• Extreme unsanitary conditions, including STDs, septic (unsterile) conditions, blood and animal feces and urine and other noxious fluids and waste, and months-old fetal remains stored in "jars, bags and jugs" (in 2013 the trial heard that Gosnell had also been in dispute with his medical waste company, with the latter stopping their services);

• Surgical malpractice including perforation of bodily organs and "on at least two occasions" death;

• Improper equipment and usage, including repeated reuse ("over and over") of disposable supplies, and "generally broken" life-saving and monitoring equipment (including blood pressure monitoring, oximeters, and defibrillators);

• Padlocked emergency access and exit routes;

• Lack of properly trained staff, "bogus doctors" — unqualified, unlicensed and unsupervised staff who misrepresented themselves to patients as qualified licensed clinicians — and no qualified nurses. The jury reported that "Most of Gosnell’s employees who worked with patients had little or no remotely relevant training or education" (ex-employee Marcella Choung, who in 2001 and at interview in 2002 gave a detailed written complaint to the Pennsylvania Department of State, testified that her 'training' for anesthesia consisted of "a 15-minute description by Gosnell and reading a chart he had posted in a cabinet.")

• Gosnell himself was largely absent and left the clinic to be operated by his unqualified employees, whom he sometimes "ordered" to perform medical actions even if they "protested" that they were unqualified. Employees testified they had to rely on themselves, as "Gosnell disliked it when workers disturbed him by calling for medication advice";

• Operation of a "prescription treadmill" whereby blank signed prescriptions would be left for those seeking controlled medications, unsupervised and uncontrolled by a practitioner (which was the subject of a parallel and separate Federal investigation);

• Willful non-compliance with laws intended to safeguard vulnerable women, including non-compliance with requirements for mandatory counseling, consent (for minors), waiting periods (between visiting and surgery);

• Fraudulent temporary employment of a nurse for 4 days during an NAF inspection, with the aim of deceiving the inspectors into believing that his practice staff included a licensed registered nurse (which it did not); over the few days of their on-site review, the nurse resigned upon realizing the fraud, which also involved Gosnell taking her paycheck back afterwards and paying her in cash instead;

• Fraudulent recording of gestational age and training of staff to manipulate ultrasound in a way that would match the stated number of weeks;

• Dishonest statements by Gosnell and employees to investigators, including claims that Ms. Mongar's death was due to her own action (discredited forensically), falsification and destruction of records, and lying about the manner of her death and Gosnell's (lack of) presence for anesthesia;

• Patients given labor and delivery inducing drugs during the day, then left waiting until late evening for Gosnell to attend or for surgery.[60] Many gave birth during the day as a result, and employees testified "it was standard procedure for women to deliver fetuses – and viable babies – into toilets" while waiting for his arrival.

• Practice staff routinely delivered living babies in the third trimester, subsequently killing them (or ensuring their death). As part of this, fetuses and babies had their demise "ensured" post-operatively by severing of the spinal cord with scissors, known by staff as "snipping". Most of these were deemed infeasible to prosecute because files and other evidence were not held, although the report stipulates they numbered in the "hundreds". Among the "few cases" where tangible evidence existed, the jury noted a boy aged 30 weeks at 6 pounds; a frozen body in a water container of "at least" 28 weeks; remains of at least one abortion of over 32 weeks for which an extra $1000 had been demanded; testimony of a baby heard to make noise; and a baby left "moving and breathing for at least 20 minutes" prior to "snipping". The jury heard testimony about "special" Sunday sessions, at which only Gosnell and his wife were present, which the jury suspected (and in some cases was able to corroborate) would include cases that were more advanced in time, or more disturbing;

• Over time, Gosnell and his practice acquired a "bad reputation" and during the decade 2000–9, local community organizations ceased referring patients there. To compensate, the practice took on referrals from other in-state cities; it became understood that Gosnell's center would perform abortions "at any stage, without regard for legal limits";

• Where induced labor failed, Dr Gosnell would attempt to abort surgically, "often calamitous[ly]" for the woman involved. Example outcomes included:

• Woman "left lying in place for hours after Gosnell tore her cervix and colon"; relatives called police after entrance refused, remedial colon surgery required.

• Woman sent home with fetal remains unremoved, "serious infection" led to near death.

• Punctured uterus leading to shock from blood loss and hysterectomy; woman "held for hours" by the practice.

• Patient suffered "convulsions" and fell off the operating table, sustaining a head injury, Gosnell "wouldn’t call an ambulance, and wouldn’t let the woman’s companion leave the building so that he could call an ambulance"

• Sedation used to mute sounds of pain; Gosnell specified pre-set amounts of drugs for non-physician staff to use on patients, but without reference to individual needs, and without records or monitoring of condition. On numerous occasions, the same patient was dosed multiple times in quick succession by different employees;

• Death of Karnamaya Mongar, who received "repeated unmonitored, unrecorded intravenous injections of Demerol" (meperidine hydrochloride, an opioid analgesic which the report describes practice staff using as a cheap but dangerous sedative), and ceased breathing. Staff were unable to revive her (emergency medications were not used and the defibrillator was not working), and paramedics were unable to revive her after gaining access, in part because they were deceived by staff as to what had happened and the drugs and dosages responsible.

Government and third-party handling

• Gosnell's practice was "caught by accident" during a raid for illegal drugs prescribing. State officials had been invited to attend the raid as well, since preparations for the drugs raid had revealed prior reports and information suggesting grossly substandard practise conditions at the clinic;

• Pennsylvania Department of Health failed to regulate properly and failed to ensure that the issues noticed were addressed on the few occasions around 1990 that Gosnell was inspected; and ceased inspections "for political reasons" (to reduce a perceived deterrent) at the time Tom Ridge took office as Governor of the State;

• Inspections were still to continue if complaints were received, yet repeated complaints did not trigger an investigation; the department's response came after media exposure;

• The Department of State's Board of Medicine, which licenses and oversees physicians, had "more damning information than anyone else", including a description of the practice by an ex-employee (Choung) a decade previously (2001 and again 2002), as well as knowledge of at least one of the serious incidents cited of surgical malpractice, but took verbal assurances from Gosnell and no other effective or substantial investigative action was taken over these;

• Department of Public Health employees "regularly" visited the practice but had not adequately reported the issues present. One inspection confirmed "numerous violations of protocols for storage and disposal of infectious waste" but no follow-up occurred;

• A "health department representative" visiting for a vaccination program in 2009 "discovered that Gosnell was scamming the program" and "was able to file detailed reports identifying many of the most egregious elements of Gosnell’s practice." Her attempts to raise concerns were ignored; the Grand Jury report states "her reports went into a black hole";

• Other third parties had knowledge, but took no visible action. These included the pediatrician and subsequent head of the city’s health department, Dr Schwartz, who around 1996–97, reported concerns about the practice, concerns on which no action was taken, and who did not himself act after being promoted, University of Pennsylvania hospital and Penn Presbyterian Medical Center who treated numerous surgical failures from Gosnell's practice, including a "flagrantly illegal abortion", but reported only one of them; the National Abortion Federation whose evaluator around 2009 noted "records were not properly kept, that risks were not explained, that patients were not monitored, that equipment was not available, that anesthesia was misused" and concluded "[i]t was the worst abortion clinic she had ever inspected", but no report was made of this to any official body.

