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April 17, 2013

Pa. abortion trial: Assistant gave anesthesia

PHILADELPHIA — A woman trained only as a medical assistant told jurors Wednesday that she gave anesthesia, set dosing amounts and performed ultrasounds when she worked at a now-shuttered abortion clinic whose owner is charged with killing a patient and seven babies.

Latosha Lewis testified as prosecutors wrap up their five-week case against Dr. Kermit Gosnell, 72. A string of former employees have testified that they went to work at the chaotic, rundown clinic because they were desperate for work, or were former patients, or knew Gosnell through his family or the gritty West Philadelphia neighborhood. A final employee was expected to testify Thursday before the prosecution rests.

Most of the former co-workers have pleaded guilty to criminal charges for the work they did, and face years in prison for murder, conspiracy, racketeering, drug distribution or abortion law violations.

Investigators say Gosnell ran a “pill mill” by day frequented by addicts and drug dealers; and an illegal “abortion mill” by night, where poor women with late-term pregnancies endured long, painful procedures performed by untrained staff until Gosnell arrived for the final phase of the surgical abortions.

Lewis, 31, had gone to a career school for eight months to qualify as a medical assistant, and was sent to Gosnell’s clinic as part of training. Before long, she was hired to do paperwork and draw blood.

But that quickly morphed into skilled work as she delivered intravenous drugs, performed ultrasounds and made independent decisions about how much anesthesia patients should get. At one point, she had a scare with a patient.  

“I had given her too much (medication) and I was concerned whether or not she would come (back) from anesthesia,” Lewis testified.

Women often got near-hourly doses of Cytotec, a drug designed to induce labor, as they waited for Gosnell, along with painkillers to quell the powerful cramping, Lewis said. She sometimes chose to reduce the clinic dosages.

By 2008, Lewis had moved to the front desk because she was no longer comfortable with the amount of drugs the patients were given.

“The women were going into labor too fast, and I didn’t want to deal with it,” Lewis testified, adding that she still handed out some medications.

The patient who died, 41-year-old refugee Karnamaya Mongar, was given four doses of Cytotec during her November 2009 visit, along with Demerol and other drugs, according to notes scrawled randomly across her medical paperwork. A medical examiner said she died of an overdose.

Lewis, who checked in Mongar when she arrived at the clinic from Virginia, said her chart does not list her weight because the clinic’s scale was broken.

As many as two dozen women a day came in for abortions, some of whom delivered babies in toilets or waiting areas before Gosnell arrived, according to staff testimony. Gosnell had taught them to snip the babies in the back of the neck to “ensure fetal demise,” according to the testimony of unlicensed doctor Stephen Massof and others.

Massof and two others have pleaded guilty to third-degree murder.

On cross-examination by defense lawyer Jack McMahon, Lewis acknowledged that several relatives had gone to Gosnell for abortions or other medical care.

McMahon has told jurors there were no live births at the clinic, and that any movement seen by the staff was an involuntary response. He has suggested that Mongar had respiratory problems and died of unforeseen complications.

The only clinic employee to go to trial with Gosnell is unlicensed doctor Eileen O’Neill, 56, of Phoenixville, who is charged with racketeering and billing as a doctor. O’Neill saw gynecological patients but did not perform abortions.

A former patient testified Thursday that she had been treated by O’Neill for eight years, presumed she was a doctor and never saw Gosnell.

O’Neill’s lawyer has tried to show that O’Neill was working under Gosnell’s tutelage as she tried to regain her medical license.

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