Kermit Gosnell

• 1. Introduction

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  Kermit Gosnell's West Philadelphia clinic was raided on the 18th of February 2010, when investigators arrived at 3801 Lancaster Avenue with a search warrant. Gosnell was a doctor who had practiced in the city for decades. The agents were there to look for evidence of illegal prescriptions. Inside the Women's Medical Society Clinic, they found the intact remains of 47 fetuses and babies stored in bags and cartons. His trial would later give the building a nickname: the house of horrors.

  Three questions run through this story. How did a physician with a record of community work come to run such a place? Why did complaints stretching back years fail to close it? And why did the trial that followed set off an argument about the American press itself?

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• 2. Mantua's Physician

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  Kermit Barron Gosnell was born in Philadelphia on the 9th of February 1941, the only child of a gas station operator and a government clerk. He graduated from the city's Central High School in 1959. He started at the University of Pennsylvania, finished a bachelor's degree at Dickinson College, and received his medical degree from Thomas Jefferson University in 1966.

  Four decades of work among the poor have been credited to him in published reports. They include a teen-aid program and the Mantua Halfway House, a rehabilitation clinic for drug addicts in the impoverished Mantua neighborhood of West Philadelphia. He also became an early supporter of abortion rights in the 1960s and 1970s. In 1972, he returned from a stint in New York City and opened an abortion clinic on Lancaster Avenue.

  In October 1972, Gosnell told The Philadelphia Inquirer: "As a physician, I am very concerned about the sanctity of life. But it is for this precise reason that I provide abortions for women who want and need them."

  That same year, he performed fifteen televised second-trimester abortions using the experimental "Super Coil" method invented by Harvey Karman. The event was referred to as the "Mother's Day Massacre of 1972." The coils were inserted into the uterus, where they caused irritation that led to expulsion of the fetus. Nine of the women reported complications, and three of those described severe ones. One woman needed a hysterectomy.

  The Inquirer article of 1972 also called Gosnell a "respected man" in his community. It noted that he was a finalist for the Junior Chamber of Commerce's "Young Philadelphian of the Year" because of his work directing the halfway house. By the late 1980s, public records told a different story. State tax liens were piling up against the halfway house, and the abortion clinic carried a $41,000 federal tax lien.

  Gosnell married three times. His third wife, Pearl, worked at the Women's Medical Society as a full-time medical assistant from 1982 until they married in 1990. They had two children, and he had four others from his earlier marriages. Pearl Gosnell's name would come up again in grand jury testimony about special Sunday sessions at the clinic.

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• 3. Inside the Clinic

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  The Drug Enforcement Administration, the Philadelphia Police Department and the state's Dangerous Drug-Offender Unit had spent months examining suspected illegal prescribing at the clinic. That inquiry turned up something else: the suspicious 2009 death of a patient named Karnamaya Mongar. Her case pointed to unsanitary operations, untrained staff including teenagers, and powerful drugs used without proper control. Those problems fell under state authority. So staff from Pennsylvania's departments of state and health joined the FBI and Pennsylvania State Police for the raid.

  Investigators told the grand jury the clinic was "filthy," "deplorable" and "by far, the worst" they had ever encountered. There was blood on the floor and the smell of urine in the air. A flea-infested cat roamed the building, and cat feces lay on the stairs. Semi-conscious women waiting for abortions sat on dirty recliners covered with blood-stained blankets. Unlicensed staff had sedated them long before Gosnell arrived, and no one could say exactly which drugs or doses they had received.

  Rusty, outdated equipment and unsterile instruments filled the procedure rooms, which the grand jury compared to "a bad gas station restroom." Many medications had passed their expiration dates. Disposable supplies were reused, and the oxygen equipment was dusty and uninspected. Blood pressure monitors, oximeters and defibrillators were reported broken. Some emergency exits were blocked or padlocked.

  Fetal remains were stored in bags, milk jugs, juice cartons and even cat-food containers. Investigators found a row of jars holding only severed feet. Medical waste was piled high in the basement, and a freezer held the intact 19-week fetus that Mongar had delivered three months earlier. Gosnell admitted to Detective Wood that at least 10 to 20 percent of the remains were probably older than 24 weeks, the legal limit. The grand jury judged that at least two of the fetuses, and probably three, had been viable.

