Position of the American Dietetic Association:Integration of medical nutrition therapyand pharmacotherapy POSITION STATEMENT It is the position of the American Dietetic Association thatthe application of medical nutrition therapy (MNT) and It is the position of the American Dietetic Association that lifestyle counseling as a part of the Nutrition Care Process the application of medical nutr
Sba-list.orgAbortionist Pendergraft's Plan:
Turn the District of Columbia Area into Worldwide Hub for Intracardiac Injection
for Abortionto Stop Unborn Heartbeats after 24 weeks
"I never try to sneak into a city . . . I want people to know they're coming to someone whois not a back-alley kind of individual.”- James Pendergraft, M.D., quoted in “About Extortion or Abortion?” Businessweek,October 9, 2000, available online at Abortionist James S. Pendergraft IV is advertising through internet websites,LateTermAbortion.net and WomensCenter.com, the availability of a “late term abortion facility”for “women up to 32 weeks” pregnant at a secret, undisclosed location, in the “Washington D.C.
area.” At this facility, “intracardiac injections to stop the fetal heart beat on late second and thirdtrimester therapeutic termination of pregnancy procedures” are performed. LateTermAbortion.net explains that intracardiac injection cannot be performed in Floridabecause “the State of Florida does not allow abortions to be performed after 24 weeks.” However, the District of Columbia no longer has any limitation on abortion, as all limitations,including a definition of an “abortion,” were repealed by the District of Columbia Council in2004. See DC ST § 22-101. It is not clear who Pendergraft has hired or enlisted to actuallyperform the intracardiac injection, since Pendergraft's license in the District of Columbia isexpired, and his Maryland license is expired as well. His Virginia and Florida licenses aresuspended. Nevertheless, Pendergraft is the point of contact for LateTermAbortion.net and thewebsite leads the reader to believe that he is the originator, and will be an integral part, of thisplan to provide late-term abortions. Pendergraft has a long history in the abortion business, and the Orlando Women’s Center websiteindicates that he has experience in performing abortions up to 34 weeks (or about eight months,in layman’s terminology). He has incurred multiple professional sanctions, and reportedly, arecent $36 million civil judgment.
Medical License Suspended Multiple Times
Pendergraft’s first suspension in Florida On December 18, 2007 the State of Florida Board of Medicine issued a FinalOrder to suspend Pendergraft’s medical license for one year, with additionalprobation for three years, and a $10,000 fine. (Earlier, on August 10, 2006 theState of Florida issued an emergency order suspending Pendergraft’s license,which was replaced by a substitute emergency suspension of license in 2007.) Administrative Law Judge Findings of Fact: According to the Administrative LawJudge, in a 2005 abortion at Pendergraft's Orlando Women's Center clinic,Pendergraft “administered Digoxin into the heart of the fetus to stop the fetal heartbeat” and "monitored the fetal heart beat using a sonogram until the fetal heartstopped.” [ALJ, p. 9]. The woman was then “given Cytotec to induce labor” ofthe now dead child. The Administrative Law Judge noted that “Dr. Pendergraftand his associate . felt that, preoperatively, the gestational age of the fetus wasbetween 27 and 28 weeks,” and found the evidence to be “clear and convincingthat Dr. Pendergraft was under the impression that R.W. [the woman] was in herthird trimester of pregnancy when he performed the abortion.” [ALJ, pp. 11-13]. Pendergraft “charged R.W. [the woman] $12,000 for the [abortion] procedure.”[ALJ, p. 11].
Violation: On October 26, 2007 an Administrative Law Judge found thatPendergraft “was under a legal obligation to perform the third trimester abortionin a hospital, and he did not do so.” [ALJ, p. 19]. The ALJ also found thatPendergraft had a legal obligation “to have the written certifications of twophysicians that within a medical probability it is necessary to perform the abortionto save the life or preserve the health of R.W. or to certify in writing than anemergency existed, and there was no other physician available for consultation.
