Illinois Abortion Facility Inspection Update – Part 6

This is another article from a friend of McHenry County Blog which summarizes conditions at abortion clinics.  The information was taken from Illinois Department of Public Health inspection reports.

Northern Illinois Women’s Center, Rockford

You have probably heard about the Rockford abortion clinic closing in the news, but I will go over it briefly.

On 5/17/11 a Life Safety followup survey was done.  All the violations (referred to in my previous letter) were corrected and the facility was in compliance with the Life Safety Code.

From 6/6/11 to 6/8/11 a nursing survey was done.

Under Standards of Professional Work it was found that the consulting committee had not documented that they had reviewed the Policy and Procedure Manuel or the pathology reports since 2008 (as far back as they went).

Under Sanitary Facility there were shoes found stored in open boxes of surgical gloves in two operating rooms. An open box of gloves was stained with a “brown substance”. Medication was stored in the nourishment refrigerator in the recovery room. The sterilizer (autoclave) was not tested weekly. This is a serious, serious violation. Specifically, it is to be spore tested weekly to determine if the autoclave is killing all the germs on the instruments. Instruments are used and reused on different patients until they wear out over years. If they are sterilized each time, there is no problem. To determine if they are sterilized, a spore test is done regularly to detect problems with the autoclave. This did not occur. It was done (for the period 6/10 to 6/11) on 7/7/10 (passed), 11/3/10 (FAILED), 11/17/10 (passed), 3/16/11 (FAILED), and 4/6/11 (passed). As you can see, there were 4 months between passing and failing. Twice. We do not know at what point the autoclave failed to sterilize properly. We also do not know what the autoclave log shows for the 16 years prior to that inspection. The IDPH has not been helpful in finding out this information, but I believe that the women who had abortions at this facility have a vital need to know whether there is any chance that they may have picked up diseases carried by other women who used the facility. They should at least be warned. Untreated, chlamydia over time will block a woman’s fallopian tubes, causing infertility, without obvious symptoms. Hepatitis, AIDS, syphilis, gonorrhea, and other diseases can be spread through the use of unsterile instruments. This could bring a public health disaster to the area. Time will tell

Under Operative Care there was no RN. At all. Specifically, from 10/10/07 to the date of inspection, except for a brief 3 months from 1/7/11 to 4/8/11. Three and one half years without an RN was not an accident. It was a deliberate move to continue operations with sub-standard and illegal care. RN’s are required in 2 capacities. The first is to supervise the other nursing personal: CNAs, LPNs and other RNs. The second requirement is that an RN with training and experience in surgical nursing must be present in the OR at all times for each invasive procedure. These rules are for patient safety. They are a minimum standard. They were ignored.

Under Post Operative Care there was no documentation of a person accompanying patients when they left the facility. This is important because it is unsafe for patients to leave by themselves. They need a person to drive them and to stay with them for a while to make sure no delayed complications arise.

Under Clinical Records there was no physical exam documented in 5/5 charts reviewed. A physical is neccessary to determine if outpatient surgery is appropriate for the individual patient (see Women’s Aid Clinic below where the woman died).

Under Nursing Personnel Standards- again it was brought up that there was no RN to supervise the nursing care of patients. An LPH was used to supervise, but it is beyond her legal scope of practice.

On 9/15/11 there was a resurvey. While many of the violations had been corrected ( Standards of Professional Work, Sanitary Facility, Post-op Care, and Clinical Records), there were still major violations related to the lack of an RN and new violations surfaced (actually, they were not new, but they had been missed in the earlier survey or the IDPH had been mislead. I’m not sure which.)

Under Operative Care- there was some attempt to hire RNs but they would quit rather quickly. Still, the clinic operated on women without any RN present. Even when they had an RN present, they still used an LPN in the OR in July, and a CNA in the OR in August. And these were found in just the charts they looked at on days when a nurse was present. At the time of the survey they were using a still untrained and unexperienced RN for their circulating nurse. I think they were trying to train her as they went along.

There were new violations found.

Under Standards of Professional Work it was found that the two physicians on staff ( the Medical director and the former Medical director) had no clinical privileges or appointments in any licensed Illinios hospital. That is a violation of the code and presents a question of quality control. If there is no hospital in the state that will have them as staff doctors, is there something wrong with their reputation or their practice?

Under Nursing Personnel- it was found that medications were being administered by a CNA and by a counselor. We’re not talking about aspirin. We’re talking about Cytotec, a drug involved in the abortion procedure. And this was on a day when an RN was in the building. This is not a task that she can delegate to unlicensed personal. It is very dangerous to the safety of the women and shows a disregard for women’s lives.

Finally, Under Laboratory Services, the clinic did not have a written agreement with an outside lab to preform tests that they could not do themselves. This is another example of sub-standard care.

At this point the IDPH had an Emergency Suspension of their license. The clinic closed on 9/30/11 and never reopened. There were 4 major violations cited.

  1. the facility’s failure to ensure the presence of an RN in the operating room during all invasive or operative procedures.
  2. the facility’s failure to ensure the presence of an RN to direct and supervise the nursing personnel and the nursing care of patients.
  3. the facility’s failure to ensure that either of the two physicians on staff have and maintain surgical practice privileges with an IL licensed hospital.
  4. the facility’s failure to have a written agreement with a lab which possesses a valid CLIA certificate to perform any required lab procedures which are not performed in the center.

There were also fines attached to the two nursing violations totalling $15,000.

There was a hearing requested. Several pre-hearings occurred while the IDPH and the clinic tried to work out an acceptable agreement. When no agreement was reached, a formal hearing was scheduled. Right before the hearing an agreement was reached and later published. From the paperwork, I can see that the clinic made attempts to find and train RNs, and made attempts to get a CLIA lab affiliation. I don’t see that there was any progress in getting privileges in IL hospitals for the MDs.

The final agreement stipulated that if the clinic paid a (reduced) fine of $9,750(over the period of 1 year) and met all the requirements for the 4 above violations it could reopen. If any of the above 4 violations were to occur within one year, the clinic would lose its license permanently and still owe the fine. Alternatively, the clinic could forfeit its license and pay a nominal fine of $1,000 and close permanently. It chose to close, although I have not seen a letter to that effect or proof of the $1000 having been paid.

This clinic is the prime example of why inspections need to be regular and frequent. It should have shut its doors a long time ago. Illinois women are safer now that it’s closed permanently.

More tomorrow.

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