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Medical examiner justifies changing death certificate in abortion doctor's murder trial

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By The Philadelphia Inquirer
Thursday, March 28, 2013, 10:12 p.m.

PHILADELPHIA — The murder trial of abortion doctor Kermit Gosnell ended its second week of testimony on Thursday with a city medical examiner defending his decision to change the death certificate of a Gosnell patient from accidental to homicide.

Gosnell defense attorney Jack McMahon questioned Assistant Medical Examiner Gary Collins at length about his decision to change the death certificate of Karnamaya Mongar, 41, a Virginia woman who died on Nov. 19, 2009, while undergoing an abortion in Gosnell's West Philadelphia clinic.

Collins testified that toxicology tests done during Mongar's autopsy showed she died of an overdose of Demerol, the sedative Gosnell used during abortions.

Collins said he initially listed the manner of death as accidental in an Aug. 13, 2010, first draft of Mongar's death certificate. He reiterated the conclusion in a second draft dated Aug. 31, 2010, that he and the city's Chief Medical Examiner Sam P. Gulino initialed.

But when Mongar's final death certificate was filed on Dec. 17, 2010, the manner of death had been changed to homicide.

The question of why the change was made is important to Gosnell's case because Mongar's death is the basis of a third-degree murder charge against him. For that reason, McMahon spent two hours this morning in an often-heated questioning of the forensic pathologist.

Collins said he only began to revise his conclusion in September 2010 after a county investigating grand jury was impaneled and the District Attorney's office began providing him with additional evidence.

Collins said he got statements taken right after Mongar's death in police interviews of Mongar's daughter and three workers present that night in Gosnell's Women's Medical Society clinic.

He also toured the abortion clinic in October 2010, Collins said.

“You're telling us that during that nine-month period you didn't see any of these statements?” asked McMahon.

“We didn't know they were out there,” replied Collins. “This is not TV. We can't go out and interview people. We are bound by the limitations of the information provided to us.”

When he first ruled the death accidental, Collins added, he assumed that Gosnell's clinic was a legitimate abortion provider: “I assumed it was a medical institution — and I'm using that word loosely — with a trained staff and working equipment doing proper procedures.”

Collins' testimony ended the eighth day of testimony in a trial estimated to last six to eight weeks. Common Pleas Court Judge Jeffrey P. Minehart is not holding trial sessions on Fridays so the trial resumes on Monday when Assistant District Attorneys Edward Cameron and Joanne Pescatore continue the prosecution case.

The prosecution alleges that Mongar died because Gosnell's untrained workers gave the diminutive woman multiple doses of Demerol and other drugs to anesthetize her and instead stopped her heart.

McMahon has argued that Mongar hid respiratory problems that made her more vulnerable to the effects of Demerol.

In addition to the charge involving Mongar's death, Gosnell is charged with seven counts of first-degree murder in the deaths of newborns whose spines he snipped with scissors after late-term abortions. He faces the death penalty if the jury finds him guilty.

Also on trial is Eileen O'Neill, 52, of Phoenixville, an unlicensed medical school graduate who worked as a doctor in Gosnell's clinic. She is not charged with performing abortions.

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