He did not do so.” [ALJ p. 19]. Recommended Order Administrative Law Judge 10/26/07 Final Order by State of Florida Board of Medicine 12/18/07 July 2, 2009, the Fifth District Court of Appeal of the State of Florida deniedPendergraft’s appeal of his license suspension. Pendergraft v. Dep’t of Health,Bd. Of Med., 19 So. 3d 392 (Fla. Dist. Ct. App. 5th Dist. 2009). Of interest: As a result of the action by the State of Florida, the VirginiaDepartment of Health Professions suspended Pendergraft’s license, and the NorthCarolina Medical Board prohibited Pendergraft from practicing medicine withoutthe Board’s prior approval.
and Pendergraft’s second suspension in Florida On January 25, 2010 the Florida Board of Medicine issued a Final Order thatfined Pendergraft $20,000 and suspended his medical license in Florida for twoyears, followed by three years probation. Administrative Law Judge Findings of Fact: According to the AdministrativeLaw Judge’s opinion of September 21, 2009, an abortion was initiated onFebruary 6, 2006 on a woman “determined to be approximately 18 to 19 weeksgestation . with the use of ‘Cytotec,’ a drug that causes cervical dilation anduterine contractions.” [ALJ, p. 4]. The ALJ reports that “Cytotec tablets, in 200microgram dosages, were administered orally to the patient by the Respondent’s[Pendergraft’s] medical assistant.” [ALJ, p. 5]. The following evening, “thepatient’s termination was not completed” and “the medical assistant moved thepatient into a procedure room at the Respondent’s [Pendergraft’s] direction.”[ALJ, p. 7]. “The Respondent [Pendergraft] began to . assess the situation.”[ALJ, p. 8]. Pendergraft “observed a fetal part protruding through the cervical osinto the vagina” and “he detached the part from the fetus by grasping the part witha ‘Hearn’ instrument and twisting the instrument.”[ALJ, p. 8]. The ALJRecommended Order states that “[a]lmost immediately thereafter, theRespondent’s [Pendergraft] reviewed the ultrasound image and observed that theimage indicated the fetus was no longer fully contained within the uterus” and that“the Respondent understood that the ultrasound image indicated a potentialuterine perforation or rupture and, appropriately, concluded that the situationcould be life-threatening for the patient.” [ALJ, p. 9]. He then contacted ahospital and spoke to two practitioners, but “failed to inform either Dr. Cates orDr. Lamberty that he had removed a portion of the fetus from the patient at theclinic.” [ALJ, p. 9]. At the hospital, Dr. Lamberty completed the abortionprocedure and “observed that . . . a portion of the fetal leg was missing” and“began efforts to locate the missing part, which he reasonably presumed remainedin the patient.” [ALJ, p. 10]. Also, according to the ALJ, Pendergraft “orderedDemerol” for the patient, but was not “properly registered with the DEA [DrugEnforcement Agency].” [ALJ, pp. 5-6]. Demerol is “routinely used to relieve painduring medical procedures.” [ALJ, p. 5]. Violation: The Administrative Law Judge found that “by failing to document theremoval of a portion of a fetal limb, the Respondent [Pendergraft] clearly failed tokeep legible medical records justifying the course of treatment” [ALJ, p. 15] andthat Pendergraft’s “failure to advise the hospital’s physicians during the telephoneconversations that a portion of the patient’s fetus had been removed . . . breachedthe standard of care and constituted medical malpractice.” [ALJ, p. 20]. Recommended Order by Administrative Law Judge 9/21/2009 Final Order by State of Florida Board of Medicine 1/25/2010 Pendergraft’s third suspension in Florida On August 25, 2010 the Florida Board of Medicine suspended JamesPendergraft’s medical license for a period of one year (followed by three yearsprobation) and issued a $10,000 fine.
Administrative Law Judge Findings of Fact: According to the Administrative LawJudge’s Recommended Order of June 8, 2010, Pendergraft “prescribed steroidsfor M.W. both for muscle building . . . and for enhancement of athleticperformance” and “did not order lab work to monitor the effects of the steroidsthat he prescribed.” [ALJ, p. 23].
