ARTICLES

Not a Back-Alley Clinic

THIS IS CHULA VISTA

It's not a back-alley abortion clinic (though its principal physician once botched an abortion so badly that he's on five years medical probation): it's at 335 West H Street in Chula Vista.

It's not a back-alley abortion clinic (though another doctor, accused of botching an abortion last year, is still under California Medical Board investigation): there's a credit union and a florist shop next door.

It's not a back-alley abortion clinic (though yet another doctor had his license suspended by the California Osteopathic Board for sexual misconduct with his patients while performing their abortions): if you cross Third Ave, you come to St. Rose of Lima Parish, at 293 H Street.

It's not a back-alley abortion clinic: it's Clinica Medica Para La Mujer de Hoy ("Clinic For Today's Woman"), and its pink flyers tout "doctors with many years of experience."

"Oh, how cheesy," said Mary Lou when shown the flyer. Mary Lou, who works at Marilyn's Flower Shop at the corner of H and Third, is a Latina, so she rapidly read the Spanish-language flyer. "God this is incredible," she said: "'$10 off.' Ten dollars off if you have this (flyer) in your hand. God how cheesy can you get." The discount apparently applies to "family planning methods" such as IUD insertion.

Mary Lou, who has worked there for six years, was unaware that at abortion clinic was on the same block. I told Mary Lou (who declined to give her last name) that the physician who had opened it, Nicholas Braemer, was on probation with the California Medical Board for a botched abortion, and she asked pointedly, "Is it a hospital? What if all of a sudden they get an emergency...."

The medical board must have similarly worried, for in putting Braemer on probation, it restricted his medical practice. During his probation, which began in January 1995, Braemer "shall perform abortions only in a hospital approved by the Joint Commission on Accreditation or in a practice setting approved in advance by the Division or its designees."

Braemer agreed to the terms of probation in August 1994, perhaps because his license was almost revoked. In fact, the medical board did suspend his license to practice medicine for 90 days. And the cause of all this discipline from the medical board was an abortion he performed with "gross negligence" in 1987, an abortion, the medical board found, botched "through haste, inattention and neglect of his professional medical responsibilities" -- all of which Braemer himself admitted in accepting probation.

"On or about Aug. 26, 1987," the disciplinary order said, "the respondent (Braemer) performed an elective abortion by dilation and extraction on "Z.A.", a 27-year-old female patient then approximately 15 to 18 weeks pregnant with a viable female fetus.

"The abortion performed by respondent was successful in removing only one arm of the fetus, and the remainder was left behind. Through haste, inattention and neglect of his professional medical responsibilities, the respondent failed to notice that he had not removed the entire fetus and failed adequately to explore his patient's uterus at the end of the procedure to determine that it was empty. The patient was sent home with antibiotics and told to return in a week.

"A day later, after experiencing labor-like pains and fever, while at home, the patient miscarried a stillborn fetus missing an arm.

"On Aug. 28, 1987, the patient was admitted to Torrance Memorial Hospital for infection and completion of the abortion by means of a vacuum suction curettage. She was discharged on Aug. 30, 1987."

That was enough for the medical board to judge Braemer guilty not only of "gross negligence" but also "repeated negligent acts" and "incompetence" as well. He was ordered as part of his probation to take courses in medical education and ethics and to demonstrate competence by passing an exam. He was assigned a monitor, another California-licensed physician to serve as sort of a medical parole officer. Braemer must make quarterly reports to the medical board's Division of Medical Quality on his compliance with probation.

In spite of all these time-consuming burdens, however, Braemer has found time to practice at a dozen locations throughout southern California (according to his business card) and to open the Chula Vista women's clinic in January 1997 (according to his receptionist).

Another business card from the clinic lists not just Braemer but "Mohamed Dia, M.D." and a "Dr. Reish" (there was no first name). The clinic receptionist said that Dr. Reish's first name was Laurence, also that his last name was spelled with a "c" not "s", so the business card has a typo, apparently. Linda Bergmann, director of the Sacramento-based California Osteopathic Board said that Laurence Reich is currently an osteopath in good standing. That explains the lack of "M.D." after his name on the business card but, according to Bergmann, "he's required to put 'D.O.' (for Doctor of Osteopathy) on that, and it's strange that his name is spelt wrong there." Bergman explained that D.O.s are licensed to prescribe drugs and perform surgery just as M.D.s do, and have equal hospital privileges, but D.O.s are trained under a medical theory which stresses the bones and the joints and their therapeutic manipulation.

Reich is in good standing, but he completed a 10 year probation in 1994 for a conviction in Santa Monica. Bergman gave me the case number: M107591. The Scarlet Survey by Kevin Sherlock, a handbook of documented abortion malpractice, says that the case, Santa Monica vs. Reich, involved a botched abortion -- and sex crimes against patients. "Santa Monica police arrested Reich in January 1982," Sherlock writes.

An investigation headed by a female police officer found two of Reich's abortion patients who charged that he had sexually assaulted them before and after performing abortions on them. No wonder one of the women also charged that Reich botched her abortion with the result that she had to return to him to have the rest of the fetus removed. "Prosecutors brought 28 criminal charges against Reich," Sherlock writes. "They charged him with assault, battery, unprofessional conduct (sexual abuse of patients), prescribing drugs without a license, falsely representing himself as a medical doctor, and attempting to coerce or persuade his victims into refusing to testify against him.

"In a plea-bargain arrangement made in June 1984, Reich pleaded 'no contest' to two counts of battery and two counts of misrepresenting himself as a medical doctor. Prosecutors dropped the other charges against him. Santa Monica Municipal Court judge Laurence Rubin fined Reich $3200 for his crimes.... However, he did not make Reich serve any jail time."

