By Meredith Raney
Published May 25, 1996
Carolina Gutierrez, pictured above in life and in death, is a victim of choice. She bought the lie that abortion is a safe, legal procedure. The pro-choice movement knows it’s a lie and they don’t care. That’s why they didn’t come to her aid during the six weeks it took her to die and that’s why they aren’t outraged that a year and a half after her death, no one has been held responsible.
The Miami Herald picked up the story after Carolina had been in the hospital for over a month. There are stories in the Herald about Carolina going back to 1989 when she was a 13 year old Nicaraguan refugee staying in the Bobby Maduro Miami Stadium as temporary shelter.
The Miami Herald did extensive coverage on her death and right afterwards – calling for a state investigation. However, there has been nothing written since May 25, 1996. It appears that Carolina Gutierrez has died a horrible death in vain – truly a victim of choice. Other victims are pictured to the right – a family broken. Jose Linarte grieves for his wife, Carolina Gutierrez, while holding his 2-year-old (at the time) son, Darwin, and 5-year-old daughter, Alba.
An update is needed to answer these questions: Has anyone been held responsible for this woman’s death? Has anyone been punished? Has anyone lost their license? Has someone gotten away with murder? Has anything changed? Did Carolina die in vain? Where is the outrage from the women’s rights groups? Email the Miami Herald and ask them to do a follow-up investigation and story. Please refer to this web page.
The first stories on Carolina Gutierrez appeared December 16, 1988 and January 19, 1989 when she was a teenage Nicaraguan refugee staying in the Bobby Maduro Miami Stadium as temporary shelter. References to her birthday verify that it is the same Carolina Gutierrez.
The Thursday 1/19/89 article refers to her celebrating her 14th birthday on Tuesday which would make her birthday 1/17/75. The 1/26/96 article says that she turned 21 in the intensive care unit which is consistent with a 1/17/75 birthdate.
Articles from the Miami Herald on Carolina Guteirrez leading up to her death from a botched abortion:
12/16/88 – STADIUM SHELTER, NICARAGUANS RETRACE PATH TO REFUGE IN LOCKER ROOM AT BOBBY MADURO STADIUM
01/19/89 – SIX NICARAGUAN FAMILIES SETTLE INTO NEW HOMES
01/26/96 – ABORTION PATIENT CRITICALLY ILL; STATE INVESTIGATES CLINIC
02/02/96 – DOCTORS AMPUTATE FEET OF WOMAN WHO BECAME ILL AFTER ABORTION
02/06/96 – RAGING INFECTION TAKES LIFE OF DADE ABORTION PATIENT
02/08/96 – CAROLINA GUTIERREZ SERVICES SET
02/09/96 – A TRAGIC CONSEQUENCE (editorial)
02/18/96 – ABORTION CLINIC REGULATIONS OFTEN FOUND TO BE LAX
03/01/96 – REGULATE ABORTION CLINICS BETTER (editorial)
05/24/96 – ABORTION CLINIC CAN RENEW LICENSE – MABER MEDICAL CENTER INVESTIGATED AFTER CLIENT’S DEATH
05/25/96 – A FAILURE TO REGULATE (editorial)
No further mention of the investigation has occurred as of November 1997.
The first mention of Carolina Gutierrez in the Miami Herald archives is in a story about Nicaraguan refugees being given temporary shelter at Bobby Maduro Miami Stadium. The refugees were fleeing a violent revolution at home. The shelter was managed by the Committee of Poor Nicaraguans in Exile.
Published in MIAMI HERALD: Friday, December 16, 1988 Section: LOCAL Page: 1C
STADIUM SHELTER – NICARAGUANS RETRACE PATH TO REFUGE IN LOCKER ROOM AT BOBBY MADURO STADIUM
CHRISTOPHER MARQUIS Herald Staff Writer
On Wednesday, City Manager Cesar Odio shut down the House of Love and Hope, a private shelter for Nicaraguan refugees. Decrying squalid conditions at the Little Havana shelter, Odio bused 157 refugees to Bobby Maduro Miami Stadium, where he said they could stay while a new shelter is being prepared.
By Thursday afternoon, 15 more Nicaraguans had moved in. Like hundreds of others arriving in Dade County each week, they showed up empty-handed, without legal documentation, and sought a cot, a roof, some food. Stuffing stacks of clothing into doorless lockers, the stadium exiles settled in, ate hamburgers and seasoned pork, and shared their stories.
Carolina Gutierrez, 13, sits on a cot eating saltines. She wears a white skirt, and her nails are painted pink.
