Topeka A Kansas doctor’s medical records don’t show adequate exams of young patients that she diagnosed with mental health problems and referred elsewhere for late-term abortions, a Georgetown University professor testified Tuesday during a disciplinary hearing.
A complaint before the State Board of Healing Arts accuses Dr. Ann Kristin Neuhaus of negligence in conducting her exams. Board attorneys presenting the case against Neuhaus to a hearing officer called Dr. Liza Gold, a clinical professor of psychiatry at Georgetown’s Medical Center, as an expert witness.
The complaint deals with Neuhaus’ care for 11 patients — ages 10 to 18 — all at least 25 weeks pregnant, who received abortions from the late Dr. George Tiller’s clinic in Wichita from July to November 2003. Kansas law then permitted the abortion of a viable fetus starting at the 22nd week of pregnancy only if the woman faced death or “substantial and irreversible” harm to “a major bodily function,” which included mental health. The law was tightened this year and now has no mental health exception.
Neuhaus provided second opinions Tiller needed under the law, diagnosing the young patients with anxiety disorder, acute stress disorder and single-episode major depression. On Tuesday, board attorneys had Gold go through Neuhaus’ records for nine of the 11 patients.
Gold testified that Neuhaus used a computer program, “PsychManager Lite,” to create reports with only “generic” statements about patients’ conditions, usually minutes after Neuhaus finished compiling answers to a series of yes or no questions. Gold repeatedly said that based on the documents, Neuhaus failed to meet accepted standards of care and her records didn’t explain to others how she arrived at her diagnoses.
Gold noted that in the cases of two young patients, Neuhaus’ records said they could be suicidal enough to legally could be committed for treatment, but there was no indication she sought to intervene immediately in what could be emergencies.
“There’s a lot of information that should be there that isn’t,” Gold testified.
One of Neuhaus’ attorneys, Robert Eye, objected unsuccessfully to Gold being designated as an expert witness, arguing she Gold doesn’t have enough expertise with abortion. Eye said during a break in the hearing Tuesday that Gold’s testimony also was flawed because it was based on only a review of records.
“She’s not interviewed Dr. Neuhaus, nor has she interviewed any of these patients,” Eye said.
Anti-abortion groups have pushed the board to discipline Neuhaus since at least 2000. The hearing resulted from a 2006 complaint filed by Operation Rescue.
Tiller was one of a few U.S. physicians performing late-term procedures when a man professing strong anti-abortion views shot him to death in May 2009. The doctor had been acquitted two months earlier of misdemeanor criminal charges that, in relying on Neuhaus for referrals, he wasn’t getting the independent second medical opinion as state law required.
The hearing officer will issue an order recommending whether Neuhaus, from Nortonville, a small town about 30 miles north of Lawrence, should face sanctions. The 15-member board, mostly doctors, will make the final decision and has the power to revoke her Kansas license.
Gold said repeatedly that Neuhaus’ patient records didn’t contain information about clients’ lives and histories needed to support diagnoses of mental health problems. Some files contained as few as five pages, she testified.
One case involved a 10-year-old rape and incest victim from California who had a late-term abortion at Tiller’s clinic in July 2003. Gold questioned whether Neuhaus met accepted standards of care because Neuhaus didn’t refer the girl to a specialist. But, Gold said, even assuming Neuhaus had the proper training, her reports contain too little data about the patient and contradictory information about whether the girl was suicidal.
“This kind of evaluation would take, even for a specialist, hours and hours and require input from other caregivers,” Gold testified. “There is no indication that kind of labor-intensive process occurred.”
Eye said Gold’s testimony didn’t adequately consider information shared by Tiller’s clinic.
“Dr. Neuhaus had an obligation to do an independent medical review, true, but there’s nothing to say that it’s not legitimate to rely on the work of others who are providing information,” Eye said. “That’s common in a doctor’s office.”
But Gold said another person’s evaluation of a patient shouldn’t have served as the basis for Neuhaus’ diagnosis when she had the opportunity to see the patient herself.
“I still have to evaluate the patient because what he or she saw last week might not be what I see this week,” Gold said.