McHenry County Blog

We are now on the seventh post of what a friend of McHenry County Blog found in inspection reports of abortion clinics by the Illinois Department of Public Health.

Women’s Aid Clinic, Lincolnwood

This clinic is now “officially” closed, but you probably have not heard about it. The office remains open, appointments can be made for medical abortions, but surgical abortions are said not to be performed there.

A Nursing Survey was conducted on Sept. 6&7 2011. Multiple serious violations were found. Because of the emergency suspension of the clinic and the later “closing” of the clinic the plan of correction and any subsequent inspections were not released ( the IDPH does not release the plan of correction until a matter is resolved. Now that the clinic is closed they still have nothing to release. Perhaps no plans for correction were submitted). Here is what the nursing surveyor found:

There was no organizational plan in the policy and procedure manual. This is to set out the duties and responsibilities of owners and employees.

There were no minutes of the consulting committee for the last 6 months. This is where professional oversight of the clinic is exercised, making sure that things like tissue results and employee qualifications are discussed, among other things.

Again, there were no tissue committee notes. This is where the results of the pathology reports are discussed to make sure abortions were complete and nothing was left inside the women.

Medications for anesthesia (narcotics and sedatives) were not inventoried, counted, or accounted for; so medications were not accurately tracked or documented. A perpetual inventory for the narcotics and sedatives was not used and the narcotic sheets did not contain documentation of drug doses given. (This allows for rampant drug abuse because noone knows what’s missing or what should be there).

The P&P manual lacked discharge criteria for all patients and a protocol for Rh- patients.

The P&P manual lacked job descriptions, orientation procedures, and personal policies for several positions.

There was no supervising RN. There had not been one since June of 2011. A medical assistant was giving Rhogam.

Under sanitary facility there are more violations than I wish to enumerate. Besides accumulated rust and dust there were open packages of gauze, syringes, and medications. There were saltine crackers in the recovery room medication drawer and cracker crumbs in the medication cups along with the meds.

A clinic worker was observed retrieving a paper towel from a garbage receptacle and using the same paper towel to cover a tray that would serve food items to patients.

Medications were kept in the refrigerator along with cola in the recovery room.

In the biohazard laboratory refrigerator were kept 8 fetal remains, medications, and 3 frozen TV dinners (YUCK).

The exam room contained 6 speculums and 20 pipettes out of their protective packages. A rip in the exam table was covered with clear tape.

The P&P manual had no procedure for emergencies like explosions, bomb threats and other non-medical emergencies.

There were outdated emergency medications and supplies on the anesthesia cart, recovery room crash cart, in the decontamination room, and in the exam room.

There was no written policy developed by the consulting committee on Medical, surgical, or psychiatric conditions to indicate which patients were ineligible for a surgical procedure. This is important. Very important. Some patients cannot be operated on, especially as out-patients, because it isn’t safe. In this case, a patient died after her abortion when she was obviously too sick to have the abortion in the first place. According to the IDFPR the abortion doctor’s license is on probabion, I assume because of this. The circumstances cited by IDFPR are basically the same as here.

There was no RN present in the OR to function as circulating nurse during all invasive or operative procedures. That, again, is because they had none in their employ since June 2011.

Again, under postoperative care, the clinic is cited for the woman who died. Rather than giving her CPR when she was having difficulty breathing, they gave her a bag and told her to breathe into it. The clinic disputed this finding.

Clinical records were woefully inadequate, about half of those reviewed were missing patient identification, pre-counseling notes, an operative record, condition at discharge, and post-operative counseling notes. There was no policy for these in the P&P manual.

As you can see, this is overwhelmingly dangerous. What happened later to suspend their license on October 21, 2011 can be summarized as related to the facility i.e. failure to ensure a sanitary enviroment; related to the staffing i.e. no RN, and related to the patient who died there i.e. operating on a person who was ineligible for surgery and failure to do CPR when she had difficulty breathing. But since I do not have any response from the clinic, I cannot include it.

On 8/11/11 a Life Safety Code inspection was conducted.

Since the clinic is now closed, it is like beating a dead horse to recite all the violations. I will give a brief summary.

It was a fire trap. The construction and building type (wood, multistory, multi-tenant) demanded sprinklers and fire wall separation from the other tenants, but there were none. What fire system they had was unknown to the staff. They could not locate the fire panel for the inspector. The doors were not wide enough, the corridors were blocked with furniture, the exits were blocked and had thumb locks ( making it difficult to exit in an emergency), There was no written evacuation plan, no documentation of in-service or training in fire emergencies, fire drills, or testing of the fire system. The emergency lighting for procedures and exiting was untested and, in several cases, unfunctioning. Oxygen tanks were improperly stored, electrical wires were improperly attached, and the 1 recovery room was overcrowded with 5 beds and 2 recliners, giving patients insufficient room to safely recover. If you would like a more detailed listing of these violations, I can provide it. Given that the clinic is now officially closed, I chose to be brief.