No wonder Bergmann, towards the end of our interview, asked me somewhat anxiously whether I had heard of Reich being accused of anything recently. I told her, no, but he was sharing a woman's clinic with a doctor who was.

Mohamed Dia, M.D., is under a September 1998 accusation, according to the California Medical Board website (www.docboard.org), but "the physician has not had a hearing or been found guilty of any charges." An eleven-page fax from Candis Cohen at the board headquarters in Sacramento gave the gory details.

Ironically, one patient had come to Dia on Dec. 14, 1996 after another physician botched her abortion -- "specifically, the patient had suffered a uterine perforation and the small bowel had been pulled through, with the possibility that the bowel had been perforated as well--only to have Dia botch it more. Although the patient was "running high spiking fevers (maximum 103.2°), which would be indicative of abscess and infection," Dia discharged her Dec. 16, claiming that her fever had gone down and she was "improving."

Wrong, said the medical board: "He discharged the patient despite her having spiking high fevers which were a clear indication that she was NOT improving or afebrile, and compounded this by instructing her to return in a week, which could be considered tantamount to abandonment."

By Dec. 20, the patient was very ill, and returned to Dia's office. Admitting her to Torrance Memorial Hospital, he handed her over to another physician's care. "Tests at Torrance Memorial revealed a huge abdominal abscess, huge amounts of fluid in the peritoneal cavity, and extremely high temperature, pulse, and white blood cell count. The patient subsequently three surgeries and remained hospitalized for over a month."

The medical board threw the book at him for his gross negligence in the case of another patient: this time it was Dia himself who perforated her uterus in performing an abortion. Recognizing that fact, and in the light of her "considerable bleeding," Dia "transported the patient to a hospital using the clinic van. At the hospital, he performed a laparotomy and removed the rest of the fetus and repaired the perforation."

What's wrong with that? Dia had both done too little and too much. He did too little when he "had the patient transported using the clinic van while she was bleeding and hypotensive, rather than calling 911 and having her transported by ambulance." He did too much when at the hospital he performed "the laparotomy procedure, which requires an assistant surgeon, without having appropriate back-up in case of emergency."

During the original abortion, Dia did too little when he failed to personally size the fetus; he did too much "performed a second trimester abortion in a clinic, using general anesthesia, in a clinic which was unsuitable and unequipped for the foreseeable and more frequent complications of such a procedure, rather than a hospital."

Interestingly, the name of the clinic where all this happened in August, 1996 was "La Clinica Medica Para La Mujer."

The accusation didn't give the location, but I figured it wasn't Chula Vista, since that one hadn't opened yet. I called Cohen at the medical board to find out -- and wherever it was Dia botched his abortion -- whether it was a clinic opened by Braemer. Anytime a physician hangs out a shingle with a name on it other than his own he must apply for a fictitious name permit. Cohen's database was crawling with Clinica-Medica-Para-La-Mujers, give or take an adjective or definite article. The one which exactly matched the one cited in the medical board's accusation -- it had a "La" in front of it -- was located at 6900 Van Nuys Blvd.

"It's not paid and up to date," said Cohen, "and it expired in 1995." Braemer's name was not connected with it, and Dia's slip of the knife happened in 1996. Perhaps the medical board's accusation got the clinic's name slightly wrong. Cohen, not having the case file in front of her, could not help more than that.

Her search did pull up a "Clinica Medica Para La Mujer de Hoy" registered in Braemer's name, located at 2140 West Olympic Blvd in Los Angeles.

Nothing for West H Street in Chula Vista? I asked. The Clinica Medica Para la Mujer de Hoy there opened in January 1997; shouldn't there be a record by now? "Yes," replied Cohen -- having waded for several minutes through waves of "Clinica," "Medica" and "Mujer" in various permutations without finding 335 West H Street, Chula Vista -- "I think when you have a fictitious name permit you have to keep the medical board posted."

"...What if all of a sudden they got an emergency?" Mary Lou was saying. I interviewed her and her co-worker, Mary Ann, March 5. Mary Ann questioned the clinic's Spanish advertising. "He's not Hispanic," she said of Braemer (he hails from Austria), "why did he choose to target Hispanics?"

The evening before about 50 Hispanics had been praying charismatically before the Blessed Sacrament exposed in St. Rose of Lima Church, about 150 paces away from the abortion clinic. Hispanics have their own chaplain there, Father Vincent Lorenz. When I told him about the abortion clinic down the street, Father Lorenz said that was the first he had heard of it. Though retired from the San Diego diocese, he also serves as a chaplain at Scripps Memorial Hospital. He said that he goes through the list of patients scheduled for abortion there and tries to talk them out of it. Father Lorenz, who hails from Spain, promised to alert the Hispanic Catholics who go to Mass to the clinic presence, and to beg them to "pray with me that we all get some sense about abortion; not only that is against God, but the terrible thing the ladies go through."

Other than that, however, "I have no authority," said Father Lorenz, who isn't even in residence at St. Rose.

Carlos Garrison, a St. Rose parishioner for 30 years, was also unaware of the abortion clinic's proximity. "I don't go for that," he told me after a mid-day stop in the church for prayer. "I don't believe in abortion. I wouldn't want people in my family doing them."

What about the people just down the street? I asked. Would you be willing to pray in front of abortion clinic with a group of other parishioners, say, once a week?

"That depends," the lifelong layman replied, "on the sisters here and the Monsignor"

I called Msgr. Richard Duncanson, pastor of St. Rose, but he never got back to me.