Carolina’s mother died when she was 4. “In the revolution.” Asked which side she fought on, Carolina shrugs. Her father ran off, the girl says, so her grandmother raised her and two brothers.
With her grandmother in failing health, Carolina left Oct. 22 with an aunt. They slipped across he U.S. border at Brownsville and bused to Miami, where Carolina was on her own. The aunt, a live-in maid, gave her $100.
At the Little Havana shelter, Carolina wrote letters to friends at home. When people told her she should enroll in school, she started to cry. “I wouldn’t be able to leave until I’m 18. I want to work for my (future) children, for my brothers.”
“So many times, you get cards with photos from people in Miami, saying,‘This is my car. I have a great job.’ The truth is I’m not so good. You have to be realistic about these things.”
SIX NICARAGUAN FAMILIES SETTLE INTO NEW HOMES
CHRISTOPHER MARQUIS Herald Staff Writer
Twenty-four Nicaraguans, six families in all, were the first refugees to move from Bobby Maduro Miami Stadium into private apartments Wednesday under a city-sponsored settlement program.
The refugees, who included a 2-month-old infant born just this side of the Rio Grande, headed for six two-room apartments made available by the Miami Christian College, located just south of the Opa-locka city limits.
City Manager Cesar Odio has given aides until Friday to clear out the stadium, which must be turned over to the Baltimore Orioles on Monday. Aides are sifting through offers from landlords across Dade County — from Miami Beach to Southwest Dade to Hialeah — said housing coordinator Pablo Canton.
The Bible Baptist Church, in conjunction with Miami Christian College, decided to adopt the first six families — which have not yet received work permits — and cover all their needs with church donations, said Russell Johnson, pastor of the church.
“Our people said: ‘Put them under our wings. Let us teach them what we’ve been taught,’” said Johnson, who showed up at the stadium Wednesday afternoon with a yellow school bus.
It was one bus that Maritza Madriz — who landed in Miami last month with two children, two brothers and a niece — didn’t want to miss.
“I want out of here,” said Madriz, 32, excitedly stuffing garbage bags with donated clothes. Madriz’s stadium bunkmates teased her, reminding her to phone home now and then.
But for Madriz, home meant peace of mind, privacy, a good night’s sleep — far from the locker room digs that still house about 170 Central American refugees. In the stadium, she said, “I felt like I could be driven out to the airport and deported on the next plane. With a new house, I feel like I’m here to stay.”
The group selected for the move quickly packed the bus with their new possessions: huge Pampers boxes full of clothes, three shiny new bicycles, bassinets, strollers and other goods donated by sympathetic Miamians.
“It looks like Christmas,” said Johnson, squeezing the loads through the bus door.
The refugees were the first of 50 families and 50 single men whom the city hopes to place in private apartments. City aides have drawn up a list of 100 apartments, offered at about $200 a month each, and plans to continue sending off refugees the rest of the week, according to Canton.
In most cases, the city plans to pay for the first month’s rent with funds raised by private donations and telethons on Spanish-language radio and television. Telethon organizers reported pledges of nearly $63,000, which would be added to more than $40,000 collected by the city in private donations since the refugees moved into the stadium. Since only a third of the refugees have received work permits, the city might have to cover subsequent rent payments as well, Canton said.
Wednesday’s move was especially sweet for the city because Miami Christian College offered the apartments rent-free for four months. Moreover, Sam Masters, director of church relations, vowed to mobilize sister churches by calling for donations on the university radio station.
Shortly before dusk, the bus pulled up to a three-story apartment complex across from the oak-studded campus at 2300 NW 135th St. A small yard off the heavily trafficked street offers a swimming pool and picnic tables.
Carolina Gutierrez, who celebrated her 14th birthday in the stadium Tuesday, (Note: that would make her birthday January 17, 1975) peered across the street at the college and asked if she could study there. From the stadium, she had bused to Robert E. Lee Junior High, and she was eager to improve her English.
Gutierrez, told she could attend a nearby school, proudly mouthed two new phrases: “I’m sorry” and “Thank you.”
Madriz, two kids in tow, ignored the footpath to her new place. In her eagerness, she stepped through the shrubs and boarded the elevator. She gave the two carpeted rooms a wide-eyed once-over, then declared with a smile: “Now all we need is a television.”
ABORTION PATIENT CRITICALLY ILL; STATE INVESTIGATES CLINIC
ANDRES VIGLUCCI Herald Staff Writer
Two days after getting an abortion at a Little Havana storefront clinic, Carolina Gutierrez was rushed by fire-rescue to Jackson Memorial Hospital, with an infection racing unchecked through her body.