Culpability

The report divided offences by Goswell and other practice employees into three categories: "charges arising from the baby murders and illegal abortions; charges in connection with the death of Karnamaya Mongar; and charges stemming generally from the ongoing operation of a criminal enterprise". The charges recommended were:

• Gosnell, Williams, Moton, and Massof – charged with first degree murder for the post-operative killings where evidence existed that the baby was born alive

• Gosnell, Williams, Moton, Massof, and West – charged with conspiracy to commit murder in relation to "hundreds of unidentifiable instances" of post-operative killings (called "snipping" by staff). The jury also recommended charges of solicitation to commit murder by Gosnell.

• Gosnell and (as co-conspirators) Williams, West, and Gosnell's wife – charged with various violations of the Abortion Control Act, including infanticide and illegal late-term abortions;

• Gosnell, Williams, and West – charged with third-degree murder (Pennysylvania's equivalent to reckless or voluntary manslaughter), drug delivery resulting in death, violations of the Controlled Substances Act and conspiracy in regard to the death of Karnamaya Mongar. The report states: "Gosnell’s contempt for the law and his patients cost Karnamaya Mongar her life. Her death was the direct result of deliberate and dangerous conduct by Gosnell and his staff."

• Gosnell, West, and Hampton – charged with hindering apprehension, and lying to the police, medical practitioners, and the grand jury about the circumstances of Mongar's death (Hampton was also charged with perjury in the same matter);

• Gosnell – recommended to be charged with abuse of corpses, in regards to the "mutilat[ion of] babies and fetuses by cutting off their feet" and the "bizarre" storage of parts of fetal bodies in around 30 jars and other containers at his practice; his explanation that this was done for possible paternity cases was "rejected out of hand".

• The Grand Jury also concluded that "Illegality was so integral to the operation of the Women’s Medical Society that the business itself was a corrupt organization" (18 Pa.C.S. § 911, "based on a pattern of racketeering activity"):

• Gosnell, Williams, West, Moton, Joe, Baldwin, Gosnell's wife, Massof, and O’Neill – charged with running that organization or conspiring to do so;

• Massof and O’Neill – charged with theft by deception for pretending to be doctors, and billing for their services as if they were licensed physicians, and (with Gosnell) conspiracy to this effect;

• Gosnell – charged with obstruction and tampering with evidence, for altering his patient files to hide illegality and for destroying or removing other files entirely;

• Gosnell and Baldwin – charged with corrupting the morals of a minor, by hiring her 15-year-old daughter as a staff member, who was "required to work 50-hour weeks, starting after school until past midnight, during which she was exposed to the full horrors of Gosnell’s practice".

• Of Gosnell himself, the report concluded,
  
  We believe, given the manner in which Gosnell operated, that he killed the vast majority of babies that he aborted after 24 weeks. We cannot, however, recommend murder charges for all of these cases. In order to constitute murder, the act must involve a baby who was born alive. Because files were falsified or removed from the facility and possibly destroyed, we cannot substantiate all of the individual cases in which charges might otherwise have resulted."

The report also examined the failings of official parties, and the key findings, analyzed in two categories:

“Janice Staloski of the Pennsylvania Department of Health, who personally participated in the 1992 site visit, but decided to let Gosnell slide on the violations that were already evident then. She eventually rose to become director of the division that was supposed to regulate abortion providers, but never looked at Gosnell despite specific complaints from lawyers, a doctor, and a medical examiner. After she was nonetheless promoted, her successor as division director, Cynthia Boyne, failed to order an investigation of the clinic even when Karnamaya Mongar died there. Senior legal counsel Kenneth Brody insisted that the department had no legal obligation to monitor abortion clinics, even though it exercised such a duty until the Ridge administration, and exercised it again as soon as Gosnell became big news. The agency’s head lawyer, chief counsel Christine Dutton, defended the department’s indifference: 'People die,' she said.”

“Lawyers at the Pennsylvania Department of State behaved in the same fashion. Attorneys Mark Greenwald, Charles Hartwell, David Grubb, Andrew Kramer, William Newport, Juan Ruiz, and Kerry Maloney were confronted with a growing pile of disquieting facts about Gosnell, including a detailed, inside account from a former employee (Marcella Choung, 2001), and a 22-year-old dead woman. Every time, though, they managed to dismiss the evidence as immaterial... until the facts hit the fan.”

Recommendations

• The Department of Health should explicitly regulate and annually inspect abortion practices, and examine patient files, licenses, and equipment on-site;

• Second-trimester abortions should be performed or supervised by doctors who are board-certified obstetrics and gynecology;

• The Department of State "must repair its review process", including easier reporting, confidentiality, post-investigation response, with cases automatically checked against past records, malpractice databases, and full past history;

• Reports about individual doctors checked against reports of medical offices where they worked, and vice versa;

• The Department of Public Health "should do at least as much to control infectious medical waste as it does to inspect swimming pools";

• The conclusions finished by examining the extent to which legislation had been inadequate, and the scope for legislative change, concluding that:

Statutory changes are necessary as well. Infanticide and third-trimester abortion are serious crimes. The two-year statute of limitations currently applicable for these offenses is inadequate to their severity. The limitations period for late abortion should be extended to five years; infanticide, like homicide, should have none. Impersonating a physician is also a serious, and potentially very dangerous, act. Yet under current law it is not a crime at all. An appropriate criminal provision should be enacted. There may also be other statutory and regulatory revisions that we, as lay people, have not thought to consider. Legislative hearings may be appropriate to further examine these issues.

Trial

In 2011, Gosnell, his wife Pearl, and eight other clinic employees were charged in the case. Eight, including Gosnell's wife, subsequently pleaded guilty, most of whom would testify against Gosnell, and three of these pleaded guilty to third-degree murder, carrying a 20- to 40-year term. A gag order was imposed on both defense and prosecution in April 2011, to bar them from talking to the media before the trial.

In December 2011 Pearl Gosnell pleaded guilty to performing illegal abortions, conspiracy, criminal conspiracy and corrupt organization; due to spousal privilege, she will not have to testify against Gosnell, although she may still go to prison.[80] She had testified to the grand jury that she alone assisted on Sundays, and that her role was to “help do the instruments” in the procedure room and to monitor patients in the recovery room. Another employee testified that she assisted with late-term abortions “on Sundays or days we were closed [to] do special cases.” She will be sentenced after the conclusion of Gosnell's trial.