  One day each week, Gosnell worked at Atlantic Women's Services in Wilmington, Delaware. Its owner, Leroy Brinkley, also owned the Delta Clinic of Baton Rouge, Louisiana. Brinkley helped arrange for staff from Baton Rouge to work in Philadelphia. By 2011, Gosnell was reported to be well known for treating poor minority and immigrant women. He was accused of racism for separating white patients from black patients and giving the white patients a slightly cleaner room.

  Unlicensed employees at the Women's Medical Society administered anesthesia and assisted in procedures. Many had little or no medical training, and some presented themselves as licensed clinicians. Training for certain tasks could amount to a brief, informal lesson. The clinic often ran without a supervising physician, and employees said they were discouraged from asking for guidance. The grand jury also found that a nurse was hired temporarily during one inspection to create an appearance of compliance. Other individuals posed as physicians and billed as if they were licensed.

  Ultrasound measurements and reported gestational ages were manipulated on staff instruction so that they would fall within legal limits. Medical and abortion records were frequently falsified, incomplete or destroyed, and drug dosages often went unrecorded. False accounts were also given to investigators and medical personnel about complications and deaths.

  Surgical mistakes at the clinic included perforated organs and, on at least two occasions, patient deaths. Women suffered torn cervixes and colons, untreated retained remains that led to severe infection, and punctured uteruses that caused hemorrhage and hysterectomy. Patients given labor-inducing drugs were often left alone for hours. Some delivered before the physician arrived. One patient who convulsed fell from an operating table and hurt her head, yet staff did not promptly call for emergency help.

  Karnamaya Mongar was 41 years old and weighed 90 pounds. Staff gave her repeated, unmonitored intravenous injections of Demerol, after which she stopped breathing. They could not revive her, and paramedics were hampered by inaccurate information about the drugs she had received. She had come to the United States as a refugee from Bhutan in 2009, the same year she went to the clinic.

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• 4. Warnings Ignored

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  In 1989 and again in 1993, the Pennsylvania Department of Health cited the clinic for having no nurses in the recovery room. In 1996, Gosnell was censured and fined in both Pennsylvania and New York for employing unlicensed personnel. Around the same time, a pediatrician named Dr. Donald Schwarz took action of his own. Schwarz had headed adolescent services at the Children's Hospital of Philadelphia and was Philadelphia's health commissioner by 2010. He testified that around 1996-1997 he hand-delivered a complaint letter to the Secretary of Health's office and stopped referring patients to the clinic. He received no response.

  In 2000, a civil lawsuit was filed on behalf of the children of Semika Shaw. She had called the clinic the day after an abortion to report heavy bleeding, and she died three days later of a perforated uterus and a bloodstream infection. The suit alleged that Gosnell had failed to tell her to return or seek emergency care. It was settled out of court in 2002 for $900,000.

  In April 2011, the University of Pennsylvania Health System said it had given authorities reports about botched procedures by Gosnell as early as 1999. The only case for which it could produce reports was that of Shaw, a 22-year-old who died at the university's hospital of bleeding and sepsis. The health system said other reports had been made orally, and it kept no records of them.

  Around 2001, Gosnell claimed to be providing children's vaccines under a program run by the Health Department's Division of Disease Control. He was repeatedly suspended for failing to keep logs and for storing vaccines in unsanitary refrigerators at improper temperatures. In December 2001, a former employee named Marcella Choung gave the Pennsylvania Department of State a detailed written complaint, which she followed with an interview in March 2002. In 2006, a patient sued after Gosnell could not complete her abortion and apparently failed or refused to call paramedics. The case was dismissed as out of time. She had told the court: "I really felt like he was going to let me die."

  In all, 46 known lawsuits were filed against Gosnell over some 32 years. Observers saw a complete failure by Pennsylvania regulators, who overlooked repeated concerns about untrained staff, "barbaric" conditions and a high level of illegal late-term abortions. Reports stated that state officials had not inspected his practices since 1993. The medical examiner of Delaware County even alerted the Pennsylvania Department of Health that Gosnell had performed an illegal abortion on a 14-year-old who was thirty weeks pregnant.

  Brenda Green, executive director of a nonprofit called CHOICE, told The Nation's Katha Pollitt that her group tried to report complaints from clients. The health department would not accept them from a third party. Patients had to complete a five-page form, available only in English, that required them to reveal their identities and be ready to testify in Harrisburg. Only two women agreed to fill it out, and both decided not to submit it.

