Dr. Geoffrey Cly’s testimony: Klopfer’s botched abortions

13. February 2008 by Seth.

Below you will find Dr. Cly’s testimony in full regarding the life threatening complications resulting from abortions performed in Fort Wayne.  The Senate passed the proposed legislation (SB 146).  It is currently awaiting a hearing in the House. 

Dr. Cly filed a medical licensing complaint with the Indiana Attorney General’s office the same day he testified.

This bill would require physicians performing abortions both to have admitting privileges at a local hospital and to notify the patient of the hospital location where she can receive follow-up care by the physician.  In addition, this bill would assure that women be given information concerning when a fetus feels pain, as well as that they be informed in writing at least 18 hours before an abortion about the following: the availability of adoptions, the option to have certain adoption-related expenses borne by the adoptive parents, physical risks to the woman in having an abortion, and that “an embryo formed by the fertilization of a human ovum by a human sperm immediately begins to divide and grow as human physical life.”

 - Seth

The ultrasound performed in the ER showed pieces of the baby were left inside and had become necrotic. I immediately had to perform a Dilation and Curettage to “finish the abortion” in order to save the patient from sepsis (a life threatening total blood stream infection) and to attempt to save her uterus so that she could preserve her fertility, as she was only 20 years old and wanted children in the future. Unfortunately, due to the pain and infection, she required a hysterectomy to fix her symptoms. She can not have any more children as a result of these complications. All of which could have been prevented with proper emergency on call coverage and quality oversight. This bill would correct that problem by requiring admission privileges and notification of the hospital where the patient can receive follow up care.

The second patient from my practice also had a termination performed prior to notifying our office. This is usually what happens, as patients many times are embarrassed to tell us they are considering a termination. This patient was unable to locate the physician who performed the procedure, as he does not have nighttime on call coverage and leaves no forwarding number to be reached. He is only in Fort Wayne on Thursdays from 9AM to 5PM, then he returns to his home state of Illinois. Without anywhere else to turn, the patient went to the ER and I was called since she had delivered a baby with our group in the past. This patient had severe abdominal pain and heavy vaginal bleeding. Again, pieces of the baby were seen on ultrasound from an incomplete termination. This patient was much more fortunate and didn’t lose her uterus and will be able to have children again.

These two patients are from my experience in the last couple of months. Unfortunately, my OB/Gyn colleagues in Fort Wayne and other parts of Indiana have reported similar occurrences. The problem is that there is no quality assurance system or “checks and balances” for terminations in the state of Indiana. Hospital privileges and notification to the patient of the hospital where the physician has privileges would immediately correct this patient safety issue.

As I mentioned, I have been the Quality Assurance Committee Chairman for the past 3 years at Dupont Hospital. Every hospital already has a Quality Assurance Committee. The committee reviews every single complication, surgical infection, and procedural complication that occurs. This system is completely done by physicians and it allows us to ensure that physicians are not harming patients because of substandard medical care or negligence. It also allows us to track complications and if necessary take educational or disciplinary action to protect our patients from harm.

If I perform a Dilation and Curettage for a miscarriage and pieces of the baby are left inside the patient. Within days I would have more than 10 physicians from a Quality Committee asking me to explain myself, what happened and why I performed substandard surgery on that patient. They would also track my complications and make sure it didn’t happen again. None of these checks and balances occur without admission privileges.

Any physician with admission privileges, anywhere in Indiana, has to have 2 emergency backup physicians listed who will provide emergency and nighttime call coverage should that physician be unavailable or out of town. This includes all physicians, because we all have to have to have admitting privileges to care for patients who have emergencies. Except - for the physicians performing terminations, they currently don’t have to worry about the quality of their care or being held accountable if their patients suffer severe complications.

In summary, as physicians, we are making life and death decisions about patients. These patients trust us with their lives. It is our duty to protect them and care for them in the best way possible. The current termination laws allow a few substandard physicians to place a group of women in Indiana in serious danger because the lack of proper quality assurance oversight. This abuse of the physician patient relationship and negligence toward the patient can not be allowed to continue. This bill will immediately ensure that all Indiana patients receive high quality, physician reviewed, proper medical care for elective terminations. I ask that you use your legislative authority to protect this group of Indiana women by passing this bill to require hospital admission privileges and notify the patient of the hospital where she can go to receive the prompt and proper medical care.

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