for “quality abortion care.”
But inspectors found a slew violations that tell a very different story.
The violations were serious enough that the Department of Health has already taken decisive action. Two weeks after the inspection was concluded, on April 24, Director Theodore Wymyslo, M.D., notified The Center for Choice that the Department intends to close the facility and assess a fine of $25,000.
The Center for Choice can request a hearing within 30 days of receipt of the letter, meaning that it has until the end of next week to do so. As of now, facility has not requested a hearing. If it fails to do so, it will be closed by the Department of Health.
The most alarming findings from the inspection are detailed below.
“No Policies and Procedures” for Just about Anything
Page 2 of the inspection report [PDF] notes that review of the facility’s policy and procedure manual “revealed no policies and procedures in place for Nursing, Medical Staff, Quality Assurance, Laboratory, Surgical, Medical records, Pharmaceuticals, and Infection control.”
It would seem that Center for Choice didn’t have a policy for anything.
Although the facility did have in its policy manual a booklet entitled “Clinical Policy Guidelines,” which contained guidelines for enacting facility policies, staff confirmed that “no specific facility policies were in place” for the aforementioned areas.
A facility can’t train employees according to a manual if there is no manual.
Unsanitary Conditions
The inspection report notes that the Center for Choice “failed to ensure the operating room equipment was maintained in a safe and sanitary manner.”
For example:
- An exam chair with cracks in the vinyl (a breeding ground for bacteria)
- Rust on exam chairs
- Rust on all of the facility’s heater unit covers
- Mold found on the rubber tubing attached to a bottle of distiller water used to fill the reservoir of the autoclave (a device used to sterilize equipment)
But in light of all of the facility’s other violations, these are actually minor.
Infection Control Problems
Page 3 of the inspection report notes that the Center for Choice “failed to establish and follow written infection control policies and procedures for the surveillance, control and prevention of post-operative infections.” In fact, the facility’s entire infection control policy was all of one (1) page in length.
When inspectors asked an employee (identified as “Staff A”) about the post-operative infection rate for patients, “Staff A stated that only a portion of patients return for post surgical follow-up exam and the facility does not monitor those patients for post-surgical infections.”
In other words: nobody ever comes back complaining about an infection, so Center for Choice assumes nobody gets an infection.
This also, of course, raises the question: Why do so many of Center for Choice’s abortion patients not come back for their follow-up exam?
Quality Assurance—Or Lack Thereof
Page 7 of the inspection reports notes that “the facility failed to establish and follow a quality assessment and performance improvement program designed to systematically monitor and evaluate the quality of patient care, pursue opportunities to improve patient care, and resolve identified problems.”
As with Center for Choice’s infection control policy, its Quality Assurance and Improvement policy was likewise all of one (1) page in length. Interestingly, the inspection report also notes the following:
“Review of the peer review information and the patient medical record audits revealed no identified problems or areas needing improvement.”
In other words: Center for Choice gave itself an A. This is why it is sheer madness to believe that abortion clinics can police themselves.
Consider, then, the sentence that directly follows the one quoted in full, above:
“Review of the patient satisfaction surveys revealed dissatisfaction with wait times prior to surgical procedures.”
So the patients tell a different story. Does Center for Choice plan to do anything about it?
In a word—no:
Interview of Staff A on 04/09/13 regarding any identified quality assurance projects for 2012 and 2013 revealed no quality assurance projects were planned or completed in 2012 or 2013. Staff A stated that patient concerns related to wait times were addressed by informing the patients ahead of time there could be a four to six hour wait.
In essence: We’re slow. We know it. Deal with it.
This might explain why so few of their patients come back for their follow-up exam.
Falsified Records
One would normally think that the information contained in a fire drill log would be rather humdrum. But not in the case of Center for Choice.
From pages 6 and 7 of the inspection report:
Review of the facility’s documentation of practice fire drills revealed fire drills had been conducted on 01/17/13, 02/17/13, 3/28/13 and 04/11/13 (current date is 04/09/13), and not every six months as required. Each of these sheets had been signed by those staff who had participated, even the 04/11/13 drill which has not occurred as of the date of the review [emphasis added].
Mark well: this is not just falsification of records. It’s falsification of records by the entire staff. This calls into question any and all of Center for Choice’s records. If they can falsify one record, they can falsify them all.
No Transfer Agreement with a Local Hospital
If medical complications or emergency situations arise, abortion facilities are required to have a transfer agreement with a local hospital. Center for Choice has been operating without one since July 2010.
This is no small matter, and the clock is ticking. If Center for Choice doesn’t obtain a transfer agreement by the end of next week, the state will step in and close it.
Significant Drug Problems
As previously reported, a DEA bust was the coup de grâce for the Capital Care facility in Cuyahoga Falls. For its part, Center for Choice had its share of drug problems as well:
Surveyor noted 156 ampules of Fentanyl on hand, each ampule containing 5 milliliters (250 micrograms per 5 milliliters). …[The] physician documented the amount of Fentanyl in micrograms given to each patient. Those dosages ranged from 75 to 100 micrograms each patient. There was no documentation of the amount of Fentanyl wasted out of each ampule. The end count identified the amount of micrograms left after deducting the amount given to each patient. The count and what was actually on hand did not match, because a large amount of Fentanyl was wasted after each patient, due to the ampules being single dose ampules.
The unused Fentanyl should have either been saved or witnessed as wasted. Instead, over half of it was presumed wasted, but not tracked. It goes without saying that this constitutes an enormous possibility for an employee to either self-consume or sell it.
What’s more:
In addition to the controlled substances in the locked medication cabinet, the physician’s prescription pads were also observed. The medication pad had three blank prescription pages, pre-signed with the physician’s signature.
This rather speaks for itself.
Drug abuse among professionals is a huge problem. Among abortion workers—who have easy access to drugs and precious little oversight—it would be reasonable to expect the problem to be even worse.
NAF Clinics = “High-Quality Care”?
Yesterday, National Abortion Federation President Vicki Saporta wrote an editorial in USA Today in which she attempted to draw a clear distinction between, on the one hand, the “high-quality care” offered by most abortion providers; and, on the other hand, the notorious Kermit Gosnell. (Although to no one’s surprise, she failed to mention that Gosnell himself formerly worked one day a week at an NAF clinic in Delaware called Atlantic Women’s Services.)
In her editorial, Saporta writes:
In addition to complying with state and federal regulations, many abortion providers are members of professional organizations like NAF. NAF members must complete a rigorous application process, including a site visit, and must comply with our Clinical Policy Guidelines, which set the standards for quality abortion care in North America. Women can be assured of receiving high-quality care at NAF member facilities.
Recall, once again, that the Center for Choice, despite its pending closure and $25,000 fine and its easily accessible inspection report [PDF], is still an NAF member clinic.
“High-quality care?” You be the judge.