As a result, the only employee on trial with Gosnell is Eileen O'Neill, an employee who allegedly held herself out as a doctor at the clinic when she was not licensed. Her lawyer told jurors she never did so, and performed medical duties only under Gosnell's orders.

On March 18, 2013, opening statements were given in a Philadelphia court. On April 23, after the prosecution had rested its case, the judge dismissed three of the seven first-degree murder charges (the next day the judge reinstated charges related to one and dismissed another, explaining the wrong charge had been mistakenly dismissed), the one count of infanticide, and all five charges of abusing a corpse Gosnell had been charged with, as well as six of the nine charges of theft by deception faced by O'Neill. No formal ruling has yet been given for these dismissals.

Media sources following the trial have suggested that there may have been insufficient evidence of post-procedure life to sustain charges in law. Although prosecutors had argued the movements were voluntary and therefore signs of life, it was argued that the evidence offered by prosecutors were equally capable of being interpreted in some or all of these as single autonomous post-mortem motor movements or spasms instead of clinical signs of life, and additionally that none of the seven were capable of being alive as all had been previously killed clinically in utero by means of drugs as part of the procedure.

Also, although staff had used descriptions such as "jumping" and "screaming" in their testimony, Gosnell's defense noted that testimony had shown only single movements or breaths, stating that the testimony was not evidence of "the movements of a live child", and the medical examiner had also testified that tests could not determine whether or not any of the 47 fetuses found had been born alive due to tissue deterioration.

The remaining four first-degree murder charges could still have led to the death penalty. The 3rd-degree murder charges in the death of Karnamaya Mongar, the racketeering charge, and over 200 charges related to multiple violations of abortion law were also left standing.

Gosnell's defense attorney rested his case summarily without calling or questioning any witnesses, and without Gosnell taking the stand in his defense, leaving the defense case until final arguments (under US law, a defendant may choose not to take the stand; if so then the jury is instructed that no inference or assumption may be drawn from this).[96] O'Neill also did not testify in her defense.

The case went to jury deliberation on April 30, 2013.

Defendants, related charges, verdicts and sentencing

Gosnell was charged with seven counts of first-degree murder (reduced to 4 counts at trial) and one count of third-degree murder, as well as infanticide (dismissed at trial), 5 counts of abusing a corpse (all dismissed at trial), multiple counts of conspiracy, criminal solicitation and violation of a state law that forbids abortions after the 24th week of pregnancy. The non-murder charges included 24 counts of violating Pennsylvania's Abortion Act by performing illegal third-trimester abortions, 227 counts of violating a 24-hour waiting-period requirement, failing to counsel patients, and racketeering. His co-defendants were:

• Steven Massof, a medical school graduate who lacked a license, pleaded guilty in November 2011 to two counts of 3rd-degree murder for the deaths of two babies who had been born alive.

• Pearl Gosnell, Kermit's wife, was charged with abortion at 24 or more weeks, conspiracy and participating in a corrupt organization. She pleaded guilty to these charged on Dec. 13, 2011.

• Steven Massof and Eileen O'Neill, both medical school graduates without proper licensing to be doctors in Pennsylvania. Gosnell presented these employees as physicians and billed insurance companies more on this allegation. All three are charged with theft by deception for these acts.

• Kareema Cross, who testified at the state trial she had seen at least ten babies breathe after being aborted who were then killed, pleaded guilty to federal drug charges over improper distribution of pain medicine from Gosnell's clinic.

On May 13, 2013, the jury reported that they were deadlocked on two counts. After returning to deliberations, the jury convicted Gosnell of 3 counts of murder, one count of involuntary manslaughter, and many lesser counts. He was found not guilty on one of the counts of murder.

On May 14, 2013, Gosnell struck a deal with prosecutors in which he agreed to waive all his appeal rights regarding his conviction on the day earlier. In exchange, prosecutors allowed Gosnell to be sentenced to life in prison without the possibility of parole. Gosnell was then "immediately sentenced."

On May 15, 2013, Gosnell was sentenced to life in prison for the third child's murder.

Impact and aftermath

Other bodies and persons claiming to have made reports

In April 2011 the University of Pennsylvania Health System claimed as early as 1999 that they had provided to authorities reports about botched procedures by Gosnell. The only case for which any reports were produced was that of Semika Shaw, a 22-year-old, who died at the University of Pennsylvania hospital as a result of bleeding and sepsis caused by a botched procedure by Gosnell. Gosnell's insurers settled a lawsuit with family members of Shaw for $900,000. The health system also claims other undocumented reports were made orally, for which they did not have records.

Regulatory and legislative impact

The Consumer Protection and Professional Licensure Committee of the Pennsylvania State Senate led by Robert M. Tomlinson began a hearing in February 2011 to look into the failure of the Pennsylvania Department of State, charged with licensing doctors, to provide any oversight of Gosnell's activities. At the same time the Public Health and Welfare Committee of the state Senate chaired by Pat Vance conducted hearings on the Pennsylvania State Health Department's failure to put a stop to Gosnell's activities.

In part as a result of the grand jury report on Gosnell, in late 2011 Pennsylvania passed a law, SB 732, that places abortion clinics under the same health and safety regulations as other outpatient surgical centers. Among those who supported the bill was Democrat Margo L. Davidson, whose cousin Semika Shaw died as a result of procedures done by Gosnell. Davidson specificially linked her support of the additional regulations to her cousin's death, which she attributed to poor medical practices.

In May 2013 as a result of the Kermit Gosnell case Representative Joe Pitts (R-Pennsylvania) of the health oversight committee of the United States House committee of Energy and Commerce began an inquiry into state oversight of abortion clinics.

In June 2013 the Republican lead United States House of Representatives passed the Pain-Capable Unborn Child Protection Act. The speaker of the house, John Boehner, said the bill was in response Gosnell's convictions. The legislation was viewed as mostly symbolic as it stood little chance of being approved by the Democratic lead senate.

Non-legislative actions resulting from the case

In February 2011 Pennsylvania Governor and former State Attorney General Tom Corbett fired six employees and commenced action to fire eight others where for legal or contractual reasons, more extensive dismissal procedures were required. These included Basil Merenda, the acting head of the Pennsylvania Department of State, Christine Dutton, the Department of Health's chief counsel (who, in reaction to being questioned why the Department did not react to a death at Gosnell's clinic, said "people die"), and Stacy Mitchell, a deputy secretary in the health department (whom the grand jury cited as a key figure in the Health Department's indifference to, and non-regulation of, abortion clinics). Some of the people most connected by the grand jury report with the failure of the government to act, such as Janice Staloski, had retired by this point and so no action was taken against them.

Civil cases

The family of Karnamaya Mongar has brought a wrongful death suit against Gosnell and sought to freeze his assets to prevent him from transferring them to other people to avoid paying. As of April 2013 the suit is still pending.

