Tuscaloosa Thread (12/06/21)
A woman from Shelby County has filed a medical malpractice lawsuit against the West Alabama Women’s Center (WAWC) in Tuscaloosa over an abortion that allegedly almost killed her and left her unable to become pregnant again last December. The five-count lawsuit was filed last month, on November 11th, in the circuit court of Tuscaloosa County. Judge Daniel F. Pruet, who was elected to his seat on the bench in 2020, will preside over the case.
“Predisposed to Suffer”
The suit centers on the plight of a Shelby County woman identified under the pseudonym “Jane Stone,” who reportedly first visited the WAWC on December 22, 2020, for a pre-admission evaluation for an abortion. “Jane Stone informed [a nurse] that she decided to have an abortion after prenatal genealogical testing revealed that her child was predisposed to suffer from lifelong health disorders, including Downs [sic] Syndrome,” according to the lawsuit. Stone also allegedly asked about the risks specific to the pregnancy termination procedure recommended to her, which is called Dilation & Evacuation. She was told that hemorrhaging was the primary complication that arose after the procedure, and a nurse allegedly explained that “a patient had died following a procedure performed at the clinic, but … the patient’s death was the result of drug use and not related to the procedure or complications of the procedure.” Stone underwent an ultrasound and scheduled her abortion for December 28th, 2020. Tamer Yvette Middleton, a Georgia physician who practices at the West Alabama Women’s Center, was set to perform the procedure.
The Process
(Editor’s note: the paragraphs below will describe an abortion procedure in detail and also outline how Jane Stone’s reportedly went wrong. Reader discretion is advised.) After setting the stage with this background information, the lawsuit explains the process of a Dilation and Evacuation procedure. According to the complaint, a D&E is the “preferred method” for performing late first-trimester and second-trimester abortions. Essentially, instruments are passed through the cervix and into the uterus, where the fetus is then vacuumed out of the body. The procedure requires advance preparation, called cervical priming, to allow the medical instruments to pass safely into the uterus. According to the lawsuit, this priming is usually done through medications such as Cytotec, which softens, thins and opens the cervix before the procedure. “In order to properly dilate the cervix pre-operatively, the woman must receive the agent at least three hours prior to her procedure,” the complaint read.
The Day of the Procedure
Stone allegedly arrived for the procedure at 10:40 a.m. on December 28th and sat in a waiting room with around three dozen other patients. At 11:30, she was called back to an office to sign additional paperwork, where a nurse reportedly apologized that the clinic was “overbooked and understaffed.” Stone was also told no one could give her any medication until she met with Dr. Middleton. An hour later, at 12:30 p.m., Stone was said to have been given 800 micrograms of Cytotec for cervical priming. At 1 p.m., she was reportedly given Xanax, Phenergan, Naproxen and Doxycycline. At 1:30 p.m., just an hour after she received her first dose of Cytotec, Stone was taken to a procedure room where Middleton performed the dilation and evacuation of the fetus. “During the procedure, which she performed without the use of ultrasound guidance and without adequate cervical preparation, Dr. Middleton lacerated the right side of Jane Stone’s cervix, perforated the lower right uterine segment, and sheared multiple uterine blood vessels,” according to the complaint. Middleton reportedly became concerned with Stone’s level of blood loss and called several nurses into the procedure room to assist in monitoring her vital signs, performing an ultrasound and administering more medication, including 800 more micrograms of Cytotec.
Progressing Toward Shock
At 2:30 p.m., Stone was carried from the procedure room to a recovery room, where she was placed in a recliner. According to the lawsuit, Stone sat there for an hour. She could not walk, was bleeding internally, complained out loud of severe pain and lost consciousness several times. “Jane Stone exhibited signs of significant ongoing blood loss,” according to the lawsuit. “In addition, Jane Stone was noted to be pale and diaphoretic, and her vital signs indicated that she was progressing toward shock. Neither Dr. Middleton nor any other physician evaluated Jane Stone during this time.” “Throughout the time, Jane Stone repeatedly told the nurses that something was wrong and that she wanted someone to call an ambulance to take her to the hospital,” Stone’s attorneys said in the complaint. “In response, Jane Stone’s nurses […] dismissed and/or told Jane Stone she was being anxious and she just needed to calm down.” By 3:30 p.m., Middleton and the staff at WAWC were reportedly struggling to find Stone’s pulse and finally called an ambulance to take her to DCH Regional Medical Center in Tuscaloosa. On the way to the hospital, paramedics reportedly called ahead to warn that Stone was unresponsive, that they could not obtain her blood pressure and that she had signs of heavy internal bleeding.
Hospitalization and Emergency Hysterectomy
Stone arrived at DCH’s emergency room at 4:08 p.m., where doctors found she had an enlarged uterus and evidence of significant hemorrhaging. At 5:25 p.m., her doctor at DCH ordered an immediate consultation with an OB-GYN, who had her rushed to an operating room. The lawsuit alleges that Stone lost around a liter of blood internally and despite the doctor, OB-GYN and a vascular surgeon making multiple attempts to stem the bleeding, they ultimately “had no choice but to perform a supracervical hysterectomy,” and surgically remove her uterus. Stone reportedly received two units of packed red blood cells and one unit of fresh frozen plasma while in surgery. Stone was then transferred to DCH’s intensive care unit and remained hospitalized until January 1st, 2021.
The Lawsuit
Stone’s five-count lawsuit outlines 17 ways that Middleton and the WAWC “breached the applicable standard of care” for Stone by administering too much Cytotec, not allowing enough time for adequate cervical priming, lacerating and perforating her cervix, uterine segment and uterine arteries, failing to respond appropriately to her bleeding after the procedure and ignoring her concerns post-operation. Stone alleges she suffered “severe acute physical injuries” and “life-threatening hemorrhaging and hypovolemic shock.” She said she endured lengthy hospitalization, surgical, anesthetic and therapeutic treatment, great physical pain and suffering and mental anguish. As a result of her hysterectomy, she will never be able to become pregnant and have children, and she expects “significant medical bills and out-of-pocket expenses related to in vitro fertilization and surrogacy.” Stone also alleges the clinic staff lied or omitted key details about their operations, leadership and history. Stone noted that another patient died on May 7, 2020 “as a result of a uterine perforation and hemorrhaging related to an attempted surgical D&E performed at WAWC;” and that staff “falsely [represented] that the death of the WAWC patient who died […] was related to a fatal drug overdose.” The clinic staff, according to the complaint, also allegedly failed to disclose that “Dr. Leah Torres, WAWC’s medical director who was responsible for the operation and safety of all practices and procedures performed at WAWC, had her medical license revoked in August 2020,” and has received a cease and desist order from the Medical Licensure Commission of Alabama and “was not authorized to function as medical director at the time.” Stone said Middleton and the WAWC staff were either negligent or improperly trained to adequately treat her and more. For each of the five counts, Stone demands judgment against Middleton, the clinic and the unnamed staff members. Her attorneys ask for a jury to determine the damages to which Stone is entitled, together with interest, court costs and “any other relief to which [Stone] may be entitled.”