According to the communication between IDPH and the clinic, they were to officially close on November 10, 2011.

However, their website is still up and advertising surgical abortions and that they are licensed by the state. IDPH has confirmed that they no longer are a licensed facility. They still answer their phones. It appears that they may be referring potential patients to other abortion clinics for surgical abortions and performing medical abortions themselves, but it’s hard to tell. It makes you wonder what the meaning of “closed” is.  The status of the $36,000 fine is unknown by me at this time.

More tomorrow.

This is the fifth of a series of posts written by a friend of McHenry County Blog summarizing Illinois Department of Public Health Inspections of abortion clinics.

National Health Care, Peoria

This is by far the most difficult clinic to write about. Of all the PTSCs that remain open it had the most violations. It is impossible to be brief in this summary.

On 6/16/11 a nursing survey was done. Here are the results listed according to survey category:

Under Organizational Plan- there was a chart to delineate lines of authority that was conflicting. Another flow chart was proposed.

Under Standards of Professional Work- There was no documentation that the consulting committee had met in 2008, 2009, 2010, or 2011. They are required to meet quarterly. This is very important because the consulting committee is the heart of how a clinic operates. It writes and updates policies and procedures for the P&P manual; it sets criteria for who can work there, qualifications, job descriptions, the granting of privileges; it serves as the tissue committee to make sure the pathology reports are read, filed, and responded to if they come back abnormal; because it consists of at least 3 qualified consulting physicians it encourages an interaction between professionals that improves the quality of care. By not meeting quarterly they did not oversee the things which are required for safe practice, which will be demonstrated below.

The P&P manual lacked a procedure for granting privileges. But there were doctors hired and working there. Credentials were to be reviewed by the credentials committee (which did not meet) so that specific practice privileges could be requested (which they were not) and could be granted (which they were not). All 4 doctors had no documentation in their files to indicate whether privileges were granted and what the scope of those privileges were. There were no requests for privileges in the files. One of the doctors didn’t even have a job application in his file. When a doctor is granted specific practice privileges he is to provide a motorized statement indicating the name of the Illinois’ licensed hospital(s) where he has skilled-equivalent practice privileges. None of the files contained this. Two doctors had hospital letters on file, but it turned out that one of them was no longer on the staff of the hospital. That means that of the four physicians only one had current hospital privileges.

Since the consulting committee did not meet, the tissue committee did not meet. The pathology reports were said to have been handled by the RN. There was no collaboration on the findings, which could improve care. There was also an unwillingness to change the procedure, expressed by the clinic administrator. The Medical Director is responsible for securing compliance with the policies and procedures pertaining to the medical and surgical procedures. First off, the P&P manual was to be reviewed semi-annually by the consulting committee (which was not meeting). But even without updating, the Medical Director allowed many violations of the current Nurse Practice Act to occur. IV moderate sedation is to be administered only by physicians and RNs. In about 1/2 of the cases it was being given by an LPN. This is unsafe, unlawful, and totally not allowed. Because the staff nurse job description had no delineation between the requirements and duties of an RN and an LPN, they ended up overlapping duties. Also, it was found that a CNA was mixing up medications for IV usage. There was no documentation that she had ever been trained to do this. This also is not allowed and is dangerous. There was also questionable training of the ultrasound techs. According to the tech, she had been trained by the administrator, but the administrator claimed that all sonographers have been under the direction of an x-ray technologist who specializes in ultrasound. There was no documentation in the tech’s file to indicate any training or demonstrated competency in perfoming ultrasounds.

Under Personnel Policies-each employee’s file is to contain documentation of orientation and/or demonstrated competency to their work. Of the 12 employees, 9 failed to have this documentation while the other 3 employees HAD NO FILE AT ALL. What kind of a place is this? How does ANY place of business not have file records on their employees? There was a dispute between the nurse surveyor and the administrator over the scope of one of the employee’s work, but since she was one of the employees without a file, it’s hard to say if she was doing things she was allowed to or not!

