Cassandra Barger knew something was wrong almost immediately. Kermit Gosnell, the abortion doctor charged in January with eight counts of murder, had begun giving her anesthetic to end a pregnancy. Barger ripped the IV from her arm.
Racked by convulsions, she crashed from the exam table to the floor. She would stay there nearly an hour while Gosnell and his staff refused to call 911 or allow her companion to leave the locked clinic for help, according to a lawsuit her lawyer filed.
Barger, 34, a recovering drug addict, had warned Gosnell that she was on methadone when she went to his West Philadelphia clinic April 2, 2005, her filing said. She knew the drug could interact dangerously with certain sedatives.
What she could not have known was that Gosnell had a long history of injuring his patients and had let his malpractice insurance lapse nearly a year earlier in violation of state law.
Lawyers at Pennsylvania's Department of State, charged with weeding out bad doctors, were told about the lapse and Barger's lawsuit - along with many others - but took no action. Barger's lawyer said he suspected that Gosnell had paid his client privately to walk away.
Barger's case provides a window into the state's system to discipline doctors, one that relies heavily on physician self-reporting and state investigators whose effectiveness has been questioned. It's a system that patient-safety advocates and a leading ethicist say is broken.
Gosnell "was able to go on despite complaints for a long time," said Arthur Caplan, director of the University of Pennsylvania's Center for Bioethics. "That is not acceptable."
Gosnell was arrested Jan. 19 with his wife and eight employees. He is charged in the death of Karnamaya Mongar, 41, who went into cardiac arrest after an overdose of anesthesia, and in the deaths of seven babies prosecutors say he delivered live and then killed.
Gosnell, who may face the death penalty, has maintained he is innocent. His lawyer Jack McMahon, who is still evaluating the case, said it appeared much weaker than prosecutors had portrayed. It may be years before Gosnell's case is heard in court.
The grand jury that indicted Gosnell denounced the Department of State for its role in the "complete regulatory collapse" that kept him in business for nearly four decades. The agency has been silent since, referring reporters to Gov. Corbett's office. Spokeswoman Janet Kelley declined to make anyone available for this article but answered a few questions by e-mail.
