Doctor Accused in Abortion Suit Testifies : Admits He Injured Inglewood Clinic Patient But Says ‘Unforeseen Complications’ Caused Death

A doctor accused of malpractice in the 1987 death of a patient at Inglewood Women’s Hospital testified in Norwalk Superior Court on Friday that the abortion he performed caused the patient’s perforated uterus but that her death was caused by other unforeseen complications that arose after he left the hospital.

Dr. Steven Pine said he recalled few details from Jan. 24, 1987, the day he performed the abortion on Belinda Byrd, a 37-year-old Los Angeles woman who was in her 19th week of pregnancy. But he said he believed that Byrd would not have been saved even if her condition had deteriorated before he left the hospital at the end of the work day.

Pine, the hospital and its chief of staff, Dr. Morton Barke, are being sued for damages by Byrd’s mother, her three teen-age children and her longtime boyfriend, Cecil Taplett. The suit alleges medical malpractice, conscious disregard for Byrd’s rights and safety, lack of informed consent and negligent infliction of emotional distress on Taplett, the father of two of Byrd’s children.

The suit charges that on Jan. 24, 1987, Pine performed an abortion that perforated Byrd’s uterus and that she lay bleeding and unattended for about three hours in a hospital bed until she lost consciousness. When nurses noticed that Byrd had no vital signs, they summoned paramedics who rushed her to nearby Centinela Medical Center, where she died three days later, according to David Berglund, the attorney for Byrd’s family. There were no physicians on duty at Inglewood at the time. The state closed the hospital in February, 1988 after finding numerous health violations.

Byrd’s abortion was completed at about 4 p.m. and Pine left the hospital shortly after 6 p.m. In dispute is whether Pine checked Byrd’s condition before he left the hospital for the day and the quality of medical care she received before she slipped into a coma, sometime after 7 p.m.

In other testimony Friday before Judge Charles E. Frisco, a nurse’s aide who worked at the hospital at the time of Byrd’s death said that Pine rarely examined patients after they left the operating room and routinely signed discharge forms before the patients left the recovery room.

Patients at the facility were routinely discharged while they were still “groggy” and “unalert” from their operations, said Margarette Wooten, whose shift ended before Byrd came in for her abortion.

Quit Without Notice

Under questioning by a defense attorney, Wooten, who now lives in Bakersfield, said she later quit her job at the hospital without notice.

“It was just a slaughterhouse and I couldn’t take it any more,” she said.

Both Robert Reback, the attorney representing Barke and the hospital, and David Weiss, who is representing Pine, refused to comment on the case while it is still in litigation. In the past, hospital officials have said that any health code violations at the facility were quickly remedied and that the clinic’s staff had developed exceptional skill in performing large numbers of abortions safely.

Barke and two nurses working on Jan. 24 testified earlier in the week that Byrd’s death was the result of a complication that caught the medical staff without warning.

“It was a catastrophic thing that happened,” Barke said. “I think she died so suddenly that if Dr. Pine was standing by her side, I don’t think that would have saved her. It was an unusual case, something I’ve never seen before.”

Berglund argued in court that patients were rushed through the 28-bed hospital so quickly and record-keeping was so incomplete that adequate monitoring of patients was impossible.

Pine performed 74 abortions in a single operating room on the day Byrd went to the clinic, leaving the staff with no time to notice that Byrd’s condition was deteriorating, Berglund told the jury. Another doctor performed two abortions that day. Byrd’s abortion was the 69th of the day and one of 24 performed by Pine in the final two hours of his shift, he said.

Byrd had sought an abortion because she feared bearing a fourth child, Berglund said in an interview. She had undergone a Caesarean section with each of her three children and doctors had warned the 95-pound woman that another birth could prove fatal to her, he said.

As is routine for such late-term abortions, Byrd was given medication at Inglewood Hospital to begin the abortion process on Jan. 23 and she returned the next day shortly before 4 p.m. Berglund said in an interview that Pine took about nine minutes to complete Byrd’s in utero abortion. Byrd was then transferred to the recovery room, where she spent about seven minutes before she was taken to the hospital’s west wing, Berglund said.

About an hour after the surgery, Byrd complained to nurses that her legs were weak and numb, Berglund said. She collapsed in the bathroom in her hospital room about a short time later and had to be helped back to her bed, Berglund said.

“This case shows a poor standard of care,” Berglund said in the interview. “It shows they’re more interested in patient volume--money--than good patient care. Their motto was maximize the profits and minimize patient care.”

But Barke denied during testimony last week that profits were put ahead of patient care. “The concern is quality of care and making sure the patients are well taken care of,” he said.

After Byrd’s death, an investigation by the county Department of Health Services found violations including “no evidence of surgical outpatients . . . being evaluated by a physician prior to discharge” and substandard post-operative care. But the county’s report did not tie those violations to Byrd’s death.

Byrd’s death was one factor that prompted state officials to launch an investigation of the hospital, which found what one health official termed “battlefield conditions.”

The state report released in December, 1987 described patients being rushed through abortions performed in an operating room where tables and floors were stained with the blood of previous patients. Inspectors said doctors at the hospital did not adequately monitor patients under anesthesia, and medical personnel did not wash their hands and equipment between operations.

Some patients were “encouraged to leave the facility before they felt comfortable doing so,” and some were not examined by doctors after surgery although the physicians signed discharge papers, according to the report.

Less than two weeks after the state revoked the hospital’s license and ordered it closed in February, 1988, the facility was opened as West Coast Women’s Medical Group, doctors’ offices specializing in abortions.

In May, 1988 the clinic was sold to Long Beach physician Edward Allred, who operates Family Planning Associates Medical Group, which runs numerous abortion clinics throughout the state. Barke, who was one of the owners of Inglewood Women’s Hospital, now works for Allred as a consultant at the Inglewood clinic.