Under Presence of Qualified Physician-”a qualified physician is required to remain until all patients are medically discharged. The discharge criteria shall be defined by the qualified consulting committee.” There was no discharge criteria in the P&P manual. And since the consulting committee wasn’t meeting…

Under Nursing Personnel-3 of 3 LPN personnel files failed to include documentation of training in observation and emergency techniques for preoperative and postoperative care of surgical patients. It appears that they were simply hired and told, “go to work”.

Under Laboratory Services-There was no written agreement with a CLIA certified lab. They later produced a written agreement with the lab they have been working with for what they said was 30+ years.

Under Equipment-There was no evidence of any preventative maintenance program or log for the equipment utilized in the provision of patient care. This includes the sterilizers (3), the suction machines used for the abortions (3), the sonogram machine, the centrifuge, the blood pressure machine, special lights, and an oxygen tank which was last checked 10/16/2000 and was empty. All the equipment was sent out to be maintained and a yearly recheck is now set up.

Also in terms of equipment management is the safety in storage and use of all narcotics and medications in accordance with state and federal law. There were many violations of procedural discipline found. There were medications stacked in unlabeled medication cups, open and unopened medications in unlocked drawers, open vials with no indication of when they were opened (once open they rapidly expire). Open and unopen vials placed on the procedure stand in the procedure rooms by the door included Fentanyl, a narcotic. It is to be kept under lock and key.

Under Sanitary Facility-The sterilizers are to be cleaned monthly. They hadn’t been. Also, they are to be tested weekly. According to the log they were only being tested monthly, and I notified the IDPH about that. A broader explaination of the purpose and importance of this will be found under Northern Illinois Women’s Center.

Also under Sanitary Facility-the laundry was processed on site, but there was no documentation that the water temperature was monitored so as to prevent cross-contamination. There was food found on the crash cart ( snack nuts and cookies), open 2×2 gauze squares in the medication closet, open packages of bandaids stored in emesis basins in all three procedure rooms, and various patient care items stored on the floor.

Under Emergency Care-While there were policies related to emergency preparedness in the P&P manual, there was nothing to indicate the staff had received any training in handling emergencies.

Under Pre-operative Care -a complete history and physical is to be done and a pre-anesthetic evaluation. In 20 out of 20 patients there was no documentation to indicate the history (completed by the patient) nor the physical examination (lab work, pelvic and sonogram completed by the nurse, lab, and/or sonographer) were reviewed by the physician prior to their procedure. Nor was there documentation to indicate a pre-anesthetic evaluation was conducted prior to the the administration of IV moderate sedation. This is so dangerous. (See the death at the Woman’s Aid Clinic below.) This is part of the definition of “abortion mill”- doing the procedure without a concern for the individual patient, her individual needs, her particulars regarding her body. Yes, the tests may have been done, but someone must READ and INTERPRET them. And histories need to be done interactively, or at least discussed. Not just filled out without scrutiny. Also, the examination completed was only a pelvic exam, a sonogram, and lab work-up. There were no other systems examined like the respiratory system (lungs) or the circulatory system (heart). This is extremely dangerous for someone undergoing IV sedation and surgery.

Under Operative Care-This is where it gets particularly scary. This relates to the actual procedures. The code states, ” Surgical procedures shall be performed only by a qualified physician within the limits of the defined specific practice privileges that have been granted”. Since there was no way of granting privileges, there are no limits on the scope of practice on doctors who were never qualified to operate. No physician had defined specific privileges granted, or even requested.

The IV sedation given by LPNs was totally outside their scope of practice. LPNs are allowed to start IVs after certification. There was no evidence that any of the 3 LPNs were even IV certified, yet they administered IV push medications, including narcotics.

Regarding the registered nurses giving IV moderate sedation- the RN must have no other responsibilities during the procedure in order to monitor the patient’s response to the medication (breathing, heartrate, etc.). She must maintain current Advanced Cardiac Life Support (ACLS) certification. The supervising physician must have training and experience in delivering and monitoring moderate sedation and possess clinical privileges at the ASTC to administer moderate sedation or analgesia. The supervising physician must maintain current ACLS certification…These RNs had multiple clinical responsibilities. NONE were ACLS certified. The physicians were not privileged to administer moderate sedation. Only 1 of the 4 physicians had ACLS certification in their professional file.

Regarding RNs in the operating room- an RN must be present in the operating room and function as the circulating nurse during all invasive or operative procedures. This was not so. If the RN is giving the IV sedation, she cannot circulate. If she is circulating, she cannot be giving IV sedation or leave the room. At some times the only person in the room, besides the physician and the patient, was an LPN. This is not safe practice. But it was their standard procedure, as voiced by the administrator.