  By 2011, none of Pennsylvania's 22 abortion clinics had been inspected by the government for more than fifteen years. Routine inspections had ceased under Governor Tom Ridge, a pro-choice Republican, because they were seen as a barrier to women seeking abortion services. Gosnell's license was finally suspended on the 22nd of February 2010, four days after the raid.

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• 5. The Grand Jury

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  On the 4th of May 2010, a grand jury received the findings of the investigation. It concluded that the clinic operated as a corrupt organization within the meaning of racketeering law. It cited a pattern of unlicensed staff, falsified records, illegal abortion procedures and regular infanticide. The jurors described a systemic disregard for the law and for patient safety, not a string of isolated incidents.

  Staff called it "snipping" or the "neck snip." According to the grand jury, clinic employees routinely delivered living infants in the third trimester and then ensured their deaths by severing the spinal cord with scissors. Many instances could not be prosecuted individually because records had been falsified, removed or destroyed. The jury said the number of such cases was in the "hundreds."

  A handful of cases left tangible evidence. The jury noted a boy of 30 weeks who weighed six pounds, and a frozen body in a water container that was "at least" 28 weeks old. It noted the remains of at least one abortion beyond 32 weeks, for which an extra $1000 had been demanded. It also noted testimony about a baby heard to make noise, and another left "moving and breathing for at least 20 minutes" before snipping. A medical expert with 43 years of experience performing abortions was appalled. He told the jurors: "I've never heard of it cutting the spinal cord being done during an abortion."

  Sundays belonged to a separate routine. The jury heard about "special" Sunday sessions attended only by Gosnell and his wife. It suspected, and in some cases corroborated, that these sessions handled cases that were more advanced or more disturbing. Pearl Gosnell testified that she alone assisted on Sundays and that her role was to "help do the instruments" and monitor patients in the recovery room. Another employee testified that she helped with late-term abortions on Sundays or on days the clinic was closed.

  The United States Attorney for the Eastern District of Pennsylvania alleged that office staff at the clinic ran a prescription "pill mill." From June 2008 until the raid, Gosnell allegedly wrote and dispensed fraudulent prescriptions for thousands of pills. They included the tablets OxyContin, Percocet and Xanax, and the syrups phenergan and promethazine with codeine. Customers could buy multiple prescriptions under multiple names. The first office visit cost $115 until around December 2009, when the fee rose to $150.

  Controlled-substance prescriptions filled at pharmacies grew from several hundred per month in 2008 to over 2,300 in January 2010. Gosnell and his staff allegedly dispensed more than 500,000 pills containing oxycodone, more than 400,000 containing alprazolam, and more than 19,000 ounces of codeine cough syrup. The grand jury estimated that this prescribing brought in an extra $10,000 to $15,000 a night.

  The jurors also proposed reforms. They called for mandatory annual inspections of abortion facilities, stricter enforcement of licensing, and a better system for reporting and investigating complaints. They wanted closer coordination between oversight agencies and qualified physicians supervising certain procedures. They urged tighter control of medical waste disposal and a new law against impersonating medical professionals. They also recommended extending the statute of limitations for late-term abortion offenses and removing time limits for infanticide.

  Finally, the panel recommended criminal charges against Gosnell, his wife and several associates, among them Lynda Williams, Adrienne Moton, Steven Massof and Eileen O'Neill. The recommendations included first-degree murder where infants were alleged to have been born alive. For Mongar's death, they included third-degree murder and drug delivery resulting in death.

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• 6. Arrest and Trial

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  Gosnell was arrested on the 19th of January 2011, five days after the grand jury's report was certified. He faced eight counts of murder. Prosecutors alleged that he had killed seven babies born alive by severing their spinal cords with scissors, and that he was responsible for Mongar's death. Pearl Gosnell and eight other suspects were also arrested. The DEA, the FBI and the Office of the Inspector General separately sought a 23-count indictment against Gosnell and seven former staff members for drug conspiracy.

  The seven first-degree murder counts rested on the "born alive rule," a principle of American common law. By default, it holds that for legal purposes personhood begins the moment a victim is born alive, which makes unlawful killing possible. Staff testified that they saw the babies move or cry after complete birth. Steven Massof, a clinic employee who pleaded guilty in 2011, testified that he had snipped the spines of more than 100 infants after birth. He said this was "standard procedure." No physical evidence existed for five of the seven cases. A photograph existed of the sixth, who allegedly had a gestational age of 30 weeks, and physical remains were obtained for the seventh. Gosnell denied the charges.

