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Missouri health chief thinks abortion clinic deal possible

After the first day’s opening statements and hearing from the state’s first expert witness, we listen to more state witnesses on Tuesday.
Credit: AP
FILE- In this file photo from Friday, June 28, 2019, Ashlyn Myers of the Coalition for Life St. Louis waves to a Planned Parenthood staff member. The fate of Missouri's only abortion clinic is at stake starting Monday, Oct. 28, 2019, when a member of the state's Administrative Hearing Commission will begin hearing arguments over whether the clinic can keep its abortion license. (Robert Cohen/St. Louis Post-Dispatch via AP, File)

ST. LOUIS — The fight continues on day two as Planned Parenthood and Missouri’s Department of Health and Senior Services go head to head.

After the first day’s opening statements and hearing from the state’s first expert witness, we listen to more state witnesses on Tuesday. The state is thoroughly going through the four failed abortions and the investigation process.

The day started off with the state’s second witness, William Koebel. He’s been with the state’s health department for years. He conducted the investigation on Planned Parenthood. He notes there were standard of care issues, including that complication reports were not submitted and there weren’t accurate medical records. Koebel said under oath he found nothing unsafe at Planned Parenthood.

Through cross examination, Planned Parenthood said the 30 deficiencies found in the investigation, were mostly on the four patients presented by the state. Their argument points out that this is Koebel’s first time ever handling an abortion facility. Beyond that, Planned Parenthood’s defense says the four abortion failures presented in court, the state’s key examples, were not selected random. Koebel agreed they weren’t.

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READ MORE: Hearing begins on fate of Missouri's lone abortion clinic

Issues preventing Missouri regulators from renewing the license for the state's only abortion clinic are "imminently fixable," the state's health director said Tuesday.

Missouri Department of Health and Senior Services Director Randall Williams testified during the second day of a state administrative hearing that will decide if the state can revoke Planned Parenthood's abortion license for its St. Louis clinic.

The state moved to revoke the license in June, citing concerns about a series of "failed abortions," and a lack of cooperation from some of the doctors involved in the procedures, who refused to talk to investigators.

Williams testified that two of the doctors have since relented and have now been deposed, and the information they provided was helpful in learning what happened with four instances where abortions went wrong.

"While these things are very concerning — they are grave — I think going forward they are imminently fixable," Williams said.

He believes there are solutions that both the state and Planned Parenthood would agree to that would allow for licensure.

The clinic remains open until the Administrative Hearing Commission ruling, which isn't expected until February at the earliest.

Wrangling over the license began when an investigator involved in a March inspection of the clinic found that a woman had undergone an abortion that took five attempts to complete. William Koebel, director of the section of the health department responsible for abortion clinic licensing, said Monday that the clinic failed to provide a "complication report" for that incident.

That failure led the health department to launch an investigation of other instances where women were required to undergo multiple procedures before an abortion was completed, Koebel said. They found four, including one where the physician apparently missed that the woman was pregnant with twins. As a result, the woman underwent two procedures five weeks apart.

Planned Parenthood officials have contended that the state "cherry-picked" a handful of difficult cases out of thousands of otherwise successful abortions. They've accused the state of using the licensing process as a tool to eliminate abortions in Missouri, saying the state is among several conservative-led states seeking to end abortion through tough new laws and tighter restrictions.

Missouri would become the first state since 1974, the year after the Supreme Court's Roe v. Wade decision, without a functioning abortion clinic if the license revocation is allowed.

Missouri is among several states to pass new restrictions on abortions in the hope that the increasingly conservative U.S. Supreme Court will eventually overturn Roe v. Wade. Republican Gov. Mike Parson signed legislation in May banning abortions at or beyond eight weeks of pregnancy, with exceptions for medical emergencies but not for rape or incest.

A federal judge in August temporarily blocked implementation of the law until the legal challenge plays out in court, which could take several months.

While the Missouri case unfolded, Planned Parenthood quietly built a new abortion clinic in Illinois, just across the Mississippi River from St. Louis. The 18,000-square-foot (1,700-square-meter) clinic in Fairview Heights, 12 miles (19 kilometers) east of St. Louis, opened Wednesday, in part to meet the demand for abortions from Missouri residents.