Under Statistical Data- There is specific statistical data to be kept at the clinic regarding procedures done, complications, deaths, and transfers. There was no data compiled nor presented. There was only an oral reassurance that the clinic has never had a death or a serious life-threatening issue in the last 36 years. I find it hard to believe.

On 9/6/11 the nurse surveyor returned. The clinic had corrected many of the problems, but significant problems remained.

Under Standards of Professional Work- there was still no procedure for granting privileges. It had been written, but had not been reviewed and approved by the consulting committee. However, privileges had been granted to physician(s?), but it was discovered that at least one of the physicians had no admitting privileges at an Illinois hospital. (Because some documents were reviewed on site I can’t tell exactly what was going on). The P&P manual had not been reviewed and approved at this time (3 months after the initial survey). The new discharge form was being implemented, although it had not been approved.

Under Pre-operative Care- There was in 14 of 14 charts no documentation to indicate that the history, lab work, or pelvic exam were reviewed by the physician prior to the procedure and there was no documentation to indicate a pre-anesthetic evaluation was conducted prior to IV moderate sedation. Again, this is after 3 months to initiate change.

The clinic had to make some drastic changes. Since only one physician had hospital privileges and ACLS certification, the others stopped practicing there. One was able, later, to get privileges at a hospital and become ACLS certified. The other two have left permanently. However, that leaves only 2 qualified physicians at the clinic, and 3 are required for a Qualified Consulting Committee, so something needs to change for compliance. Allowing them to operate without the 3rd physician will not raise the standard of care, and as you can see, it’s already pretty low.

Unfortunately, the changes that the clinic made were not always improvements. Because an RN was required to devote full attention to administer IV moderate sedation, the clinic opted for the physician route. Now the physician administers the IV moderate sedation and no nurse is involved. This is legal, but clearly less safe. He may believe that he can multitask, but the physician is split between doing the abortion and being responsible for the sedation. If he has a complication with one, how is he to monitor the other? Clearly a dangerous move, but one that is considered legal. While his license is at stake the patient risks her very life.

On 10/7/11 the IDPH did another onsite visit. Since there was only 1 physician working there and doing the IV moderate sedation himself, and since the policy and procedure manual was reviewed and approved on 9/15/11 by the (not exactly qualified) consulting committee, and since there were medical history, physical exam and discharge criteria present in 15 of 15 charts examined, the clinic was deemed compliant. Let’s hope it’s safer.

On 7/6/11 a Life Safety Survey was done. Multiple violations were found.

Under Hazardous Areas- walls did not extend through to the roof, there were areas without drywall leaving the metal studs exposed, and there were fire doors needed in some areas and needing documentation in other areas. This involved 4 different rooms of storage areas. All are fire hazards.

Under Emergency Illumination- there was no documentation of any testing of the emergency lighting. When tested by the surveyor the battery operated light for the back fire exit did not function.

Under Written Fire Plan-there was a plan, but it was neither complete, direct, explicit, nor gave proper procedures. It was rewritten. There was no documentation as to how the facility conducts an “in-service” of fire safety for their existing and new staff.

Under Fire Drills- there was no documentation of fire drills occuring. In the P&P manual they were required yearly, but the standard is quarterly and requires documentation.

Under Fire Alarm System-there were an insufficient number of smoke detectors; no documentation of testing system components; the door hardware had magnetic locks that did not allow for quick and easy egress in the event of a fire; the electric panel was not marked “Fire Alarm Circuit” and lacked a lock on devise.

Under Fire Extinguishers- there was no documentation of any testing or inspection as required. (It was later provided).

Under Electrical Wiring- They needed GFI on outlets near sinks in the procedure rooms. Multiprong adaptors were being used in 2 areas. The electrical work was corrected.

Under Support Services Areas-the corridor contained a gurney, a wheelchair, and a table all obstructing egress. They were cleared out and properly stored.

On 9/12/11 a follow-up survey was conducted. There were uncorrected deficiencies remaining.

On 10/14/11 another follow-up survey was conducted. There were still uncorrected deficiencies remaining.

Under Hazardous Areas- the rating on the existing fire doors still had not been verified.

Under Emergency Illumination- there was still no documentation of testing, even though they had submitted a form in July. The form had not been used (documenting monthly testing).

Under Fire Alarm System-they were still missing a smoke detector. The hardware for the exit door was not installed by 9/12/11. There was no sign on that door by 10/14/11 to indicate the location of the “red button” that allowed an override of the system.

On 11/1/11 a desk audit was done. The clinic had sent in pictures of the 2 fire door ratings and of the exit sign. I could find no documentation that the emergency lighting was tested. The surveyor found that all deficiencies previously identified have now been corrected.

