The Shadow Practice: Medical Board Slaps Wrist of Doctor Who Ran as Patient Died
By the time the San Gabriel police caught up with Dr. Lars Hanson, he was half-naked, locked in his car and refusing to answer questions about a patient who had been sent to the ER from his unlicensed abortion clinic.
The Los Angeles County coroner's office concluded that what happened that day in July 2009 was a homicide. The death of Ying Chen from an overdose of the anesthesia medicine lidocaine was blamed on Dr. Andrew Rutland, a doctor with a long history of state medical board infractions who had been attempting to give her an abortion.
When Chen started to go into cardiac arrest, Rutland called in Hanson to help perform CPR. Chen vomited on Hanson, according to the Medical Board of California, and he tore off his shirt, ran out of the room and allowed her to spiral downward. As the medical board's accusation against Hanson dryly notes:
The standard of care calls for a physician to provide basic life support (CPR) to a patient until emergency service personnel arrive and assume care of the patient The paramedics observed that neither [Hanson] nor Dr. Rutland were providing any care to patient [Ying Chen].
The medical board also provided a tidy list of everything an abortion clinic would need in order to comply with the law and to keep women from dying:
The standard of medical practice for an outpatient abortion clinic is to provide safe, legal and accessible abortion care. In doing so, the clinic must be adequately staffed with licensed nurses, nurse anesthetists or anesthesiologists, physicians, counselors or other personnel trained in abortion care. At least one staff member of the healthcare team must maintain a current CPR (cardiopulmonary resuscitation) certificate for emergency care whenever an abortion is being performed.
Further, the clinic must be adequately equipped to provide abortion care. This includes functioning equipment, sterile instruments, and medication. All patients who have undergone a surgical abortion must be observed during the recovery by a health care worker trained in postoperative care. The clinic must provide an emergency contact service on a 24 hour basis; the clinic must assure referral if indicated. Finally, the clinic must have appropriate equipment and medications on site to handle medical emergencies, including an oxygen delivery system, oral airways, uterotonics and epinephrine.
Hanson's clinic, called Clinica Para La Mujer, failed on nearly all those counts. He employed just one staff person, his wife, whose only qualification was being married to a physician. He lacked the right equipment to even determine the stage of a woman's pregnancy. On his shelf investigators found medications that had expired. Worse yet, they found dirty surgical instruments. Had Hanson followed the rules and had someone with CPR certification present during Ying Chen's abortion, she might be alive today.
Despite all that, the medical board thought that Hanson deserved to stay in business.
Rutland lost his license as a result of Ying Chen's death. But Hanson struck a plea deal with the board, admitting nothing other than the fact that the board had built a case against him. Next month, he will be given a public reprimand and ordered to take an ethics course.
Running an unlicensed clinic that posed a danger to patients, and then running away while a patient was dying, seem to be behaviors no ethics course can fix. Would the board have acted similarly if Hanson's clinic was not part of a shabby strip mall that catered to immigrants and advertised in Mandarin?
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Read more posts from the Shadow Practice Series here.