COLUMBUS — Toledo’s last abortion clinic on Friday argued that the state’s attempt to fine it $40,000 for alleged violations pertaining to the transfer of a patient to a local hospital last year is unreasonable and could lead to its closing.
Friday marked the deadline for both sides to submit final arguments to Karl Schedler, a hearing examiner for the Ohio Department of Health. He will make a recommendation to Director Lance Himes as to whether the fine levied against Capital Care Network should stand.
The department imposed the fine after a surprise inspection on April 11, 2017, that led to a review of this case from 10 days earlier, when a patient advocate drove a patient who had just had an elective surgical abortion to the hospital.
A doctor was concerned after an ultrasound suggested the patient might have suffered a perforated uterus.
The clinic insists the patient was transferred as a precaution and that the physician had determined this was never a medical emergency.
The state argued that Capital Care violated state regulations, regardless of whether the incident were a true medical emergency.
If it was a true emergency, the clinic failed to follow its own policy for handling medical emergencies, requiring the calling of 911 for an ambulance to take the patient to the nearest hospital, Principal Assistant Attorney General Henry G. Appel wrote. If it wasn’t, then the clinic failed to have a policy in place for handling non-emergencies.
“This civil monetary [penalty] is justified because Capital Care sent a patient who might have been suffering from internal bleeding in a private vehicle without any medical personnel,” Mr. Appel wrote. “The stated reason for why Capital Care chose a private vehicle was because ambulances are more expensive.
“This is not an acceptable reason for Capital Care to send a patient with a potentially life-threatening condition in a private vehicle without any medical professionals to monitor the patient,” he wrote.
In the end, there was no perforation. The patient was kept overnight at the hospital and discharged the next day.
The clinic’s new policy states that no staff member will personally transport a patient to a hospital under any circumstances.
“It is, while inadvisable, not in itself a violation of any law, rule, regulation, or policy,” reads the clinic’s brief filed by Cincinnati attorney Jennifer Branch. “If the situation had been an emergency, transport by private car would have been a violation of [the clinic’s] emergency policy.
“However, it has been conclusively established that there was no medical emergency and that the emergency policy was not applicable on April 1, 2017,” she wrote.
Terrie Hubbard, the clinic’s owner who works as a registered nurse there, has argued that the clinic cannot afford a $40,000 fine.
“[The clinic] operated at a loss in 2016 and has done so since at least 2012,” the clinic’s brief reads. “If a $40,000 civil monetary penalty is assessed against [it], the clinic might have to close because it cannot afford to pay that amount.”
The state, however, argued that the clinic has provided no financial documentation to support that claim.
“Without some documentary evidence that Capital Care would be unable to pay a civil monetary penalty, ODH should not reduce the proposed civil monetary penalty,” Mr. Appel wrote.
The clinic conceded it failed to document that the patient received discharge instructions when she was taken to the hospital, a violation that it said was simply a paperwork error that did not result in harm to the patient.
The clinic just regained its ambulatory surgical center operating license earlier this year after briefly losing it for lack of a mandatory agreement with a local hospital for the transfer of patients in the event of medical complications. The clinic has since struck such a deal with ProMedica Toledo Hospital.
Contact Jim Provance at jprovance@theblade.com or 614-221-0496.
First Published August 17, 2018, 10:00 p.m.