Today the young mother of two small children is critically ill, her ravaged lungs working only because of a respirator, her fingers and feet turning black from gangrene. Even if she survives, she is likely to lose them.
The state of Florida is looking into whether her condition is the result of a botched abortion at the clinic, Maber Medical Center, 1542 W. Flagler St. “Our office is doing all we can do under the law to look into this matter,” said Pete Peterson, legal counsel for the state Agency for Health Care Administration in Tallahassee.
A month after Gutierrez was hospitalized, though, the case remains steeped in mystery.
The clinic has been closed for days, its door locked and lights out. Operators Roque Garcia and Maria Luisa Garcia are not returning messages left on their office answering machine, nor have they responded to the family’s request for Gutierrez’s medical records. At a Little Havana house listed as their property in county records, a young man said they don’t live there.
According to state records, Maber had operated as an abortion clinic without a license from 1989 to 1991, but has been licensed and passed annual inspections since then.
Gutierrez’s husband, Jose Linarte, doesn’t know the name of the doctor who performed the abortion. She had it done against his wishes and went without him.
“I was never in agreement,” said Linarte, who spends most of his day at Jackson while relatives take care of the children. “This is very hard, what we’re going through. I can’t sleep. I try to take my mind off it, but it’s impossible.”
The young couple are Nicaraguan immigrants. A waitress, she has a boy, 2, and a girl, 5, from a previous relationship. He loads cargo on trucks.
According to the family’s attorney Gerardo Vazquez, Gutierrez felt she could not handle a third child, in part because the family is too poor.
Linarte said he doesn’t know who recommended the clinic to his wife. The day of the abortion, Dec. 19, a friend took her and brought her back.
The couple has no medical insurance. She paid cash, amount unknown.
Maber Medical Center is in a largely poor East Little Havana neighborhood that is home to Nicaraguan and other Central American immigrants. The area is dotted with small storefront medical clinics that cater to Medicaid and Medicare patients.
At the clinic, she was given a business card printed in Spanish — “Maber Medical Center, Woman’s Medical Center, gynecology and general medicine,” it reads — and a sheet in English warning about possible complications of the abortion, including infection.
Neither Gutierrez nor her husband reads English. The line for the patient’s signature at the bottom of the form is blank.
The family lawyer says he doesn’t know whether anyone at the clinic explained the potential complications to Gutierrez.
Major complications occur in 1 of every 200 legal abortions, according to Contraceptive Technology, a reference book written by physicians.
Depending on the patient’s age, the mortality rate for women who undergo abortions is between 1.0 and 1.6 for every 100,000 abortions, lower than the rate for childbirth, the book says.
Not long after getting home, Linarte said, his wife began complaining “of pain in her belly, of pain in her chest.” She called the clinic, and someone hung up on her, he said.
During the next two days, she called the clinic at least twice more, leaving messages on the answering machine. No one called back, he said.
By Dec. 21, she was much worse, barely able to breathe, Linarte said. They dialed 911.
At Jackson, doctors said Gutierrez was suffering from blood infection so severe that she was in septic shock — possibly a result of the abortion. Gutierrez, who turned 21 in the intensive care unit, (Note: consistent with the 1/17/75 birthdate in the 1/19/89 Miami Herald article) received a hysterectomy. Doctors told Linarte’s lawyer that her lungs began to fail, forcing them to put her on a respirator, and that the infection led to gangrene in her feet and fingers.
Doctors were scheduled to amputate this week, but put off surgery because they feared she would not survive anesthesia. They may try the operation next week.
Her condition is so critical that doctors can’t say whether she will live, attorney Vazquez said.
“They hope for the best, but she’s very sick,” he said. “What she has going for her is that she’s young and she’s strong.”
DOCTORS AMPUTATE FEET OF WOMAN WHO BECAME ILL AFTER ABORTION
PEGGY ROGERS Herald Staff Writer
Doctors amputated the feet of Carolina Gutierrez on Thursday, deciding the threat of spreading gangrene was greater than the risk of surgery.
Gutierrez survived the operation, her attorney said Thursday evening. But the 21-year-old woman remained critically ill from an infection that developed after a December abortion.
Her fingers were not amputated, a procedure that her doctors had anticipated performing, but she is expected to lose at least some of them, said attorney Gerardo Vazquez.
State health authorities have been looking into the abortion, performed at a Little Havana clinic, to determine if it was botched.
Gutierrez, who is married and has two children, is on a respirator and heavy doses of drugs. Fearing she would not survive an amputation last week, doctors at Jackson Memorial Hospital had postponed it for as long as possible. But the need to stem gangrene became greater, and her condition may have stabilized some, Vazquez said.