Media coverage and public reactions

Gosnell's arrest has been the subject of much public comment and expressions of condemnation and shock by senior public figures of all parties. Mayor Michael Nutter (D-PA) said, "I think it's quite clear that, if these allegations are true, we've had a monster living in our midst" while vowing to watch the city's remaining abortion clinics more closely. Outgoing Governor Ed Rendell (D-PA) criticized Department of Health officials saying, "I was flabbergasted to learn that the Department of Health did not think their authority to protect public health extended to clinics offering abortion services", while incoming Governor Tom Corbett (R-PA) stated through a spokesperson that he was "appalled at the inaction on the part of the Health Department and the Department of State," and District Attorney of the city of Philadelphia R. Seth Williams said "My comprehension of the English language can't adequately describe the barbaric nature of Dr. Gosnell... Pennsylvania is not a third-world country... There were several oversight agencies that stumbled upon and should have shut down Kermit Gosnell long ago."

Gosnell also practiced in other states, including Delaware. In January 2011, Delaware Attorney General Beau Biden (D-Delaware) promised a wide-ranging investigations into the abortions Gosnell performed in Delaware saying; "I'm disturbed by the allegations that were handed up by the grand jury in Philadelphia".

A spokesperson for the National Abortion Federation, an association of abortion providers, noted that Gosnell had been rejected for membership following inspection, because his clinics did not meet appropriate standards of care, but that "they’d cleaned the place up and hired an RN [registered nurse] for our visit. We only saw first-trimester procedures."[44] She adding that "Unfortunately, some women don't know where to turn. You sometimes have substandard providers preying on low-income women who don't know that they do have other (safe) options."

A spokesperson for Planned Parenthood in Southeastern Pennsylvania, condemned Gosnell, saying, "We would condemn any physician who does not follow the law or endangers anyone’s health... All women should have access to high-quality care when they are vulnerable and facing difficult decisions."

Dayle Steinberg, CEO of Planned Parenthood of Southeastern Pennsylvania, says she knew that Gosnell had provided abortions in Philadelphia for many years, but says she hadn't heard of any problems at his clinic until the allegations surfaced. She has been quoted as stating that "when Gosnell was in practice, women would sometimes come to Planned Parenthood for services after first visiting Gosnell's West Philadelphia clinic, and would complain to staff about the conditions there. We would always encourage them to report it to the Department of Health." She clarified that "when Gosnell was arrested, I asked our staff if anyone had ever heard of him, and clinic staff members reported that a few women over the years said they were concerned about the uncleanliness of his facility and came to Planned Parenthood instead... if we had heard anything remotely like the conditions that have since come to light about Gosnell's facility, of course we would have alerted the state and other authorities".

Kermit Gosnell himself gave an interview to Fox 29 in February 2011, in which he stated that:

• "I expect to be vindicated."

• [Regarding the allegations] "to tell you the truth, I hope to read them in 3 to 6 months [...] because I have lived through negative publicity before."

• "It's something I have personally experienced several times before where my surgical abilities have been challenged, where the choices that I have made have not always been perfect."

• "If you are not making mistakes, you are not really attempting to do something, so I think that my patients are aware that I do my very best by them."

• "The standard that I share with everyone that, I frequently say is that I provide the same care that I would provide my own daughter I feel."

• "I have a story to tell. [...] my work to the community is of value."

• Gosnell reported that he received outpouring of support: "letters, I have gotten wonderful little messages of support, and confidence that I am a good person will prevail."

Criticism of media coverage

A perception had built up among some journalists and pro-life groups that there had been a reluctance to report on the trial among mainstream media. In an April 11, 2013 opinion column for USA Today, Kirsten Powers wrote: "A Lexis-Nexis search shows none of the news shows on the three major national television networks has mentioned the Gosnell trial in the last three months", and that national press coverage was represented by a Wall Street Journal columnist who "hijacked" a segment on Meet the Press, a single page A-17 story on the first day of the trial by the New York Times, and no original coverage by the Washington Post.

Writing for The Washington Post, Melinda Henneberger responded that "we didn’t write more because the only abortion story most outlets ever cover in the news pages is every single threat or perceived threat to abortion rights. In fact, that is so fixed a view of what constitutes coverage of that issue that it’s genuinely hard, I think, for many journalists to see a story outside that paradigm as news. That’s not so much a conscious decision as a reflex, but the effect is one-sided coverage". Explaining why some of her colleagues did not report on the story, Henneberger wrote, "One colleague viewed Gosnell’s alleged atrocities as a local crime story, though I can’t think of another mass murder, with hundreds of victims, that we ever saw that way. Another said it was just too lurid, though that didn’t keep us from covering Jeffrey Dahmer, or that aspiring cannibal at the NYPD."[132] Writing for Bloomberg View, Jeffrey Goldberg said that this story "upsets a particular narrative about the reality of certain types of abortion, and that reality isn’t something some pro-choice absolutists want to discuss".

The Los Angeles Times, The Atlantic, Slate, and Time all published opinion columns where the writer thought the incident was not getting as much media coverage as it deserved. Megan McArdle explains that she didn't cover it because it made her ill, but also how being pro-choice influenced writers saying "most of us tend to be less interested in sick-making stories if the sick-making was done by 'our side,'" saying, "this story should have been covered much more than it was — covered as a national policy issue, not a 'local crime story.'"

Martin Baron, The Post’s executive editor, claims he wasn’t aware of the story until Thursday, 11 April, when readers began emailing him about it, saying “I wish I could be conscious of all stories everywhere, but I can’t be". They ultimately decided that, in fact, the story warranted attention because of "the seriousness and scope of the alleged crimes and because this was a case that resonated in policy arguments and national politics", adding “In retrospect, we regret not having staffed the trial sooner. But, as you know, we don’t have unlimited resources, and [...] there is a lot of competition for our staff’s attention". He insisted that “we never decide what to cover for ideological reasons, no matter what critics might claim. Accusations of ideological motives are easy to make, even if they’re not supported by the facts". The New York Times also acknowledged the lack of coverage and reported on the online campaign and subsequent increase in coverage of the case. While Powers' piece clearly sparked debate among journalists, Katherine Bindley also highlights contrasting views, as does Paul Farhi. A column on Salon.com questioned whether the Gosnell case was an example of liberal media bias, noting that conservative media and politicians had also given little attention to the story until April 2013.

In April 2013, 71 other Members of Congress joined Congresswoman Marsha Blackburn in a letter condemning the media "blackout" on the Gosnell trial.

Wikipedia.org
  

Doctor Starts His Life Term in Grisly Abortion Clinic Case

By Jon Hurdle - The New York Times

May 15, 2013

PHILADELPHIA — Dr. Kermit Gosnell was sentenced on Wednesday to life in prison without parole for the murder of a baby born alive in a botched abortion, who prosecutors said would have survived if the doctor had not “snipped” its neck with scissors.