  Gosnell's lawyer protested that his client had been convicted in the press. He accused the government of a "lynching" and called the case "a targeted, elitist and racist prosecution of a doctor who's done nothing but give back to the poor and the people of West Philadelphia." In a February 2011 interview with the Fox affiliate WTXF-TV, Gosnell said: "I expect to be vindicated." After his arrest, he also claimed to be "very close to being destitute." Records contradicted that claim. He and his wife owned at least seventeen properties across four states, including a million-dollar house in Brigantine, New Jersey.

  Eight defendants pleaded guilty, and most of them testified against Gosnell. Massof, a medical school graduate who lacked a license, pleaded guilty in November 2011 to two counts of third-degree murder. He was sentenced to 6-12 years. Pearl Gosnell pleaded guilty on the 13th of December 2011 to illegal abortions, conspiracy and participating in a corrupt organization. Because of spousal privilege, she did not have to testify against her husband, and she received 7-23 months in prison. Adrienne Moton admitted cutting the necks of ten babies and received 11.5-23 months. Sherry West, who admitted giving the overdose that killed Mongar, and Lynda Williams each received 5-10 years. Elizabeth Hampton, Gosnell's sister-in-law, admitted perjury and received a year of probation.

  Eileen O'Neill, of Phoenixville, was the only employee to go on trial with Gosnell. She allegedly held herself out as a doctor without a license. Her lawyer told jurors she never did so and performed medical duties only on Gosnell's orders. A gag order had barred both sides from speaking to the media since April 2011. Opening statements came on the 18th of March 2013 in a Philadelphia courtroom.

  On the 23rd of April 2013, after the prosecution rested, the judge dismissed several counts. The first-degree murder counts fell from seven to four, and the infanticide count and all five charges of abusing a corpse were dismissed. Six of the nine theft-by-deception charges against O'Neill also fell. Commentators suggested the evidence of life after the procedure was too thin to sustain some charges. The defense argued that the movements described could have been spasms. It added that testimony described only single movements or breaths, and that all seven had been killed by drugs in the womb. The medical examiner had testified that tissue deterioration made it impossible to tell whether any of the 47 fetuses had been born alive.

  The defense attorney rested without calling a single witness, and Gosnell did not take the stand. O'Neill did not testify either. The case went to the jury on the 30th of April 2013. On the 13th of May, the jurors reported they were deadlocked on two counts. After returning to deliberations, they convicted Gosnell of three counts of murder and one count of involuntary manslaughter for Mongar's death. They also convicted him of more than 200 lesser counts, including 21 felony counts of illegal late-term abortion, 211 counts of violating Pennsylvania's 24-hour informed consent law, and racketeering. He was found not guilty on one murder count. The murder convictions concerned babies referred to as Baby Boy A, Baby C and Baby D.

  On the 14th of May 2013, Gosnell struck a deal with prosecutors. He waived all appeal rights in exchange for their agreement not to seek the death penalty. The next day, he was sentenced to three life terms without the possibility of parole.

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• 7. Reform and Reckoning

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  In February 2011, the Pennsylvania State Senate began hearings on how the system had failed. The Consumer Protection and Professional Licensure Committee, led by Robert M. Tomlinson, asked why the Department of State, which licenses doctors, provided no oversight of Gosnell. The Public Health and Welfare Committee, chaired by Pat Vance, examined the failure of the state Health Department to stop him.

  That same month, Governor Tom Corbett fired six employees and began action against eight others who needed longer dismissal procedures. They included Basil Merenda, acting head of the Department of State, and Stacy Mitchell, a deputy secretary in the health department whom the grand jury cited as a key figure in its indifference. Christine Dutton, the health department's chief counsel, was asked why the department had not reacted to a death at the clinic. She replied, "people die." Some of the officials most closely tied to the failure, such as Janice Staloski, had already retired, so no action was taken against them.

  In late 2011, Pennsylvania passed a law, SB 732, that placed abortion clinics under the same health and safety rules as other outpatient surgical centers. Democrat Margo L. Davidson supported it. Her cousin Semika Shaw had died after treatment by Gosnell, and Davidson tied her vote to that death, which she blamed on poor medical practices.

  After the May 2013 convictions, Representative Joe Pitts of Pennsylvania began a congressional inquiry into state oversight of abortion clinics. He chaired the health subcommittee of the House Energy and Commerce Committee. In June 2013, the Republican-led House passed the Pain-Capable Unborn Child Protection Act. Speaker John Boehner said the bill responded to Gosnell's convictions. It was viewed as largely symbolic because it had little chance in the Democratic-led Senate.