RAGING INFECTION KILLS DADE ABORTION PATIENT
SANDRA JACOBS Herald Health Writer
Carolina Gutierrez died Monday, seven weeks after she began fighting a raging infection her lawyers say started with a botched abortion at a Little Havana storefront clinic.
The 21-year-old Miami woman leaves behind two small children and a husband.
“They have taken away the love of my life and right now I have to take care of my family,” said Jose Linarte, who like his wife came from Nicaragua as a teenager. Eyes red and jaw quivering, he held Darwin, 2, on his knee, and Alba, 5, tucked close by his side as the family gathered for a press conference.
Linarte’s lawyer, Gerardo Vazquez, said he warned the Maber Medical Center that a medical negligence lawsuit would be filed. Gutierrez had an abortion on December 19 at the clinic, 1542 W. Flagler St.
When she returned home that afternoon, she was staggering and complaining of pain in her belly and chest. Fever set in. She called the clinic and someone hung up, Linarte said. During the next two days. Gutierrez called the clinic at least twice more and left messages on an answering machine but no one called back, he said.
On Dec. 21 she was barely able to breathe and the family dialed 911.At Jackson Memorial, doctors said Gutierrez had a blood infection so severe that she was in septic shock.
The lawyer said doctors told him that her uterus was perforated at least twice. Perforation can occur when instruments used in an abortion accidentally pierce through the uterus, leading to infection that can be carried by blood throughout the body.
According to a study by the U. S. Centers of Disease Control and Prevention, the risk of uterine perforation is one in 500 abortions. Resulting infections can usually be controlled when treated early. The mortality rate for abortion during the first trimester is estimated at one in 200.000. according to the CDC lower than the risk for childbirth.
Gutierrez’s uterus was removed and she was given heavy doses of antibiotics and placed on a respirator to help her breathe. Despite the effort, gangrene set in and her fingers and feet turned black.
By last week, doctors decided the threat of spreading gangrene was greater than the risk of surgery and they made the difficult decision to amputate both legs just below the knees to contain the infection.
But complications and the infection continued, and by Monday morning Guiterrez’s blood pressure plummeted. Results of an autopsy were not available late Monday. Jackson referred all questions to the family’s lawyers.
The Maber Center closed in the days after initial news reports about Gutierrez’s condition and remained locked on Monday. Messages to the office answering machine in the past week have not been returned.
The family’s lawyers said the center did not respond to their request for medical records in 10 days as Florida law requires.
Florida’s Agency for Healthcare Administration has had the case under “active review” for several weeks said an agency spokesperson. But the state did not order the center closed.
CAROLINA GUTIERREZ SERVICES SET
Funeral services for Carolina Gutierrez will take place at 12:45 p.m. today at the Coral Gables Chapel of Caballero Woodlawn Funeral Home, 1661 Douglas Rd. The procession will leave at 1 p.m. for the burial at Woodlawn Park Cemetery South, 1165 5 SW 117th Ave.
Gutierrez died Monday of an infection, seven weeks after she underwent an abortion in Little Havana. State authorities are trying to determine if there were problems with the abortion that led to her death.
Survivors include Gutierrez’s husband, Jose Linarte, and her two children, Darwin, 2, and Alba, 5.
A TRAGIC CONSEQUENCE
It should be a safe medical procedure. But harassment can drive away competent doctors and clinic operators.
A tragic confluence of circumstances combined to kill Carolina Gutierrez, 21. The Miamian died this week from an infection believed caused by a Dec. 19 abortion at a Little Havana clinic.
Ms. Gutierrez’s mistake was not in exercising her right to terminate her first-trimester pregnancy, but in the clinic that she chose, the Maber Medical Center at 1542 W. Flagler St. Her uterus was punctured twice, and she ultimately developed gangrene.
Ms. Gutierrez received an informational sheet warning of possible post-abortion complications upon leaving the clinic. It was printed in English, which she couldn’t read. For the next two days the clinic shunned her repeated calls for relief from her fever and pain, her family’s lawyer alleges.
Ms. Gutierrez kept her intentions to get an abortion secret from her husband. By the time the family brought her to Jackson Memorial Hospital on Dec. 21, she was in terrible shape. Thus the young mother of two died. Tragic.
But the culprit is not abortion, as those who oppose it will allege. In fact, the obstacles that anti-abortionists have constructed to outlaw abortions may have a role in the circumstances that combined to take Ms. Gutierrez’s life.
