Dateline: 8/13/01
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The 1980s closed with a string of lawsuits for Banchongmanie and his abortion facility. The '90s brought a new decade -- but apparently no new behavior on anybody's part.
On June 12, 1990, an investigation verified that Banchongmanie's abortion facility was operating illegally. "Relsco," on the first floor of the building, performed pregnancy tests. The receptionist would give each patient an unlabeled paper cup and send her down the hall to a restroom shared by other businesses in the building. Rather than using a lab, the receptionist would do a pregnancy test at her desk and would orally give the patient her results, in the waiting room with no privacy. The receptionist would then dump the urine into a lidless glass coffee jar on her desk. When the jar filled with urine, the receptionist would go down the hallway to the public restroom and dump the urine. She did not wash her hands between tests. Pregnancy tests were performed with kits that were out of date. No counselor saw the patients. If the test was positive, the patient was sent upstairs to "Women's Health Services.
The investigation also found out from staff that physicians did not remain on the premises until all patients were discharged. Instead, the doctor left, and instructed staff to page him if there were any complications. The staff also told investigators that patients were not given complete post-operative instructions before discharge. Physicians did not perform any post-operative evaluations of patients unless staff asked him to examine a particular patient. The discharge instructions and medications were given to patients by whatever staff happened to be available, regardless of their qualifications.
The investigation also could not find out if Banchongmanie and his other physicians were washing their hands for examinations or surgery, because they refused to answer any questions about the issue. The pre-operative area was supervised by a registered nurse; the post-operative area had only a licensed practical nurse, and the operating room had only a technician. Staff substantiated that Pitocin was administered intravenously pre-operatively by an LPN without any physician present. Staff also substantiated that improperly trained and supervised staff -- including the front desk staff -- were participating in all aspects of patient care including surgery.
Staff substantiated that they began preparing patients for their abortions at 7 a.m., but that no physician was scheduled to be in the building until 9 a.m. Staff substantiated that they had no job descriptions, no criteria for performance evaluations, and no formal chain of command for responsibilities within the facility.
During the investigations, patients and their mothers were observed weeping in the hallway and reception area. They were not provided with counseling or even with a private area.
The investigation report described the facility as "dark, dirty, and drafty," with loose or missing floor tiles in the hallways of both the first and fourth floors. Carpets were littered and filthy. Ceiling tiles were dirty, missing, or water stained. Rooms were cluttered with unused furniture and supplies. The restrooms were dirty, with missing toilet tissue holders or broken. The room for preparing sterile supplies was filthy, "cluttered with unused, discarded equipment and stock supplies." The walls were chipped, peeling, and dirty. Garbage was overflowing from trash cans onto the floor. Equipment was wrapped for sterilization in stained wrappings, and too much equipment was loaded into the autoclave when it was used. The patient dressing room had brown stains, consistent with blood or Betadine, on the chair. Blankets and recliners in the recovery room were not changed between patients, and staff were not sure if pillow cases were changed between patients. Clean and soiled linens were stored together.
The investigation found that the facility had no policy for how areas were to be cleaned after surgery. Surgical equipment, including forceps and dilators, were expired. Surgical equipment was lying about on dirty, dusty trays. Medications were stored in a dirty, unlocked cabinet in the recovery room. Discharge medications were in packets on a desk. Staff substantiated that whoever happened to be working in recovery would prepare discharge medication packets from bulk jars of medicines. The staff also confirmed that they did not perform many required tests, such as coagulation tests. The equipment used to test for gonorrhea was not working properly. Improperly labeled and out-of-date tissue specimens were found in the refrigerator.
The investigation found that there was no written policy on the examination of abortion tissues. The autoclaves were not checked or tested. Staff handled blood and body fluids without wearing gloves. One registered nurse's personnel file had no documentation that she was licensed in the state, or that she was trained in CPR. Another nurse, this one an LPN, also had no verification of CPR training, and had an out-of-date verification of license. Yet another LPN was found to not be currently licensed. (Memorandum in Support of Findings ABO#-22113, Investigative Reports ARO-1 Reference No. 21451 & 22113)
Next, surely things must change -- right?
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