  In December 2013, Gosnell was convicted of illegally distributing painkillers. Prosecutors described a "staggering" amount of drugs such as OxyContin, totaling hundreds of thousands of pills, many later sold on the streets by dealers. He received 30 years in prison and was held at SCI Huntingdon. In September 2015, a Philadelphia Common Pleas judge awarded nearly $4 million in compensatory damages to Yashoda Devi Gurung, Mongar's daughter. Reports that Gosnell had few assets left made it doubtful that any of it would be paid.

  Gosnell died at a hospital in Huntingdon, Pennsylvania, on the 1st of March 2026, at the age of 85. He was still serving his sentence. His death was not reported until the 23rd of March.

  The remains recovered from the clinic were buried at Laurel Hill Cemetery, though no headstone was used. In 2019, John and Loida McKeever installed a small memorial at the site, a statue of an angel. A sign around its neck reads: "In memory of the babies that were lost at 3801 Lancaster Avenue."

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• 8. Outrage and Coverage

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  Philadelphia Mayor Michael Nutter, a Democrat, reacted to the arrest by saying: "if these allegations are true, we've had a monster living in our midst." Outgoing Governor Ed Rendell said he was "flabbergasted to learn that the Department of Health did not think their authority to protect public health extended to clinics offering abortion services." District Attorney R. Seth Williams said that "Pennsylvania is not a third-world country" and that several oversight agencies should have shut Gosnell down long ago. In January 2011, Delaware Attorney General Beau Biden promised a wide-ranging investigation into the abortions Gosnell performed in his state.

  Abortion providers also responded. Vicki Saporta, president of the National Abortion Federation, explained that Gosnell had been rejected for membership after an inspection. She said the clinic had been cleaned up and a registered nurse hired for the visit, and that the inspectors saw only first-trimester procedures. Dayle Steinberg, CEO of Planned Parenthood of Southeastern Pennsylvania, said some women had visited Gosnell's clinic first and then come to Planned Parenthood, complaining about the conditions. Her staff always encouraged them to report it to the Department of Health.

  On the 11th of April 2013, Kirsten Powers wrote a column in USA Today about the trial. She said a Lexis-Nexis search showed that none of the news shows on the three major national networks had mentioned it in three months. Dave Weigel of Slate reported that conservatives' use of Twitter did even more to push the press. Troy Newman, president of the anti-abortion group Operation Rescue, organized a campaign with the hashtag #Gosnell to break what he called the "Gosnell Media Blackout."

  A photograph became the campaign's symbol. J.D. Mullane, a columnist for Calkins Media, was struck by the absence of reporters and took a picture of rows of empty media seats in the courtroom with his iPhone. He tweeted it that night. By the 15th of April, an estimated 106,000 #Gosnell tweets later, Mullane reported that major networks and newspapers had sent reporters, including Fox News, the New York Times and the Washington Post. In the same month, 71 other members of Congress joined Representative Marsha Blackburn in a letter condemning the media "blackout."

  Journalists were divided. Melinda Henneberger of The Washington Post wrote that the only abortion story most outlets covered was a threat to abortion rights. Jeffrey Goldberg of Bloomberg View said the story upset a narrative that some pro-choice absolutists did not want to discuss. Post executive editor Martin Baron said he learned of the story on Thursday, the 11th of April 2013, when readers began emailing him. "In retrospect," he said, "we regret not having staffed the trial sooner." A column on Salon.com asked whether conservative media and politicians had also ignored the case until April 2013.

  In early 2014, filmmakers Ann McElhinney, Phelim McAleer and Magdalena Segieda announced a true crime drama about the case. The film, titled Gosnell: America's Biggest Serial Killer, was directed by Nick Searcy. Its producers raised $2.3 million on the crowdfunding site Indiegogo. Andrew Klavan wrote the screenplay, Earl Billings played Gosnell, and Dean Cain played Detective James Wood. The producers announced a distribution deal on the 26th of June 2018, and the film opened in about 750 theaters on the 12th of October 2018.

  An earlier documentary, 3801 Lancaster: American Tragedy, was released in 2013, with clips shown on CNN. Its maker, David Altrogge, won Best Short Film at the 2013 Justice Film Festival.

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