Violation: The Administrative Law Judge found that “the failure to order lab workto monitor the effects of the anabolic steroids is a Standard of Care violation”[ALJ, p. 29] and that the Board of Medicine had “proved a medical recordsviolation because Respondent [Pendergraft] failed to document adequately theeffects of the anabolic steroids – specifically, by failing to document the results ofthe lab work that must be performed when administering anabolic steroids underthese circumstances.” [ALJ, pp. 30-31].
Recommended Order by the Administrative Law Judge 6/8/2010 Final Order by the State of Florida Board of Medicine 8/25/2010 This suspension is documented in an article by Central Florida News 13. The news article states, “[t]he Department ofHealth said Pendergraft’s numerous suspensions will run concurrent to each other,and once they're finished, he'll be free to practice in the state of Florida again.” Pendergraft's fourth suspension in Florida On April 17, 2013, the Florida Board of Medicine indefinitely suspendedPendergraft's medical license until an outstanding fine ($19,000) and costs($102,303.21) from a prior disciplinary action are paid. Medical Malpractice
According to the Orlando Sentinel, in 2011 “[a]n Orange County jury awarded$18.7 million in compensatory damages and a total $18 million dollars in punitivedamages against James Scott Pendergraft IV and the Orlando Women’s Center,”for a total of “36.7 million.” A judge subsequently denied Pendergraft’s requestfor a new trial and to have the verdict set aside.
Facts: As reported in the Orlando Sentinel on August 13, 2011: The lawsuit involves a woman, identified as C.H. in court documents, whowent to the Orlando Women's Center on Nov. 15, 2001, to terminate what shethought was a 16- to 20-week pregnancy. Staff at the center determined shewas 22.3 weeks pregnant, according to the complaint and other court records.
Staff at the clinic gave her 12 doses of Cytotec and a single dose of RU-486during an 11- or 12-hour period to induce labor. Neither Pendergraft noranother physician at the facility, Dr. Randall B. Whitney, personally evaluated,examined or treated the woman, the lawsuit says.
At about 1 a.m. Nov. 16, "C.H. was instructed to and/or allowed to leave theOrlando Women's Center while in active labor," according to the claim.
She then went to the emergency room at Orlando Regional Medical Center in"active labor" and gave birth by cesarean section "to a viable female child,"the lawsuit says.
That baby, identified in court documents as J.F., was "born prematurely andhas suffered catastrophic and permanent bodily injuries, impairment,disability, [and] disfigurement." Expenses related to the child's care andtreatment formed the basis of the lawsuit.
The Second Amended Complaint filed by C.H. alleges that “Pendergraft was the medical director of the Orlando Women’s Center and was responsible for theimplementation of medical protocols and procedures and proper implementationof said clinic.” According to LifeSiteNews.com, “Although Pendergraft was stillin jail for extortion in Marian County at the time, Howard [C.H.] said she wasdrawn to one of his five abortion clinics because the facility’s website touted hiscredentials as a board certified OB/GYN.”LifeSiteNew Second Amended ComplaintCase summary available from Orange County Clerk of Courts, (H, Cet al. vs.
James Scott Pendergraft, Case No. 2004-CA-001202-O).
It is evident from Pendergraft’s paper, “Early and Late Second Trimester Abortion in an
Outpatient Clinic Setting Completed in Less Than 24 hours,” that chemically-induced second
trimester abortion is a preferred procedure of his. (Pendergraft’s paper includes abortions up to
34 weeks as “second trimester.”) According to his paper, “[a]ll patients 22 week’s gestation or
greater receive fetal intracardiac injection of a combination of digoxin and potassium chloride to
stop the fetal heart. If the fetal heart cannot be injected then a higher amount of digoxin is
injected into the fetus or is instilled in the amniotic fluid.”
However, according to allegations, sometimes the child is born alive.