I am sure that these surveyors had a hard time with this clinic. In a newspaper article in the Peoria Journal Star the clinic administrator says as much. Having gone for so long without inspection, and being unaware of many changes in the code made for a very large task of coming up to date. The clinic made a lot of substantial changes to come up to the standards. Except for their having the physician do the IV Sedation himself, rather than hire additional RNs to do it, I think these changes will result in a safer enviroment for the patients and the staff, particularly in cases of emergency. By tightening up on their medication standards they should make it more difficult for drug abuse to occur, which has been seen to be a problem in many clinical settings.

More tomorrow.

This the fourth of a continuing series of posts written by a friend of McHenry County Blog about Illinois Department of Public Health inspections of abortion clinics.

Forest View Medical Center, Des Plaines

On 6/1/11 a nursing survey was done. Several violations were found. They were mostly paperwork and related to the policy and procedure manual not reflecting the practice of the clinic.

A Rhogam dose for an Rh- woman having a medical abortion was not recorded in the Rhogam book, although it was given and recorded in her chart.

There was a dispute between the clinic and IDPH over whether an employee needed to have a background check.

There was a dispute between the clinic and IDPH over how many ultrasounds were needed in training the ultrasound tech  (the P&P manual was changed from 50 to 30 to reflect their practice).

No post-counseling notes were found.

The response of the clinic was to submit a form for post-counseling notes. They changed their P&P manual, and studied how to be certain that medical abortion patients would be included in the Rhogam book.

On 8/10/11 a Life Safety Survey was done. There were multiple violations found, but they were all corrected by 11/3/11. They included

The staff changing room was overfilled with bags of dirty linen (9-32 gal. bags).

Exit doors were not equipped for easy opening (they contained thumb screws).

Emergency lighting was missing or needed to be modified.

Fire drills needed documentation of the time of day they occurred, to show they took place at various times and conditions.

The Fire alarm system was not documented well and the circuit was not labeled in the electrical panel.

The Sprinkler system needed testing and a testing log.

While it looks like a lot, there were no huge or unusual problems here. The thumb latches were removed from the emergency doors. The linen pickup was increased to 2x/week. Memos were sent out. The fire alarm and sprinkler systems are now documented and understood. These things, again, show that frequent inspection is not burdensome and can work to save lives.

More tomorrow.

This is the third in a series of posts written by a friend of McHenry County Blog about inspection of abortion clinics by the Illinois Department of Health:

Access Health Clinic, Downers Grove

On 5/18/11 a nursing survey was done. Several violations were found

Terminal cleaning in one of the ORs was insufficient. They found a red stain on the wall, loose debris on the floor and standing water in a small bucket.

There were no post counseling notes in patient files.

The correction was to notify the cleaning company and inform them of their lack of diligence and to submit a form for post counseling notes.

On 7/12/11 a Life Safety Survey was done. Multiple violations were found

Violations include a nonfunctional sprinkler head in the storage room (a hazardous area), lack of maintenance of the fire alarm system, improperly stored oxygen tanks, sprinkler system improperly installed, electrical outlets near sinks were not GFI protected, multiprong adaptors were being used in clinical and patient areas, and the sink faucet handles were not hands-free in the exam rooms. An acceptable plan of correction was submitted, and a recheck on 1/13/12 showed all deficiencies corrected.

Again, this clinic shows that regular inspections are not burdensome and help insure the safety of patients and employees.

Michigan Ave Center for Health, Chicago

On 6/23/11 a nursing survey was done. Multiple violations were found, some I would rate as serious.

Unsanitary conditions were found in both ORs and 1 recovery room. There was rust and residue and dust on the anesthesia machine. The suction tubing (designated as “clean”) was found hanging over the biohazard container. When opened, the lid of the container touched the tubing (YUCK).

The crash cart contained expired IV bags.

Transferred patients lacked proper documentation accompanying them to the hospital.

There were no post counseling notes.

There was an acceptable plan of correction, which included trying a new betadine remover, moving the biohazard box, in service on terminal cleaning, making a new and better checklist for the crash cart, a memo to MDs and RNs that transferred patients must have complete records, and a form for post counseling. There has not been a resurvey yet, that I am aware of.

On 8/12/11 a Life Safety survey was done. Multiple violations were found.

Fire Drills were being held, but not at varying times.

The fire alarm system maintenance log was not complete.

The electrical panels were in a closet crowded with other stuff. The area needed to be clear for emergencies.