Strangling regulations that force clinics to close and discourage others from opening have long been an antiabortion tactic. Wary of controversy, medical schools and teaching hospitals have neglected instruction in this medical procedure. Organized harassment of clinics and doctors has driven many providers out of the field. The vacuum is sometimes filled with undertrained or poorly qualified physicians.
In 1982 a federal court threw out Florida’s 1980 abortion clinic regulations as overly restrictive. A less stringent law was passed in 1988, but the Department of Health and Rehabilitative Services, which regulated abortion clinics then (the Agency for Health Care Administration now does), didn’t do much about it until The Herald exposed dangers in a South Dade clinic in 1989.
Some politicians then sought a crackdown on all clinics, and tougher legislation. But HRS already had power to shut down lawbreaker clinics. It just needed to enforce the law. Eventually the state and clinic operators found common ground on enforcement.
But six years later comes Maber Medical Center, which has been closed since news about Ms. Gutierrez appeared. An investigation is needed here, and criminal charges should be filed if warranted. Blame the provider who botches the abortion, not the legal procedure or the patient who seeks it.
ABORTION CLINIC REGULATIONS OFTEN FOUND TO BE LAX
PEGGY ROGERS Herald Staff Writer
Carolina Gutierrez died a miserable death, her legs amputated in a futile effort to save her from something that almost never kills a woman — an abortion.
Stronger regulation of abortion clinics might have made a difference.
The state always approved new licenses for the storefront Little Havana clinic where Gutierrez had her abortion. The day after the mother of two died, at 21, health care inspectors took a new view of Maber Medical Center:
A “high risk of health and safety,” an inspector warned in a Feb. 6 statement. Florida’s Agency for Health Care Administration went to court for a search warrant to review and copy every medical record at Maber — a move that is “very vital to the health and welfare of the citizens of Dade County.”
Annual inspections for Florida’s 65 licensed clinics now consist of six questions — all answered from paperwork, not examination of medical equipment or operating practices or staff training.
Even when Maber Medical Center was found in 1991 operating without a license, it didn’t suffer. The operators applied for a license, and got one. The same year, inspectors found that a doctor working at Maber was also working at a second unlicensed clinic in Miami. There was no apparent penalty for the doctor or the second clinic.
Amid the news about Carolina Gutierrez’s condition, Maber abruptly shut. Its operators, Roque and Maria Luisa Garcia, have not responded to several messages seeking comment.
“Whatever your sentiments about abortions, if they are going to be legal in this country, let them at least be performed safely,” said Gerardo Vazquez, whose Miami firm represents Gutierrez’s family, as well as Miami Right-to-Life.
“Pro-choice people feel that any attempts to regulate abortion is an infringement on that right. But this is a health care issue,” Vazquez said.
Pro-choice supporters point out that abortions are among the safest forms of minor surgery in America, safer even than giving birth. Most clinics in Florida operate without reported incident.
Yet scandalous revelations over the past dozen years about a few in Dade, especially those who target lower-income women, have revealed the potential for unscrupulous medical practices to go unchecked by lax regulators.
A Miami clinic was shut in 1983 after four women died.
The Herald reported in 1989 that another clinic, in Kendall, was bungling abortions and telling women who weren’t pregnant that they were.
Regulators learned of another clinic in 1989 with “deplorable” conditions — moldy operating equipment, expired medications, poor infection control. The state suspended the license it had granted only three months earlier to the Westchester clinic.
It is operating again with the same administrator and the same president, a doctor who had lost his license, state records show.
“I’m not going to answer any questions by The Miami Herald,” said Blue Coral administrator Virginia Suarez. She hung up.
Soon after leaving the Maber Medical Center, Gutierrez suffered wracking pains and fevers. Her calls to the clinic went ignored, her husband has said. She was hospitalized two days after the Dec. 19 abortion, a virulent infection destroying her organs and tissue.
The abortion unleashed the infection, Dade medical examiners determined. They and state health care investigators are trying to determine if the abortion was performed correctly. Earlier suspicions that her uterus was perforated were unfounded, but correctly done abortions rarely trigger such an aggressive infection, said Associate Medical Examiner Dr. David Start and other doctors.
“It’s a shame,” said Gina Shaw, spokeswoman for the National Abortion Federation, a voluntary group that sets medical standards for clinics that want to be members. “The information and quality care is out there. Quality is the rule, not the exception. But the women who need the information most, often have the hardest time getting it.”
Despite periodic calls for a crackdown, including a special session of the state Legislature in 1989, pro-choice advocates have resisted opening the door to more rules.
