Monday, Jul 23, 2018
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Abortion clinic can't afford fine, owner says

COLUMBUS — Having just regained its operating license, the owner of Toledo’s last abortion clinic said Thursday it may yet have to close if forced to pay a $40,000 state fine.

Capital Care Clinic is fighting the fine issued by the Department of Health following a surprise inspection last year. The state claims the clinic violated its own policies on April 1, 2017, when a staff member drove a patient to the hospital to be checked out after an abortion rather than call an ambulance after the doctor worried she might have a perforated bowel or uterus.

It was later determined that she did not.

“The business might have to go away because we don’t have $40,000 if I can’t get a loan to pay for it,” Terrie Hubbard told state hearing officer Karl Schedler on Thursday. She has owned the clinic with her husband since 2010 and also works as a registered nurse there.

The clinic contends the patient transfer was never believed to be an emergency and, therefore, did not violate its policies.

At the time the clinic did not have policies governing non-emergency situations or referrals to other health-care providers. It has since adopted such policies.

“If, in fact, it was a perforated bowel or uterus, that is a significant and serious condition?” Mr. Schedler asked Ms. Hubbard.

“If that happened? Yes…,” Ms. Hubbard said. “In a perforation situation, which I have been involved with in my 30-some years [as a nurse], there is always a fluctuation in their vital signs. There was none in this patient’s case.”

She also said the patient did not experience bleeding beyond what would be expected after a first trimester abortion, something that would be expected with a perforated uterus. The patient was 11½ weeks pregnant before the abortion.

Ms. Hubbard said there has never been a true emergency at the clinic for as long as she’s been involved with it as owner and, before that, an employee.

Under its new policy, no staff member under any circumstances would personally transport a patient to the hospital.

Of the inspection findings against the clinic, Ms. Hubbard conceded one violation — that the clinic failed to send discharge papers along with the patient to the hospital.

The surprise inspection occurred as the clinic was fighting to hold on to its state license to operate as an ambulatory surgical facility after going months without having a mandated written transfer agreement in place with a local hospital in the event of emergency complications, so the clinic’s policies as to what it would do in a medical emergency were already a subject of debate and litigation. The department’s decision to impose the fine as a result of that inspection came before the clinic appeared before the Ohio Supreme Court in its final bid to defend its license.

The clinic lost that court fight as well as its license in April and temporarily halted surgical abortions. But the department later issued a new license after the clinic struck a last-minute deal with ProMedica Toledo Hospital.

Under questioning by the clinic’s Cincinnati attorney, Jennifer Branch, Ms. Hubbard said the clinic was in compliance with guidelines set by the National Abortion Federation, whose members must meet certain standards of care.

But Henry Appel, principal assistant attorney general, noted that the clinic did not join NAF until after the state inspection.

At the conclusion of the two-day hearing, Mr. Schedler set Aug. 10 as the deadline for both sides to submit their final arguments to him. He will then make his recommendation to state Health Director Lance Himes.

Contact Jim Provance at: jprovance@theblade.com or 614-221-0496.

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