The Shadow Practice, Part 1: Disciplined doctor found an exile community in immigrant health care
The Anaheim obstetrician accused in a patient's death was part of a community of doctors on the fringe who had escaped the stigma of their pasts by treating immigrants.
Dr. Andrew Rutland was charged by the Medical Board of California in December of negligence after the death of a Chinese immigrant, Ying Chen, at a San Gabriel clinic. Rutland had been trying to give her an abortion, the board said, when he administered a fatal dose of lidocaine, an anesthetic.
Rutland began catering to the immigrant community after he lost his license for five years and had it restored in 2007. The charges against him were essentially scarlet letters for an ob-gyn. The board had said that his negligence had led to the death of two babies and injuries to other patients.
He was able to shake all this bad press by slipping into the shadows and tapping into the often cash-only market of immigrant patients in Southern California.
It's an ignoble tradition, where the patients can't read about their doctors' misdeeds because they don't know the language or the customs for finding that information. And the doctors who can't treat anyone else turn to treat some of the most vulnerable members of society.
The women's clinic in San Gabriel where the fatal abortion occurred is called "Clinica Para La Mujer." It has a sign in Spanish and Chinese, but not English. The facility is not licensed to offer medical services, although Rutland had applied for a business license for that location.
The clinic took out a full-page phone book ad, in Mandarin. It offers abortions 24 hours a day at a "special price," $286. There's a caveat to that, though. It "excludes pain relief."
The ads advertise the San Gabriel location and Rutland's office in Anaheim Hills. Rutland, however, claimed in a filing with the office of administrative hearings that the clinics owners "surprised me, on or shortly before July 28, 2009, by posting a sign bearing my name on the office window." July 28, 2009, was the day Ying Chen died. Rutland was trying to persuade a judge that his name was not on the door of the clinic until that unlucky day.
Regardless of the truth of that statement, the unlicensed San Gabriel clinic was operating in plain view 24 hours a day.
Over a series of posts, Antidote will profile some of the physicians in clinics like this, who worked directly with Rutland or in the same neighborhoods. These examples help put what happened in the death of Ying Chen into a broader context, and they underscore the need for a serious investigation into the way medicine is practiced among the poor and the disenfranchised.