The sentence was part of an agreement that Dr. Gosnell reached with the Philadelphia district attorney’s office under which he waives his right to appeal the first-degree murder conviction and two others that a jury returned on Monday.

Under the agreement, Dr. Gosnell, 72, will be spared the death penalty, which prosecutors previously said they would seek.

Dr. Gosnell, in a dark suit similar to one he wore throughout his five-week trial, declined an offer by Judge Jeffrey P. Minehart of Common Pleas Court to speak to the court before being sentenced.

After he was told that he would spend the rest of his life in prison without parole for the murder of a victim known as Baby A, Dr. Gosnell shook hands with his lawyer, Jack J. McMahon, and was escorted out of the courtroom to begin his sentence.

Dr. Gosnell was also sentenced to a total of 30 to 60 years on two charges of conspiring to kill two of the babies and on one charge of violating the corrupt organizations act, which has to do with ordering subordinates to commit crimes. And he was sentenced to two and a half to five years on involuntary manslaughter in the case of Karnamaya Mongar, a woman who died after being given too much anesthetic in Dr. Gosnell’s West Philadelphia abortion clinic.

Outside the courthouse, members of the jury spoke publicly for the first time. The foreman, David Misko, said it had been emotionally hard for the jurors, seven women and five men, to deal with the trial’s gruesome images and searing testimony.

“It was emotionally tolling for everyone involved,” he said.

Asked what had led the jury to convict Dr. Gosnell on three counts of first-degree murder, Mr. Misko said: “Premeditation. It was business as usual. He snipped the necks no matter what.”

Mr. Misko, 27, who works for a health care company, said he had been offended by Dr. Gosnell’s expression during the trial. “He just sat there smirking,” Mr. Misko said. “It wasn’t good. I didn’t care for it.”

Sarah Glinski, one of three jurors who appeared before the news media after the trial, said she believed that Dr. Gosnell had started his clinic with good intentions of helping women who had little ability to afford abortions, but that he had gone wrong along the way.

“He is an abortion doctor who tried to give people who may not have had the money the services they needed,” said Ms. Glinski, a public affairs officer with the Defense Department. “I think somewhere, something went wrong in his mind that made him do these things to these children that were born alive.”

Ms. Glinski, 23, said she believed in a woman’s right to choose whether to have an abortion, but added, “That doesn’t mean I don’t believe in the sanctity of life.” She does not have children, which she said had made it easier to take a detached view of the evidence, but she concluded that the acts Dr. Gosnell were convicted of were “evil.”

“It was hard for me to admit that this kind of evil exists in this world,” she said.

Another juror, Joseph Carroll, 46, said he might need to seek counseling after hearing all the evidence and seeing disturbing images of aborted fetuses and of the squalid conditions and grisly items in Dr. Gosnell’s clinic, including jars of fetuses’ feet, discovered by law enforcement officers during a drug raid in 2010.

The Philadelphia district attorney, R. Seth Williams, said the Gosnell case was probably the most gruesome he had dealt with since becoming district attorney three years ago.

“I will not mince my words: Kermit Gosnell is a monster,” Mr. Williams said after the sentencing. “Any doctor who cuts into the necks, severing the spinal cords of living, breathing babies, who would survive with proper medical attention, is a murderer and a monster.”

But Dr. Gosnell’s lawyer, Mr. McMahon, reiterated his defense that his client had snipped the necks only of fetuses that were already dead.

“He believes he never killed a live baby,” Mr. McMahon told reporters. “The jury has made its decision on what happened here. We respect it, but that doesn’t mean it’s the truth.”

  

Convicted abortion doctor Kermit Gosnell is spared death penalty

Los Angeles Times

May 14, 2013

PHILADELPHIA — Kermit Gosnell, the abortion doctor convicted of killing three babies who were born alive in his grimy clinic, agreed Tuesday to give up his right to an appeal and now faces life in prison but will be spared a death sentence.

The 72-year-old Philadelphia doctor was found guilty Monday of first-degree murder in the deaths of the babies, who were killed with scissors.

In a case that became a flash point in the nation's abortion debate, former clinic employees testified that Gosnell routinely performed illegal abortions past Pennsylvania's 24-week limit, that he delivered babies who were still moving, whimpering or breathing, and that he and his assistants dispatched the newborns by “snipping” their spines, as he referred to it.

Prosecutors agreed to two life sentences without parole, and Gosnell was to be sentenced Wednesday in the death of the third baby, an involuntary manslaughter conviction in the death of a patient and hundreds of lesser counts.

Prosecutors had sought the death penalty because Gosnell killed more than one person, and his victims were especially vulnerable given their age. But Gosnell's advanced age had made it unlikely he would ever be executed before his appeals ran out.

Gosnell has said he considered himself a pioneering inner-city doctor who helped desperate women get late-term abortions. Defense lawyer Jack McMahon said before the sentencing deal that his client's bid for acquittal was a battle.

“The media has been overwhelmingly against him,” McMahon said. “But I think the jury listened to the evidence … and they found what they found.”

The gruesome details of Gosnell's operation came out more than two years ago during a grand jury investigation of prescription drug trafficking. Authorities raiding Gosnell's clinic for drugs instead found bags and bottles of fetuses, including jars of severed feet, along with bloodstained furniture, dirty medical instruments and cats roaming the premises.

Prosecution experts said one of the babies was nearly 30 weeks along when the abortion took place, and was so big that Gosnell allegedly joked the baby could “walk to the bus.” A second baby was said to be alive for about 20 minutes before a clinic worker snipped the neck. A third was born in a toilet and was moving before another clinic employee severed the spinal cord, according to testimony.

A fourth baby let out a whimper before Gosnell cut the neck, prosecutors alleged. Gosnell was acquitted in that baby's death, the only one of the four in which no one testified to seeing the baby killed.

Gosnell's attorney argued that none of the fetuses were born alive and that any movements were posthumous twitching or spasms.

Pennsylvania authorities had failed to conduct routine inspections of all its abortion clinics for 15 years by the time Gosnell's facility was raided. In the scandal's aftermath, two top state health officials were fired, and Pennsylvania imposed tougher rules for clinics.

Partisans on both sides of the nation's polarized abortion debate were quick to weigh in after the verdict. Abortion foes said the case helped to illustrate the disturbing reality of abortion.

“This has helped more people realize what abortion is really about,” said David O'Steen, executive director of the National Right to Life Committee. He said he hopes the case results in more states passing bills that prohibit abortion “once the unborn child can feel pain.”

Supporters of legalized abortion said the case offered a preview of what poor, desperate young women could face if abortion is driven underground with more restrictive laws.

“Kermit Gosnell has been found guilty and will get what he deserves. Now, let's make sure these women are vindicated by delivering what all women deserve: access to the full range of health services including safe, high-quality and legal abortion care,” said Ilyse G. Hogue, president of NARAL Pro-Choice America.