Missouri women have been increasingly getting abortions at the Hope Clinic for Women in Granite City, Illinois, another St. Louis suburb. Deputy Director Alison Dreith said 58% of the abortions performed at the Hope Clinic through August of this year involved Missouri women, compared with 37% involving Illinois women.

Another abortion clinic sits in Overland Park, Kansas, a Kansas City suburb. The clinic is 2 miles (3 kilometers) from the state line. Information from the state of Kansas shows about 3,300 of the 7,000 abortions performed there last year involved Missouri residents.

The hearing at a downtown St. Louis state office building is expected to last five days. Missouri officials have asked St. Louis police for heightened security since the licensing issue has generated protests from those on both sides of the debate.

DAY 1 | Oct. 28

Patient safety at Missouri's only abortion clinic is the point of contention at a state administrative hearing that will decide if the clinic can remain open.

Opening statements and testimony began Monday before a commissioner with the Missouri Administrative Hearing Commission. At issue is the state health department's effort to revoke the license for Planned Parenthood's clinic in St. Louis.

Assistant Attorney General John Sauer outlined four cases of "failed abortions," including one where a woman had to have up to five procedures to complete the abortion, and another where the doctor failed to recognize that a patient was pregnant with twins, requiring a second procedure to remove the second fetus.

Planned Parenthood attorney Chuck Hatfield played a video deposition of a health department official indicating the clinic is not unsafe.

Hatfield says these four deficiencies are unique. They said out of 3,000 women they help, the state looked at these specific cases, not at random. According to their argument, if there was serious problem, they could've suspended the facility or limited the amount of patients.

Commissioner Sreenivasa Rao Dandamudi is presiding.  A commission official said that in his role, Dandamudi "acts as an independent trial judge." A ruling isn't expected until February at the earliest.

Missouri would become the first state since 1974, the year after the Supreme Court's Roe v. Wade decision, without a functioning abortion clinic if the license revocation is allowed. The battle also comes as abortion rights supporters raise concerns that conservative-led states, including Missouri, are attempting to end abortion through tough new laws and tighter regulation.

Planned Parenthood has been battling the Missouri Department of Health and Senior Services for months to try to keep open its St. Louis clinic.

People who are with Planned Parenthood made their presence known Monday morning. They unfurled two large banners on a parking garage that's across the street from where the hearing is taking place.

One banner reads, 'Abortion is healthcare', while the other reads, 'Shame on Gov. Parson'.

The state said concerns arose from inspections in March. Among the problems health department investigators cited were three "failed abortions" requiring additional surgeries and another that led to life-threatening complications for the mother.

The health department has sought to interview physicians involved in those abortions, including medical residents who no longer work there. Planned Parenthood has said it can't force them to talk and that the state's concerns were addressed long ago. Attorneys for the health department wrote in legal filings to the commission that physicians' refusal to talk "presents the final, critical obstacle."

Missouri is among several states to pass new restrictions on abortions in the hope that the increasingly conservative U.S. Supreme Court will eventually overturn Roe v. Wade. Republican Gov. Mike Parson signed legislation in May banning abortions at or beyond eight weeks of pregnancy, with exceptions for medical emergencies but not for rape or incest.

A federal judge in August temporarily blocked implementation of the law until the legal challenge plays out in court, which could take several months.

While the Missouri case unfolded, Planned Parenthood quietly built a new abortion clinic in Illinois, just across the Mississippi River from St. Louis. The 18,000-square-foot (1,700-square-meter) clinic in Fairview Heights, 12 miles (19 kilometers) east of St. Louis, opened Wednesday, in part to meet the demand for abortions from Missouri residents.

Missouri women have been increasingly getting abortions at the Hope Clinic for Women in Granite City, Illinois, another St. Louis suburb. Deputy Director Alison Dreith said 58% of the abortions performed at the Hope Clinic through August of this year involved Missouri women, compared with 37% involving Illinois women.

Another abortion clinic sits in Overland Park, Kansas, a Kansas City suburb. The clinic is 2 miles (3 kilometers) from the state line. Information from the state of Kansas shows about 3,300 of the 7,000 abortions performed there last year involved Missouri residents.

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