New Jersey Health Department Releases Records Of Investigation Into Operations Of Abortion Clinic, Reasons Behind Closure

New Jersey Department of Health and Senior Services officials on Tuesday released the records of their investigation of one of the state's largest abortion providers, Metropolitan Medical Associates in Englewood, N.J., after ordering the clinic to close last month, the Bergen Record reports (Padawer, Bergen Record, 3/14). Metropolitan Medical, which opened in the 1970s, performs more than 10,000 abortions annually and is one of the few clinics in the state that performs abortions up to 24 weeks' gestation. Rasheedah Dinkins, who had an abortion at Metropolitan Medical, earlier this month filed a lawsuit in the State Superior Court in Newark, N.J., against the clinic, charging clinic physicians Keith Gresham and Nicholas Kotopoulos with "negligent, careless and reckless care." According to Dinkins' lawyer Adam Slater, Dinkins on Jan. 27 went to Metropolitan Medical to have an abortion of a fetus at more than 15 weeks' gestation. After the procedure, she had pains and was taken to Newark Beth Israel Medical Center, where she was unconscious for more than three weeks, had two strokes and was forced to undergo a hysterectomy, according to Slater. Newark Beth Israel filed a complaint against Metropolitan Medical to the state health department (Kaiser Daily Women's Health Policy Report, 3/2). Investigators in separate records released on Tuesday concluded that Metropolitan Medical failed to notify the health department "of an event occurring within the facility that jeopardized the health and safety of a patient." The department declined to release details of the event, the Record reports (Bergen Record, 3/14).

Investigation Findings, Reaction
The health department after a licensing inspection last month ordered the clinic to stop seeing patients after finding violations that posed "immediate and serious risk of harm to patients" (Kaiser Daily Women's Health Policy Report, 3/2). According to investigation records, state health officials found "brownish blood-like residues" encrusted on forceps, rusty crochet hooks used to remove intrauterine devices, and one-quarter-inch of dark red "dirt and debris" under an examination table at the clinic. Health officials also found that the clinic could not provide evidence that it had an infection-control plan or of an infection-control specialist on staff. The clinic had a letter on file documenting the appointment of a particular employee as the infection-control professional; however, that employee was not familiar with the appointment. The employee also had not received training or certification in infection control and prevention, which is a violation of state law. The report found that packs of sterilized instruments, which are supposed to be opened just before their use, had been unsealed and left open in storage. In other areas of the clinic, investigators found open packages of sterilized speculums, scissors, forceps and clamps, and some surgical instruments were found in the same drawer as light bulbs, the Record reports. According to the records, the clinic failed to train janitorial personnel upon employment and annually about proper cleaning procedures and equipment care, as is required by law. In addition, the health department found that a clinic patient who is suing for malpractice had incomplete medical and operative records (Bergen Record, 3/14). The state is requiring the clinic to hire infection-control and administrative consultants, both of whom must be approved by the state and be at the clinic at least 40 hours per week. The consultants "shall have full authority to review, revise, if necessary, and implement all facility policies and procedures," the order said. In addition, the consultants must submit weekly written reports to the health department (Kaiser Daily Women's Health Policy Report, 3/2). Representatives of the health department and the clinic say the clinic is working to correct the problems and hoping to resume operations as soon as possible. "It is clear that facility is going through an extremely rigorous review," Frank Capece, attorney for Metropolitan Medical, said. He added, "We can debate whether that is arbitrary or necessary, but it's a moot point. It is the intention of the facility to be in full compliance with all requirements. And it's my perception that everyone's working in good faith. ... There's no doubt that we're being held to a strict standard, a tougher standard than any other facility that we know of" (Bergen Record, 3/14).














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