Health Care

Missouri lab records show evidence of failed abortion at clinic with ‘re-aspiration’

Planned Parenthood advocates march in St. Louis, last abortion clinic in Missouri could close

Protesters opposed to Missouri's restrictive abortion law gathered at the St. Louis arch Thursday, May 30, 2019. Anti-abortion protesters maintain presence at the clinic.
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Protesters opposed to Missouri's restrictive abortion law gathered at the St. Louis arch Thursday, May 30, 2019. Anti-abortion protesters maintain presence at the clinic.

An inspection report from a lab that reviewed tissue samples from an embattled Planned Parenthood clinic in St. Louis shows evidence of a failed or incomplete abortion that necessitated a second procedure a month later.

State officials, in a court fight with Planned Parenthood over the facility’s license, have cited the lab report as one reason they want to interview physicians who worked at the clinic.

“A failed surgical abortion — a very rare complication — in which a woman remains pregnant after a surgical procedure, can usually be detected by the examination of fetal tissue confirming the abortion was performed both by the physician performing the abortion and pathological examination by an accredited laboratory,” officials with the Missouri Department of Health and Senior Services said in a news release. “State law and standard of care require the physician to grossly examine tissue at the time of the procedure.”

Planned Parenthood officials have said the interview requests amount to “interrogations” meant to intimidate the doctors. Some are residents and fellows that the organization can’t compel to talk to state officials because they don’t work for the clinic, officials said.

They’ve sued the state and a judge has temporarily blocked regulators from pulling the license while the case is active. If the clinic closes, Missouri would become the first state since Roe v. Wade without a place to get a legal abortion.

Colleen McNicholas, a doctor who heads clinical care at the Planned Parenthood clinic, said Friday its “top priority has always been the health of our patients” and called the state’s news release about the lab “a diversionary tactic” and “fearmongering.”

“The state continues to hold our license hostage, creating worry and uncertainty for our patients,” McNicholas said. “Planned Parenthood continues to focus on caring for every person who walks in our doors, and that will remain our matter what distraction tactics the state chooses to deploy next.”

Planned Parenthood officials didn’t immediately respond Monday to a request for comment on the lab inspection report itself.

The lab, Columbia-based Boyce and Bynum Pathology Laboratories, also didn’t respond.

Page 1 of 12, Boyce and Bynum Pathology Laboratories inspection report Click here for the entire report
Page 1 of Boyce and Bynum Pathology Laboratories inspection report

Missouri Gov. Mike Parson, an abortion opponent, has said the state is investigating three failed abortions at the St. Louis clinic. The lab report shows evidence of only one.

Vacuum aspiration, in which the contents of the uterus are sucked out, is the most common form of surgical abortion for pregnancies of less than 15 weeks.

According to the report, the lab received tissue from a procedure performed May 26, 2018 and a lab employee wrote that it indicated a completed abortion. But the lab then received a “re-aspiration” sample from the same patient on June 30, 2018, that also contained “placenta and fetal parts.”

Researchers have found that vacuum aspiration results in completed abortions 95% of the time or more. Serious complications are extremely rare, with one study on abortions conducted in New York City finding they happened less than 0.1% of the time. When they do occur, they can include infection, excessive bleeding, incomplete evacuation of the uterus and ongoing pregnancy.

After a vacuum aspiration abortion, tissue is reviewed by both the physician and a pathologist in part to make sure the woman does not have an ectopic pregnancy — a potentially deadly condition that occurs when a fertilized egg implants somewhere other than the uterus.

There is no information in the Missouri lab inspection report about whether the unnamed patient had serious complications.

Inspectors cited Boyce and Bynum for mishandling the incident, including not communicating the “unexpected findings” with the physician involved and not revising the report on the first sample after receiving the second.

Inspectors also cited the lab for other deficiencies related to training and quality control in the report dated April 29..

The lab submitted a plan to correct the problems to the federal Centers for Medicare and Medicaid Services.

Results of a state inspection of the Planned Parenthood clinic in St. Louis, conducted in March, have not been released yet because the process is not complete.

Thomas reported from Jefferson City.

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Kansas City Star health reporter Andy Marso was part of a Pulitzer Prize-finalist team at The Star and previously won state and regional awards at the Topeka Capital-Journal and Kansas Health Institute News Service. He has written two books, including one about his near-fatal bout with meningitis.
Crystal Thomas covers Missouri politics for The Kansas City Star. An Illinois native and a graduate of the Missouri School of Journalism, she has experience covering state and local government.