Broken System

09.18.14 1:10 AM ET

Indiana’s Crazy Administrative Abortion Demands Have Doctors Racking Up the Violations

Forget the actual medical procedure, Indiana’s doctors are facing near-impossible requirements when it comes to providing abortions—on the administrative front.

On Wednesday, the Indiana Attorney General’s office filed complaints against four doctors who provide abortions for either failure to sufficiently complete all state-required forms, or to file them within the allotted time period.

Attorney General Greg Zoeller has requested that the Indiana Medical Licensing Board take “appropriate disciplinary actions” against doctors Ulrich “George” Klopfer, Kathleen Glover, Reed Pasic, and Raymond Robinson. These four physicians are facing potential loss of their medical license for “violations of abortion record-keeping and advice and consent laws,” according to a press release from Zoeller’s office.

These violations essentially stem from unsatisfactory patient paperwork. Under Indiana law, abortion providers must fill out an extensive Terminated Pregnancy Report (TPR). The state charges that the aforementioned doctors have failed to complete these forms within the established guidelines.

While some of the information requested is pertinent, such as the type of termination procedure and date of procedure, other categories seem more onerous: name of the father, age of the father, number of previous abortions and/or miscarriages a woman may have had, and dates of said abortions. Additional information required seems bluntly biased, such as “post-fertilization age of fetus” and “information as to whether the fetus was delivered alive.”

The violations also stem from submission of TPRs past the state-mandated deadline. Under Indiana law, TPRs for abortions performed between January 1 and June 30 must be submitted to the State’s Department of Health by July 30, and TPRs for abortions performed from July 1 through December 31 no later than January 30.

The Indiana Attorney General’s office appears to be taking its cue in their complaints against Klopfer, Glover, Pasic, and Robinson from state and local Right to Life groups. The nature of the violations almost entirely stem from the alleged failure to properly complete a TPR or for filing one too late, a tactic anti-abortion groups have used in the past against abortions providers within the state, including Klopfer.

Dr. Klopfer, 73, in particular has been a target of Indiana Right to Life groups multiple times and is considered the “most egregious” offender, according to the Attorney General’s office. He is charged with 1,833 violations for the 1,818 abortions he performed between January 2012 and November 2013.

According to the complaint, he failed to note the father’s name and age in the TPR 100 percent of the time, even though the forms state this information only needs to be filled out “if known.” His other violations include: failing to record the patient’s date of last menses (27.7 percent of the time) and prior abortions or miscarriages (36.9 percent of the time). In addition, the complaint alleges he performed abortions on women the same day they signed their consent forms, which violates the state’s 18-hour waiting period. He also faces violations for performing abortions on six women “whose consent forms list a registered nurse or licensed practical nurse as the provider performing counseling prior to the procedure.” Under Indiana’s health code, this counseling can only be given by the:

“referring physician or a physician assistant (as defined in IC 25-27.5-2-10), an advanced practice nurse (as defined in IC 25-23-1-1(b)), or a certified nurse midwife (as defined in IC 34-18-2-6.5) to whom the responsibility has been delegated by the physician.”

Klopfer is already facing criminal misdemeanor charges in Lake and St. Joseph counties for failure to notify the state within the state-mandated three-day window about abortions performed on women under 14. Under the law these abortions must be reported to both the Indiana State Department of Health and the Department of Child Services within this 72-hour period.

An affidavit (PDF) filed in Lake County dated January 3, 2014, accuses Klopfer of performing an abortion on a 13-year-old on September 28, 2012, for which the report was not received by the Indiana Department of Health until January 22, 2013. This alleged violation was uncovered by Lynn Scherschel, a Lake County Right to Life member. A trial for this misdemeanor is set to take place January 26, 2015, with his trial for St. Joseph County infractions taking place on August 1, 2015.

In total, women from local Right to Life groups in Fort Wayne and St. Joseph County filed more than 1,200 complaints against Klopfer from October to December 2013 regarding similar patient form violations.

“Why didn’t the state department of health contact me about the reports?” Klopfer told the South Bend Tribune after the Allen County Right to Life filed complaints with the Indiana Attorney General. “The state got the report in July, they said. Why didn’t they contact me? Why am I hearing about it from a Right to Life group? If we’re sending forms into the state, why is it coming from this group?”

Klopfer alleged in an interview with RH Reality Check that these anti-abortion groups have doctored his forms. “They take a document and they fill it in their way and then send it into the state saying that I falsely reported this stuff. Then it doesn’t match the report I have in my chart or the patient’s chart,” he said. “Because we keep a copy of everything we send to the state.”

Until the licensing board holds a disciplinary hearing, all four physicians’ licenses to practice will remain active. But, the trial will no doubt bring renewed scrutiny to abortion practitioners who are already mandated to follow such pedantic regulations. It is little wonder then that anti-abortion activists are hailing the Indiana Attorney General’s complaint as a major victory.

“We commend the Attorney General for taking this necessary step to uphold Indiana law,” said Indiana Right to Life President and CEO Mike Fichter. “Our legislators passed laws regarding consent and record keeping to ensure high standards of quality and care for Hoosier women.”