RULING ISSUED ON DOCTOR; BOARD MAY ACT ON BOTCHED ABORTIONS

Missouri's Board of Healing Arts has been cleared to discipline a doctor who performed abortions at the former Women's Health Center in Cape Girardeau.

The board charges Dr. Scott Barrett Jr. of Chesterfield with eight counts of misconduct in abortions he performed in Springfield and Cape Girardeau.

The complaint against Barrett was first filed by the board in March 1990. It followed a similar complaint filed against Dr. Bolivar Escobedo, who operated the Women's Health Center in Cape Girardeau.

The center opened in 1982 and stopped performing abortions in 1990. Escobedo's hearing before the three-judge Administrative Hearing Commission has been set for Oct. 13-15.

The commission's ruling Monday issued by Commissioner Edward Downey allows the board to take disciplinary action against Barrett on all eight counts.

Included in the charges are that he failed to provide adequate care following a botched abortion in March 1989 in Cape Girardeau. In the abortion, Barrett failed to remove all of the fetus and placenta from a 15-year-old girl before sending her home.

The day after the abortion, the girl identified only as S.C. complained of excessive pain and bleeding. But when her mother tried to call emergency telephone numbers given her at the Women's Health Center, she could only get a recording, the board's complaint said.

"Although she left her name and number, no one ever returned her calls," the complaint said. "In all, she called each number about nine times throughout the day."

Two days after the abortion, the mother rushed her by car to the emergency room at St. Francis Medical Center, where an ultrasound examination revealed "the presence of retained `products of conception' within her uterus," the complaint said.

S.C. also suffered infection of the uterine lining, which had spread to her bloodstream.

Downey ruled that Barrett is subject to discipline because he failed to provide proper follow-up care for S.C.

"In this course of conduct, Barrett was negligent, grossly negligent, and incompetent," the ruling said. "Also, it was conduct that might be and, in fact, was harmful to patient S.C.

"Also, Barrett exacerbated the problem by providing telephone numbers that were not answered. We are convinced that S.C.'s mother would have more timely sought medical attention for her daughter elsewhere were she not waiting for a return phone call from Barrett or his staff."

The ruling also said Barrett showed "an astonishing level of negligence, gross negligence, and incompetence" in the case of Stacy Ruckman.

Ruckman, 23, of rural Springfield, died Feb. 20, 1988, after Barrett performed an abortion.

Downey found that Barrett gave Ruckman excessive doses of a local anesthetic and then failed to resuscitate her properly.

A tentative date of Aug. 8 was scheduled for a disciplinary hearing.

A spokesman for the attorney general's office in Jefferson City said Tuesday that the discipline can vary between a letter of censure to revocation of Barrett's license.

"If they revoke the license, or any discipline, the doctor can appeal to the Cole County Circuit Court," the spokesman said.

Ruckman's mother told The Associated Press Tuesday it has taken too long for the case to reach this point. "I know they have to be sure of their facts, but four years is a very long time," Judy Ruckman said. "And it's not over....

"Until they say this man cannot practice and they actually take his license, I don't think we will ever feel any sense of justice. And, of course, nothing will ever bring Stacy back."

Other counts in the complaint include:

The case of an 18-year-old who went to Central Health Care for Women in Springfield in 1988 for a second-trimester abortion.

When complications arose after the procedure, a receptionist at the clinic refused to summon an ambulance at the request of the girl's family. When she finally was taken to the emergency room of a nearby hospital, she had lost about two-thirds of her blood, the complaint said.

"But for the efforts of the paramedics (and doctors at the hospital), she would have died," the board charged.

The case of B.J., 20, who was advised by the physician treating her for cervical cancer to have her pregnancy aborted at Barrett's Springfield clinic.

The complaint said she awoke after the abortion "drenched with blood," seated in a chair in the recovery room of the clinic with "no clinic staff members" present.

She subsequently was taken to Cox Hospital-South in critical condition, where she was found to have a torn uterus and her right ovary had been torn loose.

"But for the efforts of (the doctors and other Cox Hospital staff), B.J. would have died," the complaint said.

Barrett was accused of improper administration of Lidocaine, an anesthetic. The complaint said that of 15 to 20 patients Barrett had at two Springfield clinics each day from 1984-1987, "generally at least two developed toxic reactions" to the drug.

Pre-signed prescription blanks were found in Barrett's office.

He was found to have operated an unlicensed abortion facility, and he failed to have privileges at any hospital near his Springfield or Cape Girardeau abortion clinics. He also was found to have failed to maintain required records.

Barrett closed his Central Health Center for Women in Springfield after a man entered the clinic with a shotgun in late December. The assailant asked for Barrett, but then shot the building owner and the office manager.

Springfield police have said the gunman was never identified and the investigation remains open.

Barrett's attorney, Earle Leadlove of St. Louis, did not return telephone messages left at his home or office Tuesday afternoon by The Associated Press.