The state of California and Providence St. Joseph Hospital have agreed to a proposed stipulation under which the hospital’s care staff will follow the state’s Emergency Services Law by allowing physicians to terminate a patient’s pregnancy when necessary to protect a mother’s health.
The proposed stipulation — which does not represent a settlement in the case and includes no admission of liability by the hospital — is not binding until signed by a judge.
But it does represent a swift effort to address some of the issues in the underlying lawsuit brought by the California Attorney General’s Office, which alleges the hospital endangered a local woman’s life when it refused to abort a nonviable pregnancy in February due to concerns the procedure would violate the hospital’s policies, which adhere to the Ethical and Religious Directives for Catholic Health Care Services created by the United States Conference of Catholic Bishops.
The proposed stipulation filed with the court Oct. 28 states the hospital and the state agree to take all hearing dates off the court’s calendar for the time being as settlement discussions continue. Further, St. Joseph agrees to allow physicians to terminate a patient’s pregnancy whenever they determine that failing to immediately do so would jeopardize the patient’s health, impair their bodily functions or result in “serious dysfunction of any bodily organ or part of the patient.” Further, the hospital agrees that it will not transfer a pregnant patient without first providing all emergency services necessary to the point that transfer will not result in “a material deterioration” of their condition or expected chances for recovery.
“[St. Joseph Hospital] agrees that, within seven days of the issuance of this order, the Providence Hospital shall provide written notice of this order, and all obligations under it, to all of Providence’ Hospital’s medical staff and each and every physician with privileges at Providence Hospital,” the proposed court order states, adding that, if signed by a judge, it would be enforceable by the court.
The underlying lawsuit filed Sept. 30 alleges that St. Joseph Hospital violated state law requiring hospital emergency rooms to provide care necessary to prevent not only maternal death but “serious injury or illness” when it reportedly denied care to Anna Nusslock in February.
Nusslock, a local chiropractor, was 15 weeks pregnant with twin girls when her water broke and she arrived at St. Joseph Hospital, bleeding and in severe pain on Feb. 23, according to a sworn declaration. After an ultrasound, Nusslock said Sarah McGraw, the doctor on call that night at St. Joseph, diagnosed her with preterm premature rupture of membranes and told her that while both fetuses still had detectable heart tones, they had “essentially” no chance at survival and attempting to continue the pregnancy carried “significant maternal morbidity and mortality” risks.
But Nusslock alleges the hospital refused to perform the needed abortion and instead discharged her to be driven by her husband to Mad River Community Hospital, saying a nurse gave her a bucket and a towel “in case something happens in the car.” Nusslock reportedly arrived at Mad River having passed an “apple-sized blood clot” and bleeding heavily before being rushed into emergency surgery. The physician who treated Nusslock at Mad River said in a sworn declaration filed with the court that she arrived “not clinically stable” and “appeared to be deteriorating.”
St. Joseph Hospital issued a statement after the suit was filed saying it was “heartbroken” over Nusslock’s experience, then sent a message to staff the following day saying, “this was a tragic situation that did not meet our high standards for safe, quality, compassionate care.”
“We are immediately re-visiting out training, education and escalation processes in emergency medical situations to ensure that this does not happen again and to ensure that our care teams have the training and support they need to deliver the best possible care for each patient we serve,” the hospital said.
A press release from Attorney General Rob Bonta’s office asserted the lawsuit was an “especially critical” step because Mad River Community Hospital had recently announced it would close its labor and delivery unit this month, leaving patients in Nusslock’s position to “face an agonizing choice of risking a multi-hour drive to another hospital or waiting until they are close enough to death for Providence to intervene.”
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