In the 2011 civil malpractice suit against Pendergraft discussed earlier, LifeSiteNews.com quotesa witness to the courtroom proceedings as saying that Pendergraft’s associate, Randall Whitney“cavalierly stated that yes, babies are delivered in the toilet all the time and many times are stillalive, wiggling a In 2005, WORLD Magazine reported on an abortion at Pendergraft’s EPOC clinic where Angele“gave birth to a live pre-term baby” who died “after abortion workers refused to render aid or callfor emergency help.” WORLD Magazine describes how “Angele delivered Rowan into a toilet .
Then, she said, Rowan’s leg moved. Next, she saw the tiny boy curl up as though cold.” Angele“screamed for clinic workers to call 911 . ” and then “[f]rantic, Angele says she grabbed her cellphone and asked the friend who had driven her to the clinic to call 911.” Transcripts of the 911 call received by Orlando Fire Department [OFD] were made available toWORLD Magazine. The WORLD Magazine article contains the following: Angele’s Friend (AF): It’s a women’s clinic. . . . My friend is having an abortionand the baby was born alive. . . . They’re not allowing her to use the phone there.
They’re wanting the baby to die! OFD: She wants the baby to live?
AF: That’s correct. . . . [She] said the baby was just born and it was alive and theywere wanting her to leave it in the toilet and, uh, just let it die, and she’s notwanting Baby Rowan “stopped moving” before the 911-responders arrived. The story, as recounted forWwas the basis forthe film, 22 Weeks. The film’s trailer is available Allegation of Attempted Extortion
In 2000, James Pendergraft and an associate were convicted of “attempted extortion .
mail fraud . conspiracy to commit extortion, mail-fraud, and perjury.” According to theEleventh Circuit Court of Appeals “the charges against Pendergraft and Spielvogel aroseout of their threat to seek damages in a lawsuit against Marion County, Florida, and to usefalse evidence in support of the lawsuit.” [Opinion page 2]. On appeal the EleventhCircuit said “we reverse the attempted extortion and mail-fraud convictions, and wevacate the conspiracy convictions. However, we affirm Spielvogel’s [Pendergraft’sassociate] convictions for perjury and making false statements.” The court remanded thecharge of conspiracy to commit perjury back to the district court for a new trial. UnitedStates v. Pendergraft, 297 F. 3d 1198 (11th Cir. Fla. 2002). The opinion can be foundhere: Pendergraft's four-year battle with prosecutors ended in 2004, when, according to theOrlando Sentinel, Pendergraft “pleaded guilty to one count of accessory after the fact tomaking a false statement. The Sentinel reports that Pendergraft "conceded in federalcourt . . . that he impeded justice by supporting a business associate he knew waslying." Pendergraft’s activities in the “Washington, D.C. area”
James Pendergraft's Florida medical license was suspended in 2007 for performing a third-
trimester abortion outside of a hospital and it is currently suspended for other violations
(discussed above). His license is suspended in Virginia, and expired in Maryland and the District
of Columbia. But that has not stopped him from attempting to capitalize on the more lucrative
third-trimester abortions by orchestrating a third-trimester abortion facility either in the District
of Columbia – which currently has no limits on abortion at any point in pregnancy – or in
Maryland, where limitations are very weak. Pendergraft is the point of contact for a website
(Latetermabortion.net) devoted entirely to late-term abortions, which provides details to
interested women on how to obtain a late-term abortion in the Washington, D.C. area.
