It was delightful news for the Worcester woman following her ultrasound last year at Clearway Clinic: A nurse said the results showed the start of a healthy pregnancy, according to the woman.
Her delight turned to devastation the next month, however, when she suffered a sudden shooting pain in her side and, after being rushed to the hospital, learned there never was a healthy pregnancy. Clearway Clinic had allegedly misdiagnosed an ectopic pregnancy that would need to be ended immediately, or she could die.
What followed was an invasive emergency surgery that resulted in the removal of one of the woman’s fallopian tubes, according to a lawsuit against the clinic.
The case has cast a spotlight on crisis pregnancy centers such as Clearway Clinic that do not provide, and often steer patients away from, abortions. Unlike a traditional abortion or reproductive health clinic, crisis pregnancy centers are not always staffed by licensed medical doctors. Last year, the state issued an advisory warning that crisis pregnancy centers “may appear to be reproductive healthcare clinics” but “do not provide comprehensive reproductive healthcare services or counseling.”
Jill Jorgensen, executive director of Clearway Clinic, said the pending lawsuit is the first and only one against her clinic.
“Clearway Clinic has served more than 10,000 women and their families in the Worcester area for the past 22 years at no cost,” she said in a statement. “We hope to continue to provide needed services to women and their families in Massachusetts for many more years.”
Attorney General Andrea Campbell is pledging to crack down on facilities that mislead patients or provide inadequate care. Last month, she touted the opening of a Reproductive Justice Unit that may pursue civil or criminal charges against those who deceive people seeking comprehensive reproductive services.
“It’s at the top of the list,” Campbell said, adding that the misinformation given out by crisis pregnancy centers is “just that: misinformation. And so we know there’s a role for us to play, and it’s . . . to take action.”
Most recently, the office joined a national letter sent by 16 attorneys general urging Yelp to issue consumer warnings or alerts for crisis pregnancy centers to “help educate consumers and ensure patients are informed of what services are and are not available at” the centers.
Campbell said her office has continued to receive complaints from patients who say they were misled by centers into thinking they were at a traditional clinic, only to discover months later that they hadn’t been receiving proper care. She said the unit would be aggressive in enforcing regulations that prevent the centers from posing as abortion clinics.
“Clearway has caused grave harm to many women,” Shannon Liss-Riordan, who filed the consumer protection suit against the clinic in June on behalf of a woman referred to as Jane Doe, told the Globe. “Clearway’s practices, like other so-called crisis pregnancy centers across Massachusetts, have been deceiving patients and depriving pregnant women of their ability to obtain standard medical care for a long time.”
Attorneys for Clearway filed a motion to dismiss the complaint in August, and are awaiting a ruling by a Worcester Superior Court judge. They argued that because the clinic’s services were offered for free, a 1986 Supreme Judicial Court ruling exempts them from the state’s consumer protection law against deceptive or misleading business practices.
In a brief opposing the motion, Liss-Riordan argued, “Clearway’s motivation in entering the marketplace has been to damage and destroy other (legitimate) healthcare providers, which, as demonstrated by [the woman’s] horrific experience, is confusing to patients and can cause life-threatening harm.”
Also last month, Rebecca Hart Holder, president of advocacy group Reproductive Equity Now, sent a letter to the Department of Public Health urging the department’s licensure and certification division to investigate whether another center, Your Options Medical in Revere, is engaging in the deceptive advertising of “immediate” results ultrasounds in its new mobile van on Cape Cod. Lettering on the side of the van reads “Free Pregnancy Testing and Ultrasound” and “Immediate Results/Walk-ins Welcome.”
Hart Holder said she is “concerned that registered nurses could be operating outside of their scope of practice by diagnosing ultrasounds immediately. Any such action would be . . . not only unlawful, but also may result in a misdiagnosis.” In Massachusetts, registered nurses may not operate fluoroscopy or radiographic equipment, according to the state’s Board of Registration in Nursing. Ultrasounds taken at hospitals and health clinics may only be interpreted by board-certified physicians, with results usually available within 24 to 48 hours.
Your Options Medical executive director Teresa Larkin said “immediate” same-day results refers to the pregnancy tests offered by the van, not to ultrasounds. Larkin added that the center has been “in close communication” with the Department of Public Health.
In July, the center renewed its license, which covers the Revere headquarters and the mobile van, according to the DPH. However, during follow-up surveys of both facilities the following month, the department found deficiencies with the center’s ability to ensure patient safety and quality of care, according to a spokesperson who said last week that the list of deficiencies is not yet publicly available.
After receiving a correction plan from Your Options Medical earlier this month, the department is reviewing the plan to determine whether it appropriately addresses the issues, according to a spokesperson. Separately, the DPH is also reviewing the complaint from Reproductive Equity Now to determine whether additional onsite investigation into Your Options’ mobile van is necessary.
Campbell’s office partnered with Reproductive Equity Now to launch an abortion legal hot line in January. Hart Holder encouraged people with questions about their care to call (833) 309-6301 for free legal assistance from pro bono attorneys.
Crisis pregnancy centers outnumber abortion clinics such as Planned Parenthood more than 2 to 1 in Massachusetts, according to Reproductive Equity Now. Critics of the centers allege many of them use the promise of free pregnancy tests or ultrasounds to attract people who may not be aware of what their reproductive rights are, or how to fight back when they are challenged.
“A lot of these clinics are not licensed medical facilities, and when they’re not licensed, I don’t know that you have the same kind of recourse to act,” said Dr. Luu Ireland, an obstetrician-gynecologist at UMass Memorial Center who also works with Planned Parenthood. “So unfortunately I think a lot of folks just kind of have to live with that experience.”
Dr. Danielle Roncari, vice president of Medical Services for Planned Parenthood and a Tufts Medical Center ob-gyn, said she helped a patient fill out a consumer complaint with the attorney general’s office recently, but was eager to see more legal avenues for patients to advocate for their reproductive rights.
Several doctors said they routinely encounter patients who have had their pregnancies misdiagnosed during a visit to a crisis pregnancy center, or received incorrect and even dangerous medical advice. Roncari said many of her patients who had previously visited a crisis pregnancy center had no idea they were not at “a legitimate medical facility.”
Ireland recounted experiences in which women were incorrectly told by staff at a crisis pregnancy center that they were too far along to have an abortion, and said one patient hoping to have a child was mistakenly told she had a molar pregnancy, a rare complication that causes a tumor to develop in the uterus.
“When we did her ultrasound in the office and showed her that it was a normal pregnancy at 15 weeks, she was very relieved, but also frustrated and angry,” Ireland said.
Attorneys say it could be difficult for prosecutors to pursue criminal charges against the centers or their employees unless there is severe injury or death. On the civil side, however, Campbell’s office has more latitude in going after the centers than individuals pursuing civil claims.
Iván Espinoza-Madrigal, executive director of Lawyers for Civil Rights, said the centers may expose themselves to civil rights suits if they are preying on certain groups. Lawyers from his organization have been “monitoring the situation to see if these clinics are specifically targeting women of color, low-income women, or women who don’t speak English well,” he said.
Suffolk University law professor and criminal defense attorney Christopher Dearborn noted that a person convicted of illegally practicing medicine could face up to a year in jail, or up to 10 years if their actions resulted in bodily injury.
Individuals can also sue for damages under civil malpractice law.
“Any clinic that is inducing vulnerable women to come in and knowingly deceiving them is in violation of state law,” added malpractice attorney Victoria Santoro Mair. “Without a doubt, giving somebody uninformed and dangerous medical advice rises to that level.”