Illinois Abortion Facility Inspection Update – Part 7

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.

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