During the trial, Gosnell proved a solitary figure from beginning to end, with no friends or relatives in the courtroom, despite the fact he's been married three times and has six children, nearly all of them adults.

Gosnell did not testify and called no witnesses in his defense. But McMahon branded prosecutors “elitist” and “racist” for pursuing his client, who is black and whose patients were mostly poor minorities.

“I wanted to be an effective, positive force in the minority community,” Gosnell told the Philadelphia Daily News in a 2010 interview. “I believe in the long term I will be vindicated.”

Gosnell was also convicted of infanticide, racketeering and more than 200 counts of violating Pennsylvania's abortion laws by performing third-term abortions or failing to counsel women 24 hours in advance.

The defense also contended that the 2009 death of 41-year-old Karnamaya Mongar of Woodbridge, Va., a Bhutanese immigrant who had been given repeated doses of Demerol and other powerful drugs to sedate her and induce labor, was caused by unforeseen complications and did not amount to murder, as prosecutors charged.

Bernard Smalley, a lawyer for the woman's family, said he now hopes to bring “some sense of justice and quiet to this family that's been through so much."

  

Dr. Kermit Gosnell and the Philadelphia Abortion Mill

BY Tricia Romano - TruTV.com

Inside the Clinic

For over 30 years, Dr. Kermit Gosnell ran the Women's Medical Society in Philadelphia. Ostensibly, this was a women's health clinic, where abortions were performed, but also where women could get check ups and prescriptions.

In a normal clinic, the walls are white, the lights are bright, and everything is sterilized and sparkling clean.

In Dr. Gosnell's world, the walls, the furniture, the chairs, the hospital beds, were bloodstained. The surgical tools used to operate on women often went uncleaned between patients. Fetal parts were kept in the freezer and in jars that lined the hallways. Medical equipment -- tools used for saving lives -- were broken and corroded. The office was a dangerous maze of narrow hallways, which made moving women from floor to floor or room to room difficult.

But these unsanitary conditions were only part of the egregious violations that Gosnell and his cast of unsavory characters allegedly performed on a regular basis at this clinic.

The Grand Jury investigation report overseen by District Attorney R. Seth Williams is a mind-boggling 281 pages -- enough for a novel.

For several months, according to the Grand Jury report, Gosnell had been carelessly handing out prescriptions for drugs like Oxycontin. This is perhaps the only reason he was caught. The Drug Enforcement Agency (DEA), the Philadelphia Police Department, and the Dangerous Drug-Offender Unit busted into Gosnell's clinic on February 18, 2010. While their aim was to find evidence supporting their drug-trafficking charges -- they instead saw that Gosnell's clinic had entirely different problems -- problems that seemed far more serious.

According to the Grand Jury investigation, the conditions inside were described by the agents as: "filthy," "deplorable," "disgusting," "very unsanitary, very outdated," and "horrendous."

"There was blood on the floor. A stench of urine filled the air. A flea-infested cat was wandering through the facility, and there were cat feces on the stairs. Semi-conscious women scheduled for abortions were moaning in the waiting room or the recovery room, where they sat on dirty recliners covered with blood-stained blankets."

What investigators learned as they began interrogating the employees and going through the files, is that Dr. Gosnell didn't run a health clinic -- he ran a death clinic.

Dr. Gosnell and several of his employees are charged with killing one adult woman, and seven newborn babies. It is alleged that he and his staff killed babies by severing their spinal cords with scissors after they were born from induced labor. Countless others are alleged to have been delivered into a toilet by the women, and fished out later so as not to clog the pipes.

In the state of Pennsylvania, the cut off date for a late-term abortion is 24 weeks. The gestation period is determined by ultrasound. Women who elected to have a late-term abortion must wait 24 hours before undergoing the procedure; and they must receive counseling about other options.

In Dr. Gosnell's clinic, ultrasounds were routinely fudged to show that the women were not as far along in their pregnancies. Counseling and 24-hour waiting period were waived in lieu of cold, hard cash.

When he wasn't killing babies or patients, the Grand Jury report alleged, he was infecting women by not using sterilized tools. He spread venereal disease from patient to patient -- oftentimes young women from poor backgrounds and immigrant communities. During his surgical procedures, he would often puncture and perforate women's wombs. They would later need hysterectomies or further surgery. Often, they would be deprived of being able to have babies. Sometimes, according to the report, he'd leave behind fragments of the fetuses, causing his patients to get infections and nearly die. When they would get so sick that they would need to go to an emergency room, Gosnell and his staff would refuse to let them go. It didn't matter: the hallways were too narrow to transport patients on a gurney. And the emergency exit was padlocked; the key was hard to find, and the lock harder to open.

The clinic was open for over 30 years; and despite numerous reports and incidents, it had never had a full inspection by the heath authorities in the state. There is a now lawsuit underway brought by the family of one of the victims.

The Staff

During the day, Gosnell's clinic was primarily used for seeing patients and prescribing drugs. A pre-signed pad was left at the clinic so that staff -- none of whom were licensed doctors and nurses -- could write prescriptions at will. According to the Grand Jury report, it is estimated that Gosnell pulled in hundreds of thousands of dollars a year. The Grand Jury report also stated "Gosnell was one of the top three Oxycontin prescribers in the state of Pennsylvania." He had written so many prescriptions that by 2010, a nearby pharmacist had stopped filling the prescriptions coming from Gosnell's clinic.

Based on the evidence, the Grand Jury recommended charging Gosnell and part-time employee Steven Massoff with conspiracy to violate the Controlled Substances Act.

The fact that none of the employees on his full time staff were trained medical professionals was the biggest red flag that Gosnell was not operating a normal facility. His staff was entirely untrained and paid nearly minimum wage, often in cash.

Among his employees were Ashley Baldwin, a 15-year old full-time high school student, and her mother, Tina Baldwin, who'd worked for Gosnell for nine years. Also employed by Gosnell were Latosha Lewis, Lynda Williams, and Sherry West. In all cases, the women were overseeing and participating in procedures that were far above their pay grade -- which wasn't much. Lewis was paid $7 an hour -- with overtime, but then was "upgraded" to $12 an hour and no overtime. If she worked on a late-term abortion, she could get a bonus of $20. West was paid between $8 to $10 an hour.

Like the others, the high school student was given absurd responsibilities: performing ultrasounds, giving patients drugs, and helping with the surgeries. While Tina Baldwin and Lewis had attended the Thompson Institute and received rudimentary medical training, only Baldwn received a certificate of completion -- in 2009, near the end of her tenure. Williams, in helping with procedures, would allegedly deliver babies, born fully alive, and then sever their spinal cords -- as she had learned from the doctor. Sherry West, a former patient of Gosnell's, was diagnosed Hepatitis C and never used gloves or other sanitary precautions when touching patients, administering IVs and drawing blood.

