By the time paramedics arrived, the patient was lying in a pool of her own blood, her pulse racing and her blood pressure dangerously low.
The woman, identified only as Angela P. in records of the Medical Board of California, had gone to the Clinica Medica Para la Mujer de Hoy in Santa Ana in the summer of 2004 for an abortion.
Dr. Phillip Rand, then in his early 80s, performed a vaginal suction procedure, despite having determined that Angela was about 20 weeks pregnant, well into her second trimester. She was given no anesthesia or painkillers.
According to the National Abortion Federation, vacuum aspiration procedures are normally performed on women who are up to 14 weeks pregnant. After 14 weeks, a more complicated procedure, known as dilation and evacuation, is standard.
"A suction abortion is not appropriate at 20 weeks," said Vicki Saporta, president of the federation.
Angela P.'s experience was cited in a 2004 medical board accusation against Rand as "barbaric" and a "severe departure" from a reasonable standard of care. Rand surrendered his license in 2005.
Rand was one of at least six doctors with histories of malpractice complaints, addiction or medical board actions who were employed by a chain of Southern California abortion clinics, according to court and medical board records.
Now Bertha Bugarin, 48, who authorities say manages the clinics, has been charged with practicing medicine without a license on five patients in February and March 2007, according to a statement from Los Angeles County Dist. Atty. Steve Cooley's office. Her sister Raquel Bugarin, 49, is accused of helping with the procedures. Both have pleaded not guilty.
The two sisters were arrested last summer, but a protective order filed in the case has made information difficult to obtain. Bertha Bugarin's attorney, Rickard Santwier, declined to comment, as did her sister's attorney, Christopher Chaney.
The prosecutor, Deputy Dist. Atty. Carolyn Nakaki, would not discuss the case or details of the sisters' connection to the clinics.
A fictitious name statement from 1991 filed for the business lists Bertha Bugarin as the person behind Clinica Medica Para La Mujer de Hoy, although paperwork filed with the medical board lists Nicholas Braemer, a Torrance doctor who lost his license in 2000, as the sole registrant of the clinics between 1991 and 1999.