They say some anti-abortion politicians exploit the issue — seeking to make abortions exorbitantly costly and inaccessible. Each licensed doctor performing abortions is responsible for his or her medical practices at the clinic.
The flaw in that reasoning is underscored in Gutierrez’s case. Doctors come and go at abortion clinics. Some attend at several clinics, and some clinics have more than one doctor. Patients often don’t get their names, and the state doesn’t ask for them.
Gutierrez’s family cannot be sure who performed her abortion. Little, in fact, is known about the entire clinic staff.
Maber’s operators, Roque and Maria Luisa Garcia, are not doctors, which is typical. The state requires no background information on owners and administrators.
The names of doctors are not requested in order to keep them out of public licensing records and away from anti-abortion extremists, state authorities say.
According to county records, just one doctor has an occupational license to practice at Maher. He is Dr. Luis J. Marti.
But it is not known if Marti, 63, had a role in treating Gutierrez. He has not responded to numerous requests for comment. He appears to have shut his own Little Havana practice, at least temporarily. Despite repeated calls during weekday hours, only an answering machine picks up.
“Dr. Marti does not have any comment to make to you at this time,” said an attorney, Michael Levinson.
Demanding good medical care or even asking the name of the doctor was not among the concerns of Ana Figueroa, who is poor and the mother of five, when she sought an abortion two years ago. Nor did she complain to the state when things went wrong.
The cost worried the Hialeah cleaning woman. She was told of Maber Medical Center.
Her charge was $175, she said. Gutierrez, also poor, paid $225, according to family lawyers. Private South Florida doctors performing abortions in their own offices can charge as much as $800, local doctors estimate. Of the relative few who do them, a good number keep their fees high because they don’t want to attract too many women — and attention.
Maber Medical Center sits amid the bustle of Little Havana in a neighborhood filled with mom-and-pop medical centers.
A narrow and dingy waiting room, little more than a corridor with chairs facing each other, can be seen through Maber’s plate-glass window. The rules are posted. No lying down. No children in the waiting room. Everyone shows at 9 a.m. You take a number off the peg on the wall, and you wait your turn.
When pain and fever sent Figueroa back to Maber, they said they couldn’t help her, according to Figueroa and her family physician, Dr. Elba Mora. She had an incomplete abortion, Mora said, and her womb was expelling fetal remnants and blood.
Doctors operating on Isabel Camacho of Homestead several months later also found remnants of her pregnancy, according to medical records and her lawyer, Bob Allen. She, too, had gone to Maber. She, too, had failed to ask the doctor’s name.
Maher Medical Center began offering abortions during the 1980s. Marti took out his first occupational license to practice at Maher in 1988. The next year, he got a license to practice at Orvi Medical Center in Miami.
But as of 1991, neither center had a state abortion-clinic license, then being issued by Health and Rehabilitative Services authorities.
Orvi Medical Center’s owner, Orlando Zaldivar, said he doesn’t think the clinic ever operated without a license. It has one now.
“It is amazing,” said attorney Jerome Hoffman, the state health care agency’s general counsel, while recently hunting through Florida laws on the issue.“There is apparently no criminal penalty, or any penalty at all, for performing abortions at a clinic without a license.”
“If an unlicensed clinic were found today”, said Marshall Kelley, who oversees the agency’s licensing of health care facilities, “we would close them down.”
“And if they applied for a license,” Kelley said, “we would apply the same rules to them that we apply to anyone else.”
Qualifying for a license is not tough. It requires a once-a-year inspection — announced beforehand, said Anne Fowler, owner of A Woman’s Health Care in Miami. “I tell them they don’t have to call ahead. They can come in and inspect any time.”
Dr. Marti used to work at Fowler’s clinic, said Fowler, backed up by county occupational licensing records. She said she stopped having him come because she was concerned about the way he handled some abortions at her clinic.
The state inspectors check to see if the clinic posts its license, keeps good patient files and has arrangements for medical waste disposal.
To learn if doctors are performing the abortions, the inspectors look for any physician names in files but don’t compile them into lists.
These checklists aren’t enough to ensure that clinics are operating safely, say lawmakers and others who favor stronger scrutiny.
But creating additional regulation would make abortion costlier, further limiting choices for lower-income women, said state Rep. Ben Graber, a Coral Springs gynecologist and chairman of the House Health Care Committee.
The way to expand safe choices is to remove political pressures against abortion professionals, Graber said.
“The abortion clinics have materialized because physicians were reluctant to perform abortions in their own offices because of the political controversy,” said Graber, who emphasized that the procedure itself carries little risk. “It’s very rare to see women not only dying these days but even for them to have serious infections.”