There were others -- including Randy Hutchins (the only licensed medical provider briefly on staff,) Maddline Joe, Steve Massof and Eileen O'Neill (medical school graduates who were unlicensed and never entered a residency program,) and Andrea Moton, who "assisted" with surgeries and allegedly killed living babies. Also on staff was Pearl Gosnell, Dr. Gosnell's wife. She administered drugs and performed medical procedures, but her only license was for Cosmetology.

Even Gosnell himself was not board certified and was not officially an obstetrician or gynecologist.

The Procedures

Despite being in charge of the clinic, Gosnell was almost never on the premises, leaving his untrained, incompetent staff alone. They would only resort to calling him once in a while because, as they told the Grand Jury, he had a temper and didn't like to be bothered. What was Dr. Gosnell doing while his patients moaned in pain, unmonitored by his minimum-wage staff? Swimming, jogging and relaxing.

Meanwhile, his staff were performing dangerous procedures -- using outdated, unsterilized and often broken equipment.

The motive for the madness at the Women's Medical Society was simple: money. In a normal medical clinic, only a doctor administers drugs; this is especially important during surgical procedures when the patient needs to be under anesthesia. But at Gosnell's clinic, drug packages were sold to women, often for abortions that in a normal clinic would be done in an hour and not require any major pain medication.

The choices were outlined in a handwritten chart made by Ashley Baldwin, the 15-year-old high school student.

The words "Heavy," "Twilight," "Custom" and "Local" were color-coded with yellow, green, and blue dots. The amount of drugs for each was incredibly high by any standard, and included a mixture that often could have dangerous double effects on the central nervous system.

The "recipe" for "Twilight": 75 milligrams of Demerol (meperidine); 12.5 milligrams of promethazine (Phenergan); and 7.5 milligrams of diazepam (Valium).

They were administered without regard to the height or weight of the woman receiving the treatment, not to mention her prior medical history.

Latosha Lewis told the Grand Jury how the patients were presented with their choice of medicine: "You can pick which anesthesia you want to receive, whether you want to be up, half asleep, if you want to be knocked out, and it's additional to your procedure, but local anesthesia is included in the smaller cases and custom anesthesia, which is the highest, to be put to sleep in the bigger cases."

Again, no qualified anesthesiologist was on staff.

The cost of the medicines were printed on a chart that advised:

It will probably be best to pay the extra money and be more comfortable if some of the following conditions are true for you.

1. The decision to have the procedure is a difficult decision.

2. Medication is usually necessary for your menstrual cramps.

3. Your decision has been forced by your parents or partner.

4. Your family members or friends 'don't like pain.'

The drugs cost $50 more for heavy sedation; $140 for twilight sedation and $200 for the custom option. The cost of an abortion was rated based on how far along the mother was -- if the woman was willing to pay cash and was only four to eight weeks pregnant, the procedure cost $450. But women who were between 21 to 24 weeks pregnant paid between $1575 to $1850 in cash.

For those women who were there for the late term abortions, the procedures were a two-day affair. They would arrive the afternoon or evening prior to the operation, and one of Gosnell's untrained staff would start inducing labor. Cytotec was given to most of the women to begin contractions. Normally put inside a patient's lip, Williams habitually put in it inside their vaginas. Sometimes, the staff would sometimes insert synthetic or seaweed rods called laminaria the night before their procedure, to help the dilation of the cervix. This procedure is delicate and should be performed by a doctor.

Because the cramping from the laminaria and the Cytotec was so severe, the women were often in excruciating pain for hours at a time. Gosnell was usually not on the premises. This meant they were immediately drugged -- often to the point of overdosing. Restoril, a sleep disorder treatment with muscle relaxant properties, was the drug of choice -- often given in addition to the sedation packages.

Most of the time, eight or ten women were kept in a single room, moaning and groaning in pain. Gosnell's instructions were to drug them up as much as possible to "quiet them."

Tina Baldwin testified at the Grand Jury that they would take the loudest woman, "Put her in a room, let's give her her medication, quiet her up. She's upsetting everybody else. So usually she would get done first."

Sometimes, Baldwin testified, Gosnell would slap women to get them to shut up; if that didn't work, he would completely sedate them. He did this because he was afraid that any screaming would be cause for attention from the police.

The Death of Karnamaya Mongar

Though the amounts given were already careless, a bigger problem was that the staff didn't keep track of when they had dosed someone, or how much they had already dosed someone. In some cases, they didn't even follow the dosage as laid on the pre-sale chart. This was especially true of Sherry West and Lynda Williams. According to testimony by another employee, Kareema Cross, Williams routinely used too much medication in her drug dosages, causing Cross to complain about it to Gosnell himself. Gosnell responded by instituting a logbook of drug dosages -- but that was only put in place to keep them from spending too much money. They still did not keep track of the drugs on the patient charts.

Even more troubling, the clinic was not outfitted with up-to-date or working monitoring equipment. At hospitals, patients are hooked up to machines that keep track of their heartbeats and their breathing. According to the Grand Jury report, "Without the benefit of machines, monitoring at a minimum would require physically watching the patients to make sure they were breathing. Neither Williams nor West did this."

This reckless and cavalier attitude towards administering heavy drugs is what ultimately led to the overdose and cardiac arrest of Karnamaya Mongar.

Mongar was a 41-year old Nepalese refugee. She was only 4'11" and 110 pounds. She had a daughter, Yashoda Gurung, and was married. On 2:30, November 19, 2010, she was admitted to the clinic, and immediately dosed with Cytotec and Restoril by Williams and West. Gosnell was not on site, but Gurung clearly thought the two women were doctors, and referred to them as such. They did nothing to dissuade her.

According to the Grand Jury report: "Mrs. Gurung testified that, between 3:30 and 8:00 p.m., her mother was given five or six doses of oral medicine." The medicine was likely Cytotec. She was then put to sleep for a few hours. They didn't stay in the room to monitor Mongar. When Mongar's daughter tried to visit her mother in the recovery room, she found her mother unresponsive -- instead of double-checking on her mother's vital signs, the staff told her that she was sleeping and sent Gurung to another waiting room until the doctor arrived.

Dr. Andrew Herlich, the Chairman of the Anesthesia Department at the University of Pittsburgh Medical Center, testified about the dosages used by Gosnell and his staff as being outrageous. "Mr. Herlich opined that if average-sized adults, with no particular sensitivities to the drugs, were given two 'custom' doses within four hours, 'most would stop breathing.'"

Gosnell had arrived and was attempting to perform CPR; when that failed, they went upstairs to retrieve the "crash cart," which contained medication that can help revive someone having a heart attack. They attempted to use the defibrillator. But like most of the medical equipment at the facility, it didn't work.

An ambulance was ultimately called at 11 p.m., three hours after Mongar's daughter had seen her be unresponsive. Gosnell and his staff omitted key facts: they didn't tell the EMTs that she had been given Demerol. By the time EMTs arrived, they had removed her IVs. They also hadn't bothered injecting her with Narcan, which can jump start a failing heart.