The website for Orlando Women’s Center, an abortion clinic founded and managed byPendergraft, details Pendergraft’s “Consultation and Referral Services for women up to 32weeks” pregnant. At a “referral facility” in the “Washington, D.C. area,” the initial “preparation”of pregnant women will be performed. According to the Orlando Women’s Center “[t]hispreparation requires fetal intra-cardiac injection of medications to stop the fetal heart beat.” (Thisis accomplished, as explained at LateTermAbortion.net, by using “a spinal needle [that] is guidedslowly into the fetal heart where a feticide agent or 50cc's of air is injected via a syringe to stopthe fetal heart beat.”) This will then be followed by the pre-arranged removal of the now-deadbaby by the woman’s referring physician back in her home state, or else by another facilityrecommended by Pendergraft’s office. The Orlando clinic refers interested individuals to a separate website, LateTermAbortion.net, tolearn more de LateTermAbortion.net “is a medical practice that specializes in performing intra-cardiacinjections of second and third trimester pregnancies (greater than 24 weeks).”, available to“patients worldwide.” These abortions will be performed at an undisclosed “location inWashington, D.C.”. The location is “near 3 major airports, and the D.C. Amtrak train station,not far from the I-95 corridor.” The patient is not even told the secret location of the facility inadvance of arrival. Rather, on the day of the patient’s arrival to D.C., the patient will be toldwhere someone will pick her up to take her to the facility. See image from website below. According to the website, she will be able to leave for home “10 to 15 minutes after the procedure is performed.” The woman can then return to her home state, or a facility to which sheis referred by LateTermAbortion.net, for removal of the now-dead baby, whichLateTermAbortion.net explains is “no longer defined as an abortion” since the baby no longerhas a heartbeat.
LateTermAbortion.net is “affiliated with Orlando Women’s Center,” but LateTermAbortion.netexplains that intracardiac injection cannot be performed in Florida because “the State of Floridadoes not allow abortions to be performed after 24 weeks.” Note, Florida law requires that third-trimester abortions (defined as post-24 weeks) be performed in a hospital and certified by twodoctors (or certification of an emergency). See Fla. Stat. § 797.03(3) and Fla. Stat. § 390.0111.
Elsewhere, the website states: “It is my hope to one day challenge the unconstitutionality of a lawthat requires procedures after 24 weeks to be performed in a hospital when there are no hospitalsin Florida that allow a termination procedure to be performed as long as a fetus still has aheartbeat . . . .” LateTermAbortion.net assures the reader that “the facility and place where the intra-cardiacinjection will be carried out is one where the procedure is absolutely legal to perform.” (Note,the District of Columbia no longer has any limitation on abortion, as all limitations, including adefinition of an “abortion,” were repealed by the District of Columbia Council in 2004. See DC LateTermAbortion.net explains that it “specializes in performing intra-cardiac injections .
where fetal anomalies are found to be incompatible with life .” Elsewhere the website listssome of the birth defects or fetal abnormalities that may be cause for a late abortion. Theyinclude “congenital dwarfism,” “spina bifida,” and “Trisomy 21 (Down syndrome).” Pendergraft's D.C. late-term abortion facility will be available to "patients worldwide." Pendergraft’s Orlando Women’s Center clinic in Florida announces that patients have come fromall over the world. See imag In recent months, Pendergraft has posted ads using an internet classifieds service, Backpage.com.
This site functions as a community billboard where users can post ads for services, jobs, realestate listings, etc. There are individual sites for cities and regions.
Pendergraft’s ads have been placed on these online billboards for many places across the country,including Washington D.C, Philadelphia, Pennsylvania, Denver, Colorado and eveninternationally in Buenos Aires, Argentina. The web ads announce that “womenscenter.com ishere to serve women in the U.S. and the world.” Similar to Pendergraft’s LateTermAbortion.net website, the web advertisements instructedwomen seeking more information to contact Pendergraft via email or his toll-free number, butremained cryptic about the exact location of Pendergraft’s late-term abortion business beyondsaying “Dr. Pendergraft . . . made the decision to help open a facility in the Washington D.C. areathat would be instrumental in helping women . . . carry out their termination of pregnancy . . . .”The headline for the ads is “Abortion Clinic: 3 to 34 weeks, Late Term/Third Trimester AbortionsComplete in 24 Hours or Less.” As shown in the image, the search results on the communitybillboard indicate that the location of the abortion services is the “Washington D.C. area.”
1. Which of the following is NOT 9. Motor fl uctuations are best regarded as a cardinal symptom of defi ned as: Before December 7, 2011, print this page, complete the LEARNER FEEDBACK multiple choice questions by circling the correct answer and 2. All of the following are common QUESTIONS mail or fax to: ADVANCE for Nurses, Learning Scope, 2900 “non-motor” symptom