More than 73,000 reported abortions were performed in Florida in 1994 — 18,000 of them in Dade. More than one of every three licensed abortion clinics in the state is in Dade — 25 out of 65.
The National Abortion Federation is a voluntary group that has set standards for abortion clinics seeking to be a member. The standards include:
- Naming a medical director, a licensed physician who has overall responsibility for medical practices, staff and emergency patient needs.
- A system for having a licensed nurse or doctor accessible on a 24-hour basis for post-abortion complications.
- Requiring the doctor to remain on the premises until all women are recovered and discharged, and having licensed nurse or doctor supervise the recovery area.
- Equipping the clinic with emergency medications and equipment.
- Operating under only one name.
- Providing clear, comprehensive counseling and answers to any questions before the procedure.
The federation’s toll-free hotline number is (800)772-9100.
A. ENRIQUE VALENTIN / Herald Staff
GRIEF-STRICKEN: Jose Linarte, left, cries on brother Julio Linarte’s shoulder at Jose’s wife Carolina Gutierrez’s burial.
CANDACE BARBOT / Herald Staff
HURTING: Ana Figueroa, right, with daughter Dawn McManus.
REGULATE ABORTION CLINICS BETTER
ROBERT N. ALLEN JR. Special to The Herald
Robert N. Allen Jr., a Miami lawyer, provides pro bono legal services for Miami Right to Life and represents one of the women suing Maber Medical Center.
CAROLINA Gutierrez, 21, died Feb. 5 from an abortion at Maber Medical Center in Miami. The doctor believed to be responsible appears to be in hiding. The clinic failed to deliver its records on the incident, as required by law, to Gutierrez’s attorneys or to the Department of Health Care Administration. The clinic has closed — not by state order — but because of negative publicity.
Since Gutierrez’s case became public, our law firm has received numerous calls from women who have developed complications following abortions performed at Maber or by its staff physician, Dr. Luis Marti. Their complaints mirror what happened to Gutierrez. The principal difference is that they survived, and she didn’t.
Common elements of their complaints are: unsanitary conditions; unanswered phone calls (some women were even turned away at the door when they sought help after developing complications); a failure to explain risks, including the insistence that Spanish speakers sign releases printed in English; questionable administration of general anesthesia; misrepresented credentials; and no malpractice insurance.
In every case our callers had developed a life-threatening infection, either as a result of a perforated uterus or an incomplete abortion. Sometimes as long as two years after their abortion, the women continued to have medical problems — constant pain, enlargement of the ovaries, even infertility.
Marti’s record is not appealing. He took over the operations of Dr. Ippolito Barreiro at the Women’s Medical Center after Barreiro’s abortions led to four deaths in 1983. Later Marti operated out of Blue Coral Medical Center, where Dr. Nabil Ghali, chief abortionist at Dadeland Medical Center (closed by authorities for activities exposed by pro-life activists and The Herald), also operated. Ghali, by the way, was a convicted child molester whose medical license had been suspended in Ohio while he was performing abortions in Miami.
Abortion rights supporters, exemplified by the Feb. 9 Herald editorial A tragic consequence, blame Gutierrez’s death in part on anti-abortion activists who, they believe, want “strangling regulations that force clinics to close.” That isn’t true. The pro-life movement’s objective is a nation that does not condone abortion.
The distortions inherent in the editorial’s accusation are revealed when the law governing abortion clinics is considered. In Florida, clinics must be licensed ($250). They must dispose of fetal remains in a sanitary fashion. Abortions must be performed by a doctor. Consent must be given and signed. Records must be kept. Only third-trimester abortions need be performed in a hospital. Nothing more.
Is it “strangling” to demand sanitary standards? Training for support personnel? Consents printed in the patient’s language? Special regulation for the use of anesthesia? Infection controls? Such regulations have been consistently opposed by unbending abortion rights activists and lobbyists for the abortion industry.
Under regulated abortion clinics are maiming Florida women by the dozens, if not hundreds, every year. It’s time not only for the criminal investigation of Marti, Maber, and other “medical” clinics — called for by The Herald — but also for a grand jury investigation of the local abortion industry. I have asked State Attorney Kathy Fernandez Rundle to institute this action.
Florida!s women should no longer be pawns in the battle by abortion rights activists to avoid all restrictions on abortion. To the pro-life movement, each abortion has at least two victims: the child and the mother. We care about both.