The plan of correction was accepted- mostly memos and contacting their fire alarm company. There was a resurvey on 11/4/11 that found all in compliance, except for lack of documentation of the location of the sprinklers in the sprinkler system. That documentation was submitted and the facility was declared compliant on 1/24/12.

This is another example of the importance of regular inspection and that it need not be burdensome. I do have concerns about the nursing inspection. The biohazard box location shows a lack of thinking/noticing a dangerous situation. That worries me. The transfer of patients with complications is a very important part of outpatient surgery. Getting it wrong is one of the major arguments against out-patient surgery in the first place. Out patient surgery is a relatively new endeavor. There are still doctors who insist that abortion is safe only in the hospital setting. This is an example of why.

More tomorrow.

This is a continuation of a summary of inspections made of Illinois abortion clinics by a friend of McHenry County Blog:

ACU Health Center, Hinsdale

On 5/24/11 a nursing survey was done. Relatively few problems were found.

Clinical records lacked post counseling notes. This was true of virtually all the clinics.

The ORs had not been totally cleaned at the end of the day ( called “terminal cleaning”.  At this point the room should be spotless and ready for the next day’s surgical patients) – there was tape on the IV pole that should have been removed. There was dust and brown stains on the suction machine.

The plan of corrections included a post counseling form and assigning the nurse supervisor to monitor terminal (end of day) cleaning. I have not received a resurvey at this time. I don’t know if there will be one because the problems were few.

On 7/12/11 a Life Safety Survey was done. There were multiple deficiencies found, but by 10/28/11 they had all been corrected and the clinic passed inspection.

The deficiencies were related to emergency and exit lighting, fire alarm system, sprinkler maintenance, fire extinguishers, electrical wiring, and storage of equipment in the main OR corridor.

This clinic shows that the standards of PTSCs are not impossible to reach and that regular inspection imposes a reasonable burden yet improves safety for all concerned.

AAnchor Health Center, Glen Ellyn

On 5/4/11 and 5/5/11 a nursing survey was done. There were several violations found.

There was no job description for circulating nurse (the nurse in the OR)

The autoclave was not tested 3 of 9 weeks in March and April. The testing of the autoclave is important because it is used to sterilize the instruments that are used and reused on subsequent patients. There is more about this under NIWC, below.

There were no post counseling notes found in any of the patient charts.

The clinic’s response was to submit a job description (not specific to the clinic, as it refers to patients as “he or she”), reprimand the autoclave person and have an inservice on the importance of spore testing of the autoclave, and submit a form for post-counseling. I have not received a resurvey at this time. IDPH may have accepted the forms as sufficient.

On 7/13/11 a Life Safety Survey was done. Multiple violations were found, but by 12/20/11 the clinic was found to be in compliance.

Violations included a need for fire resistant walls in hazardous areas, problems with the fire alarm system, dampers, and the fire alarm panel.

Again, this clinic shows that regular PTSC inspection is not burdensome while it assures a minimum standard of care, which patients have a right to expect.

More tomorrow.

This letter to State Rep. Jack Franks from a friend of McHenry County Blog tells what Illinois State Department of Public Health’s belated inspections have found:

First, I want to thank you for your assistance in bringing abortion regulation/inspection to the attention of the IDPH and securing their commitment to you to inspect all PTSCs in 2011.

They have done it.

This is a summary of the recent surveys of the licensed abortion clinics in Illinois. The data is as current as I have been given, but there is a fairly large delay in what I have because it is not usually released until an acceptable plan of correction has been received and is not released when disciplinary action is ongoing. Some things I have gotten from the press, and other things you, as a legislator may have access to, but this is what’s available to the public and I’ve tried to be as thorough as possible.

Pregnancy Termination Specialty Centers (PTSC’s)

American Women’s in Des Plaines

A nursing survey was done on 6/23/11. A followup should have been done by now, but none has yet been released.

There were multiple serious violations found here.

Specifically-

There was no RN in the operating room (ever) to circulate. While there were 2 RNs on staff, the policy of the clinic was for them to not be in the OR. This is against state rules and is dangerous to the patient.

There was no documentation of a person accompanying the patient home in 4/10 charts reviewed. This is inappropriate and dangerous if a woman were to leave on her own and have complications unattended or attempt to drive herself.

There was no pre-op or post-op counseling at all. This is where the term “abortion mill” comes from. Get them in and out without a care about whether the procedure is what they want or appropriate to their situation. This, of course, begs the question of informed consent.

The last problem is one I’m not sure how to handle. The surgical consent form did not correspond to the post-operative reports. Women signed consents for laminaria insertion and in 4/4 cases the post-op reports stated either another procedure was performed or there was no report at all. What actually occured in those situations was not possible to reconstruct from the data.

