A state board Tuesday told Lawrence's only abortion provider she cannot administer general sedation to patients until she demonstrates that she follows national standards for its use.
But Dr. Kristin Neuhaus, whom the Kansas State Board of Healing Arts has prohibited from using such sedation, said she may not be able to keep her business afloat long enough to meet the new test.
Tuesday's decision by a board hearing officer called for Neuhaus to improve her record-keeping, follow national guidelines and prove to the board that improvements have been made. It also raised questions about her handling of syringes and training of clinic staff to handle emergencies.
Mainly, though, the decision followed the reasoning of a Kansas anesthesiologist who testified at a Monday hearing about Neuhaus' records of sedation.
"The medical record is necessary for reasons beyond merely creating documentation for later review," board hearing officer Dr. Kyle Tipton wrote in Tuesday's decision. "By monitoring and documenting information periodically, the physician's attention is automatically drawn to those items which, as stated in (national) guidelines, are necessary for adequate patient protection."
Dr. James Glenski, the anesthesiologist, said in testimony Monday that inadequate record-keeping may indicate the level of care patients received from Neuhaus.
Neuhaus, citing her record of no patient complaints and no emergencies during abortion procedures, testified she was providing quality care but just didn't have the paperwork preferred by the board.
About Tuesday's decision, Neuhaus said, "I thought the recommendations made were eminently prudent."
Until she can resume using general sedation, though, Neuhaus can use only local anesthesia, under terms of an emergency order issued Aug. 14. That means she will have to send about half her regular number of patients to other doctors in the state. Neuhaus is the only abortion provider between Kansas City and Wichita.
"We're certainly not in a good financial position when we have to refer half to someone else," she said. That could mean the end of her practice.
The board is not scheduled to meet again for two months. Donald Strole, Neuhaus' attorney, said he would spend today trying to find out whether the board would appoint a hearing officer, as it did for Monday's hearing, or have a special meeting sooner than its next scheduled meeting.
"If it's two months, that would be extremely difficult for us to deal with," Neuhaus said.
The board's inquiry into Neuhaus' use of general sedation began earlier this month when she asked the board for permission to use the sedative ketamine in addition to Valium.
In Tuesday's decision, Tipton said Neuhaus was clearly knowledgeable about the use and problems that can arise when using ketamine. He recommended her request be reconsidered once her record-keeping is in order.
The decision and emergency order can be appealed to the board or through the court system.