ABORTION CLINIC CAN RENEW LICENSE MABER MEDICAL CENTER INVESTIGATED AFTER CLIENT’S DEATH
ROSA TOWNSEND Herald Staff Writer
A Little Havana abortion clinic that came under investigation by state prosecutors in February after one of its patients died has been authorized by the state to renew its license.
The Agency for Health Care Administration has concluded that Maher Medical Center, 1542 W. Flagler St., “meets the current regulations” and is entitled to renew its license, which expires in June.
Agency spokeswoman Lisa Jacques said the inspection did not focus on the abortion that reportedly caused the death by blood poisoning of Carolina Gutierrez, but on the overall quality of medical attention furnished by the clinic.
But the agency’s inspectors based their decision on documents provided Feb. 8 (three days after Gutierrez died) by the clinic’s administrators. And the inspection consisted of six questions relating to those documents; it did not involve an examination of the medical equipment or the surgical practices or the personnel’s skills.
The clinic shut down abruptly in mid-February after the circumstances of Gutierrez’s death became public. The 21-year-old Nicaraguan died Feb. 5 at Jackson Memorial Hospital, where she was taken Dec. 21 in a coma two days after undergoing an abortion.
The autopsy gave the cause of death as “septicemia, Streptococcus A, subsequent to termination of pregnancy.”
Andrew Quartin, one of Gutierrez’s attending physicians, said a relationship between the abortion and her fatal condition “was not perfectly clear, although the coincidence in time is suspicious.”
The Herald was unable this week to communicate with Maber’s administrators and with the only physician licensed to practice there, despite repeated efforts.
Maber Medical Center is owned by Sonexport, 300 NW 16th Ave. According to Dade County records, that address is also the home of the clinic’s operators, Roque Garcia and Maria Luisa Garcia, whose personal relationship has not been determined. The building appears to be unoccupied.
State records list the Garcias as Sonexport’s president and treasurer, respectively. They also indicate that Sonexport did not submit an annual report May 1, as requested by the state’s corporate registrations department.
According to the Agency for Health Care Administration, Sonexport owns other abortion clinics in Dade, but the agency declined to name them.
Ever since Maber shut down, calls to the clinic are automatically transferred to Orvi Medical Center, another abortion clinic in Miami.
Dade County and agency files show that only one physician holds an occupational license to practice at the Maber clinic: Luis J. Marti, who also obtained a license in 1989 to practice at Orvi.
It is not known if Marti, 63, participated in the abortion procedure on Gutierrez. His office, at 2346 NW Seventh St., is closed, and his telephone was disconnected this week.
Calls to Palm Springs Hospital in Hialeah, where Marti has some patients, were not returned. A receptionist at the Orvi clinic told The Herald Marti no longer works there.
The state attorney’s investigation remains open, said Ralph Talbot, the prosecutor in charge of the case.
A FAILURE TO REGULATE
State agency had no business authorizing a license for the Maber Medical Center.
It’s outrageous that the Agency for Health Care Administration authorized a license renewal for the Maber Medical Center while the Dade state attorney is still investigating the death of a woman after her abortion at the Miami clinic.
Carolina Gutierrez had the procedure done at Maber last Dec. 19. When complications arose, the clinic refused to answer her phone calls, according to family members. On Dec. 21 she was admitted to Jackson Memorial Hospital. On Feb. 5 the 21-year-old woman died, according to an autopsy, of an infection “subsequent to termination of pregnancy.” When her death became public in early February, the Maber Medical Center shut its doors. Operators Roque Garcia and Maria Luisa Garcia dropped out of public sight.
Just three days after Ms. Gutierrez died, the AHCA received the requisite documents from Maher to trigger its license-renewal process. But this coincidence of timing is no excuse for the AHCA botching its oversight. The agency should have been aware of the investigation and conducted more than a routine inspection by paperwork. There was no on-site scrutiny.
When the clinic’s operators failed to submit a required annual report by May 1, it was another warning flag. Nevertheless, this month the AHCA approved Maber’s right to renew its license. This sorry example of mis-authority begs for a review.
Abortion foes use onerous regulations to discourage abortion clinics. Responsible clinic operators have fought hard to make sure that regulations are tough enough to ensure safety but not unjustifiably burdensome. When regulators don’t guard against unscrupulous clinic operators, the consequences fuel more conflict on this divisive issue. And it’s women and their constitutional right to seek abortion that suffer most when government fumbles its regulatory role.
As of November 1997, a year and a half later, nothing further has been mentioned about the investigation into Carolina’s death. The clinic still has its license, Dr. Marti still has his license, nothing has changed. Carolina Gutierrez has apparently died in vain -a victim of choice.
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