The response of the clinic was a multitude of forms and memos and policy revisions. The informed consent form they submitted was laughable. Personally, I don’t think they would ever use it. They pulled it out of somewhere, but nowhere in Illinois, because the form refers to state laws that don’t exist in Illinois. I have not received a follow-up survey as of this writing, but I do expect one.

On 8/11/11 a life safety survey was done at American Women’s in Des Plaines.

Multiple violations were found:

Storage room walls did not extend to the deck above (the storage room is considered a hazardous area because of all the paper stored there).

There were problems with emergency exit lighting.

There were problems with the fire alarm system (multiple problems cited).

Medical gases were stored close to combustibles.

The clinic has responded to the survey, but the plan of correction was not yet acceptable as of 12/15/11. There has been communication between the IDPH and the clinic, but I have not seen anything stating that they are currently compliant.

All the life safety code violations appear to be fixable.

My concern with this clinic is that the professional violations reflect a lack of concern for the women treated there (no counseling, consents not matching procedures, lack of RN in the room during procedures, not verifying person accompanying patient home).

While it’s impossible to legislate care, it is possible to monitor the framework in which procedures must occur.

This clinic is a prime example of why frequent inspections are necessary.

More tomorrow.

A press release from the Peace Action Network:

The History of Women’s Reproductive Rights

Wednesday February 15th 11:30-12:45 MCC Employee Dining Room

This event, sponsored by the Student Peace Action Network and the College Democrats will begin with an overview of the United Nations CEDAW, the Convention on the Elimination of All Forms of Discrimination against Women.

Guest speakers

• Kathy Clark,
• Elaine Whalen, and
• Mary Ewert

will discuss the History of Women’s Reproductive Rights in the United States, and then specifically Mchenry County.

Discussion will follow the presentation.

This event is free and open to the public.

Here’s the message I got from a friend:

NIWC CLOSED FOREVER!!!!!!!
Submitted by Editor on Fri, 01/13/2012 – 2:15pm

Rockford Pro-Life

ANNOUNCEMENT – ProLifeCorner – 2-13-2012 – Northern Illinois Women’s Center (NIWC) announced today that they would not be reopening their killing center. To God be the glory!!! NIWC said they would not reopen for many reasons, one of which is “lack of support”. Certainly their inability or their unwillingness to comply with existing laws is one of the major factors in their own demise. Some in the pro-abortion group would like to blame the pro-life community for this occurrence. Their unprofessionalism, their blatant disregard for the laws, and their lack of concern for the health and safety of women, to the point of contempt towards women, is another major part of this closing.

The staff of the Rockford Pro-Life Initiative and the Pro Life Corner would like to take this opportunity to thank all of the prayer warriors, sidewalk counselors, and the countless individuals who worked and prayed so hard to bring light and truth to the Rockford area.

Please check often for full details into this miraculous event.

I searched for the group’s web site and found it here.

Since the Rockford Register-Star is the source of this information, after checking the abortion clinic’s web site, where there is nothing about the closure, I went to the Rockford Register-Star article.

You can, too, for more information.

Bishop Dr. Michael J. Love of Trinity Baptist Church International in Crystal Lake was one who spoke to the fund raising dinner.

Two sections of the Concord Banquet Hall in Lake Zurich were filled by Pro-Life supporters of the Tri-County Pregnancy and Parenting Center Thursday night.

Dennis DeMoss

The night was held for the purpose of replenishing the treasury of the ministry, which operates offices on the street where the McDonald’s Playland is located in Crystal Lake and in Grayslake.

Board Chairman Dennis DeMoss remembered giving the pitch twenty years ago when the group did not have the money to pay for the dinners.  This year, donors picked up the tab prior to the event.

Besides pledges and donations made at the dinner, churches set out large plastic baby bottles that bring in about $40,000 a year.

And a thrift store earns $600 a week.

But expenses are high for the two locations, both of which Tri-County is purchasing, rather than renting.  That saves money because under not-for-profit ownership they are property-tax exempt.  There is also no hassle with landlords.

The price to operate the two offices four an half days a week is $4,300 a month.

One day is dedicated to the Spanish speaking population.

By attending classes, clients gain points to purchase items needed by babies, diapers.

One featured speaker, 38-year old Gloria Farber, couldn’t attend because she gave birth today.  Her doctor concluded that the child was not getting enough nourishment in the womb and decided an early delivery would be best.