At least ten minutes had passed between the administering of CPR and the 911 call; more minutes still passed when the medics couldn't get into the facility because of the locked emergency exit.

After 45 minutes, Mongar's heart started beating and she was taken to Intensive Care at the hospital where she was put on life support until her family could arrive. She was pronounced dead the next day.

Viable Babies

An 18-page chapter in the Grand Jury report is entitled "The Intentional Killing of Viable Babies." Gosnell was supposed to perform abortions, but because he often performed abortions on women who were well past the legal limit of 24 weeks, many of the fetuses were fully-formed and could survive if delivered. The practice of inducing labor, actually meant that many of the women gave birth. Sometimes they were told to sit on a toilet and expunge the baby, because Gosnell was not there to oversee the procedure. Other times, a baby would come out of the womb and Gosnell would take a live, screaming, kicking baby and sever its spinal cord with a snip of the scissors. It was a practice, the Grand Jury report alleges, that happened hundreds of times over the years, but because much of the paperwork and evidence was destroyed, there were only seven provable incidents.

His young victims included Baby Boy A, nearly 7 and a half months, killed and discarded in a plastic shoe box. Baby Boy B, 28 weeks, was frozen forever in a gallon water bottle. Baby C was living in the world for 20 minutes before Williams, according to testimony by Cross, came in and extinguished the new life with a slice to the neck, as she'd seen Gosnell do.

Kareema Cross had actually taken a picture of Baby A, because he was so large. At 18 to 19 inches, he was large enough for the doctor to joke about: "This baby is big enough to walk around with me or walk me to the bus stop."

Cross testified: "I knew something was wrong because everything, like you can see everything, the hair, eyes, everything. And I never seen for any other procedure that he did, I never seen any like that."

Where were the authorities? Surely a place this disgusting and dangerous would have been noticed and reported. Though many of the women were likely too scared to go to police (they had after all, undergone an illegal procedure), many times they would turn up at hospitals with fetal remains still inside them, bleeding from puncture wounds, or going into septic shock from infection. The doctors who treated these women would sometimes alert authorities, attorneys who were representing some of the women would complain to the Department of Health. The powers that be even knew that a woman had died while at his clinic and had been tipped off by a former employee to the full extent of the conditions there years earlier.

Incredibly, though, no one inspected the premises between 1993 and 2010, and Gosnell stayed in business.

Charges

It may have taken 30 years, but the process of justice for the women who went to Gosnell's clinic is moving swiftly. Mongar's family is suing the city of Philadelphia over her death; they have also filed a civil suit against Gosnell. Other malpractice suits are under way as well.

Gosnell, his wife, and eight members of his staff have been charged by the city for their actions at the clinic. Most have pleaded guilty to reduced charges. Below is a breakdown of the charges.

Kermit Gosnell, 70, is charged with eight counts of murder -- one for Mrs. Mongar and one each for Baby Boy A, Baby Girl A, Baby Boy B, Baby C, Baby D, Baby E, Baby F and Baby G. He is also charged with multiple counts of infanticide, drug delivery resulting in death, conspiracy to commit murder, solicitation to commit murder, abuse of a corpse, racketeering, theft by deception, participating in corrupt organizations, Controlled Substances Act violations, obstruction, tampering with evidence, hindering prosecution, and abortion at 24 or more weeks.

Gosnell's wife, Pearl Gosnell, was charged with abortion at 24 or more weeks, conspiracy and participating in corrupt organizations. She pleaded guilty on Dec 13, 2011 to performing an abortion after 24 weeks of pregnancy, two counts of conspiracy and participating in a corrupt organization. Her original Feb 15, 2012 sentencing date was deferred to March 21, 2012, when it will again be deferred until Sept. 12, 2012.

Lynda Williams, 42, was charged with murder in the 3rd degree, conspiracy, abortion at 24 or more weeks, participating in corrupt organizations, drug delivery resulting in death and related charges. On November 9, 2011, Williams pleaded guilty to two counts of murder in the 3rd degree, two counts of conspiracy, participating in corrupt organizations and drug delivery resulting in death. Her sentencing is set for March 21, 2012.

Sherry West, 51, was charged with murder in the 3rd degree for the death of Mrs. Mongar, abortion at 24 or more weeks, conspiracy, tampering with records, hindering prosecution, obstructing administration of law and other related offenses. She pleaded guilty on Oct. 27, 2011, to murder in the 3rd degree, conspiracy, drug delivery resulting in death, and participating in corrupt organizations. Her sentencing is set for Sept. 12, 2012.

Adrienne Moton, 33, was charged with murder in the 3rd degree, conspiracy, conspiracy to commit murder and participating in corrupt organizations. She pleaded guilty on Oct 27, 2011, to Murder in 3rd Degree, conspiracy and participating in corrupt organizations. Her original Feb 15, 2012 sentencing date was deferred to March 21, 2012, when it will again be deferred until Sept. 12, 2012.

Dr. Gosnell's sister-in-law, 51-year-old Elizabeth Hampton was charged with obstructing administration of law, hindering prosecution, perjury, and false swearing. She pleaded guilty on Oct 13, 2011 to perjury. Her sentencing is set for Sept. 12, 2012.

Eileen O'Neill, 54, is a medical school graduate who worked as doctor at the clinic. She had no license or certification. She was charged with theft by deception, conspiracy, perjury, racketeering and false swearing.

Tina Baldwin, 45, was charged with participating in corrupt organizations, conspiracy, and corruption of a minor. According to the DA, she allowed her teenage daughter to administer anesthesia. She pleaded guilty on Nov 14, 2011, to participating in corrupt organization, conspiracy, and corruption of a minor. One conspiracy charge was dropped.

53-year-old Maddline Joe was charged with conspiracy and participating in corrupt organizations. She was the office manager at the clinic. Her trial is scheduled for March 14, 2013. Pre-trial hearings will start August 13, 2012.

An unlicensed medical school graduate, Steven Massoff, 48, was charged with3rd degree murder in deaths of two babies, conspiracy, theft by deception and participating in corrupt organizations. He pleaded guilty on December 13, 2011 to both counts of 3rd degree murder, conspiracy and participating in corrupt organizations.

District Attorney Seth Williams, who oversaw the Grand Jury report, told reporters "I am aware that abortion is a hot-button topic, but as district attorney, my job is to carry out the law. A doctor who knowingly and systematically mistreats female patients, to the point that one of them dies in his so-called care, commits murder under the law."

Perhaps the good doctor didn't understand what he was doing was wrong. It seems impossible.

At the time of his arraignment, the AP reported that Gosnell didn't understand why he was being charged with eight murders. He told a magistrate. "I understand the one count, because a patient died, but I didn't understand the seven counts."

TruTV.com