When the Supreme Court tossed out certain provisions of a Texas abortion safety law earlier this year, in Whole Women’s Health v. Hellerstedt, it did so without considering egregious conditions that exist in Texas abortion facilities, which prompted the passage of the contested legislation in the first place.
The most recent inspection reports for each Texas abortion facility were obtained from the Texas Department of State Health Services in response to Operation Rescue’s Freedom of Information Act request.
“As far as I know, these inspection deficiency reports were never submitted to the Supreme Court’s consideration. The reports show us that more oversight is needed for abortion facilities, not less,” said Troy Newman, President of Operation Rescue. “We expect conditions at Texas abortion facilities will continue to deteriorate in the wake of the Supreme Court’s errant ruling that protects abortion businesses and their sloppy, corners-cutting practices above the health and welfare of women and their babies.”
Of the 17 surgical abortion facilities in Texas that require licensing, eight are licensed as “Ambulatory Surgical Centers.” These clinics are required to meet stricter standards than the remaining nine facilities, which are licensed simply as “Abortion Facilities.”
In Texas, Ambulatory Surgical Centers and Abortion Facilities are required to submit to annual inspections. However, they do not appear to be required to pass the inspections in order to be licensed or have their licenses renewed.
Facilities are required to submit a plan of correction, but of the 17 inspection reports obtained by Operation Rescue, there is no evidence that any follow-up visit ever took place to ensure the often egregious violations were ever corrected.
Infection Control Failures
Of particular concern was a failure in 13 out of 17 facilities to ensure infection control protocols were developed and implemented to provide a sanitary environment and prevent the spread of infectious diseases.
Proper hand washing by staff, considered among the most basic and common-sense infection control measures, was an issue at several facilities. Inspectors observed clinic staff failing to wash their hands before and after the use of gloves, as required. This was particularly disturbing when the failure occurred after involvement in bloody abortion procedures, and after handling aborted baby remains.
Critical areas in many clinics were found to be unclean and/or covered with a layer of dust and debris. But it was the failure of staff to understand or practice proper sterilization techniques for surgical instruments used on women during abortions that was particularly disturbing. This had the potential to negatively impact the health of every patient that received an abortion, and in some cases, every patient that walked through the facility door.
In 10 out of 17 facilities, protocols involving testing and maintenance of the autoclave, where surgical instruments are sterilized, were not followed. There was an absence of testing in several facilities to ensure there were no biological contaminants in the autoclave or whether it reached a sufficient temperature to complete sterilization. In other cases, peel pouches that were to hold the sterilized instruments were not properly sealed.
In one facility, Southwestern Women’s Surgery Center in Dallas, tape was used to close the so-called “sterile” pouches, which were too small for the instruments they held.
This means that unsterile, contaminated surgical implements and supplies are being used on women during abortions at facilities in Texas today. This has left women subject to the spread of disease and infections.
As evidence that such infections occurred, at least one facility, the Women’s Center of Houston, was cited for the way they handled post-operative infections, which appeared to occur on a regular basis.
Overall Slothful Sanitation Practices
Citations were also issued for serious violations that existed for years, despite certification that each facility meet licensing requirements.
Some facilities had medications and supplies available for patient use that had expired years before. Others lacked policies and procedures that should have been in place prior to licensing, which were related to staff training, infection control training and protocols, and testing employees for infectious diseases such as tuberculosis and Hepatitis B.
One facility, the Suburban Women’s Center on Red Oak Drive in Houston, had a Medical Director who said he did not know his staff needed to be tested for tuberculosis and Hepatitis B, leaving patients at risk of having these diseases transmitted to them by untested staff.
That same Medical Director signed off on minutes to mandatory quarterly quality control meetings that only he attended, leaving doubt about how seriously he takes quality control. Based on the violations cited at his abortion facility, quality control appears non-existent.
He was also caught with a bottle of Morphine Sulfate in his unlocked desk drawer. He told inspectors that he opened one bottle each month and used it on several patients, but his story did not ring true. The bottle was labeled for single use. It contained no anti-microbial preservative and should have been discarded after one usage.
Other violations of note within the reports included:
• Failure to post required information where complaints could be filed against the facility. (Planned Parenthood in Dallas & Austin)
• Failure to report child abuse on a minor patient (Austin Women’s Health Center)
• Failure to observe waiting periods (Hilltop Women’s Reproductive Clinic & Reproductive Services)
• Call button for use by patients was placed out of reach of anyone who suffered a fall. (Planned Parenthood in Dallas)
• Failure to examine women prior to surgical procedures. (Planned Parenthood in Dallas & Ft. Worth, Southwestern Women’s Surgical Center)
• Cracked and/or contaminated vaginal ultrasound probe. (Hilltop Women’s Reproductive Clinic & Suburban Women’s Clinic)
• Cross-contamination of instruments/supplies with aborted baby remains. (Houston Women’s Clinic & Whole Women’s Health in San Antonio)
Need for Licensing Reform
Despite conditions and practices that are reminiscent of Kermit Gosnell’s Philadelphia “House of Horrors” abortion facility, the 16 Texas abortion facilities that failed inspections still qualified for licensing.
It is now obvious that regulatory reforms are needed to protect women from the serious health dangers posed by Texas abortion facilities. Abortion facilities should be required not only to submit to inspections, but also pass them before Ambulatory Surgical Facility or Abortion Facility licenses are issued or renewed. If the facility cannot comply, its ability to conduct abortion should be suspended for safety reasons.
It may have been beneficial for the Supreme Court Justices to have reviewed the inspection documents prior to declaring common-sense safety provisions to be an undue burden. It appears the Supreme Court’s undue burden referred to slovenly abortion businesses that complain about having to clean up. However, for women, those provisions were far from burdensome; they were protection. In fact, they were the only layer of protection they had from unsafe conditions and practices that continue to endanger them at Texas abortion facilities today – including Whole Women’s Health, the abortion business that challenged the constitutionality of Texas abortion safety law.
“It is troubling that in the wake of the Hellerstedt decision, the mainstream media continues their propaganda campaign to convince the public that abortion facilities are clean, safe, and in no need of regulation or oversight, when nothing could be further from the truth,” said Newman. “The indisputable facts are evident in the inspection records, and those facts are ugly enough to make a Billy goat puke.”
Operation Rescue has been raising the alarm about the dangers of Texas abortion facilities for years. In 2011, Operation Rescue conducted a random investigation of Texas abortion facilities that exposed serious health concerns that resulted in fines and disciplinary action against two Whole Women’s Health abortion facilities and two of their abortionists.
In 2013, Operation Rescue brought to light accusations made by former clinic workers against Douglas Karpen, a Houston abortionist, which were supported by photographic documentation. The women claimed Karpen was committing murder by twisting the necks of babies born alive during illegal late-term abortions. While a grand jury controlled by a corrupt district attorney with close ties to Karpen’s attorney failed to indict him, but the media attention on the Gosnell-life horrors contributed to the passage of HB2, the law that was considered in the Hellerstedt decision.
The chart below lists the name of each abortion facility and categories of violations that were recently discovered there. Below the chart are summaries of violations found in the inspection reports for each facility, along with links to the documents themselves.
Continue reading for case by case details…