Staffers don’t usually assist with births, but one of the worker bees for the dinner had agreed to do so and when she got a call just as she was about to leave to help prepare the banquet hall’s decorations and silent auction, Farber called and said it was her time.

Since she was supposed to speak, a written statement was induced.

Farber told of having lost her job, the father being an hour away and showing little interest in her being pregnant had led her to consider “terminating the pregnancy,” as she put it.

She looked up Planned Parenthood locations, but turned to Tri-County for a free pregnancy test.

Tri-County helped her to clarify her feelings and she decided to keep the “fetus,” as she described her child.

As one who has been on both sides of the abortion issue (Pro-Choice during my 8 years in the Illinois House in the 1970′s, Pro-Life during the 8 years I served in the 1990′s), I was struck by the Pro-Choice language I heard in the written testimony.

Nevertheless, the Pro-Life servants of the Lord at Tri-County helped bring Farber’s child’s soul into the light of day.

Rebecca and Jonathan Brown admire their baby.

One couple who spoke this year, Rebecca and Jonathan Brown even managed to locate a woman who would help them with a home birth, thus avoiding hospital costs.

“We didn’t go broke.  We have money in the bank,”  he revealed after explaining that the family’s health insurance would have still left them with a big bill had they went the tradition hospital birth route.

Tryler Schneiderman, Angela Rabeler and baby.

Another new father, Tyler Schneiderman told of his and mother Angela’s having taken every class possible to earn points.

When the birthing process began, he was pressed into service to hold his wife’s leg.  He indicated that was more than he had signed on for, but there was a shortage of personnel at the hospital.

The father whose child was born at home could identify because he ended up holding the mother’s leg during birth, too.

Neither seemed to have relished the task.

Imagine my delight with Grayslake’s Lord of Glory Lutheran Church Pastor Brian Davies’ benediction was the blessing that I give my son every night:

Pastor Brian Davies announced his family's newest pregnacy for the first time at the dinner.

“May the Lord bless and keep you.

“May the Lord make his face shine upon you.

“May the Lord lift up his countenance upon you and give you peace.”

He added some additional thoughts as well.

To set the stage, Davies recalled how the children of God won battles when Moses hands were held high, even when his closest followers were holding up the tired arms for him.

He told those in attendance that they were holding up the arms of staff and volunteers who served in Tri-County’s mission.

You know I look for politician types at events.  This time the only one I saw was District 3 McHenry County Board candidate Mary Alger.  One of Dave McSweeney’s advisors, Charlie Johnston was in attendance as well.

When I heard that the abortion clinic in Rockford had been closed at the end of September, I asked the Illinois Department of Public Health for the documents involved.

Friday I received a partial reply to my Freedom of Information request that reveals the “Northern Illinois Women’s Center has requested a hearing and the information withheld is pertinent to that action.”

The hearing request was made October 5th by a doctor, identified as “Acting Medical Director,” whose name is not typed and whose signature is impossible to decipher.

There is no letterhead on the accompanying letter, which is signed by the same doctor.  Click to enlarge the appeal document below and tell me if you can figure out the “Acting Medical Director’s” name:

Click to enlarge. Ten points for coming up with the new doctor's name.

Making the withheld documents public would “interfere with active administrative enforcement proceedings conducted by the public body that is the recipient of the request…” That’s the excuse for secrecy.

This abortion clinic received an “EMERGENCY SUMMARY SUSPENSION.” Emphasis is in the original.

There was notice of a “FINE,” also in capital letters and boldface type. $15,000.

“The license suspension shall commence immediately and continue indefinitely.” Again the boldface type is in the original document.

And here’s why:

The summary of what was found to be wrong follows: The records sent me indicate some of the deficiencies have been corrected, but the abortion clinic is still unable to find a nurse with operating room experience willing to take part on the enterprise.

All it had was a Licensed Practical Nurse for 14-week and 17-week abortions on September 14th. But it wasn’t just a lack of qualified nurses. The physicians didn’t meet state requirements either, as you can see below:

Neither of the last two medical directors had practicing privileges at an Illinois hospital, as required.

One was said to have had Wisconsin privileges, but there was no documentation of that in the file. And these were identified as the “Medical Directors.”

Medicine was not administered according to the Illinois Nurses Practice Act.

Certified Nursing Assistants and even counselors were found to be administering drugs, e.g., Naproxen and Cytotec.

A closed-door hearing will be held.

= = = = =

There is a question that comes to mind:  How did this abortion clinic stay open with medical directors who did not meet the requirement of having practicing privileges at an Illinois hospital.

More information about the regulation of abortion clinics by the Illinois Department of Public Health here.