The District of Columbia medical licensing board has revoked the medical license of Dr. Robert J. Sherman, who had been accused of purposely performing incomplete abortions, including one that resulted in the death of a 16-year-old girl in 1975.
In materials supporting its Sept. 2 decision, the Commission on Licensure to Practice the Healing Arts described Sherman's former clinic in Northwest Washington as a place where women often were given abortions with improperly sterilized plastic instruments that had been reused so often that "the tips of them . . . were broken off."
Sherman, the commission found, allowed a barely literate assistant to perform surgery on women in at least 50 instances and directed aides to give some treatments routinely to women on Medicaid "because that is a way of raising the bill."
Sherman's clinic "illustrated an indifference to the maintenance of an antiseptic atmosphere," the commission found. "the general routine in the office operation exhibited a helter skelter practice.
Sherman, the commission found, "placed very little value on the life of his abortion patients.
"His primary interest was the abortion fee and the follow-up additional . . . fee of $150 he could extract," the commission said. "These fees were paramount over the welfare of the patient. Clearly, a doctor who places such minimal worth on his patients deserves to haev his license lifted."
Sherman already had admitted negligence in the March, 1975, death of Rita C. McDowell, who died of blood poisoning and shock four days after Sherman performed an incomplete abortion on her. A, D.C. Superior Court jury awarded the McDowell family $392,000 in compensatory damages and Sherman agreed out of court to settle a claim for $3 million in punitive damages. He paid the family $525,000 to settle that claim, according to sources quoted earlier.
Sherman no longer is believed to be praticing medicine in the city and could not be reached yesterday for comment. D.C. Corporation Counsel John R. Risher Jr., president of the licensing board, said the revocation would "preclude the risk that he might decide to resume his practice."
It was the sixth medical license revocation or suspension by the board since April, 1976. There are seven more cases currently under investigation, a spokesman for Risher said.
Risher said the revocation of the D.C. license would not immediately ba
Sherman from practicing elsewhere. "There's no automatic consequences in any other jurisdiction," he said.
Risher said Sherman has a license to practice in Maryland, which, along with other states, will be notified of the D.C. board's decision. "They will have to do what they deem appropriate," Risher said.
U.S. Attorney Earl J. Silbert would not comment yesterday on any specifics of the Sherman incident. Silbert did say, however, that negligene in itself is not sufficient to support a charge of manslaughter. Prosecutors would have to prove "gross negligence" disregard for life" to sustain a criminal charge, Silbert said.
The 44-page decision of the five member board was based on 14 days of testimony by patients, employees and former employees of Sherman's now defunct Columbia Family Planning Clinic, 1835 I St. Nw. Sherman also testified.
Sherman, 64 and a licensed District physician since 1957, offered abortions at the clinic as well as general obstetrics and gynecological services.The clinic had a significant number of clients who received medical treatment through the federally funded Medicaid program for the medically needy. In 1974, the clinic was paid more than 100,000 for services to the city's poor and $77,000 in 1975.
The decision to revoke the license was based on findings that the conditions in the clinic did not adhere to prescribed medical standards of cleanliness and practice. The clinic was one of five that had refused to be inspected as part of a voluntary program to insure minimum medical standards.
Among the violations cited most frequently in the decision were those covering minimal qualifications of medical personnel and sanitary conditions.
While most abortion counselling is expected to last from half and hour to three hours, sessions at Sherman's clinic were "performed in 5 to 10 minutes," the decision said.
One doctor who worked at the clinic from October, 1973, to March, 1974, testified that he never saw any abortion counseling during his short stay, the commission reported. Another said that the high volume of abortions at the clinic (about 15 a day) "was not conducive to effective counseling." Some counseling was done by a woman employed as a receptionist, it was said.
In some instances, the commission was told, cotton swabs were used to clean one patient, then put back into a bottle of antiseptic solution. Other swabs to clean other women were later put into the same bottle.
While many abortion clinics used steel cannulae (a special instrument) to extract the fetus from the womb, Sherman's clinic used plastic ones and did not properly sterilize them with as between uses, the commission said.
"Disposable plastic cannulae were reused at the clinic to the point where the tips of them, which are rounded to prevent damage to the uterus, were broken off. Such plastic cannulae were sterilized at the clinic in a boiler-type rectangular pan, and in some instances . . . tissue was still clinging to the cannulae while being sterilized in such a pan," the commission said.
Cryosurgery, a method of deep freezing tissue to heal ulcerated areas, was performed at the clinic by a nurse's aide Who, the commission said, "could hardly read or write." The operation is supposed to be performed only by a physician, paramedic or nurse under direct supervision of the treating physician, according to the commission.
It was these treatments, the commission said, that Sherman permitted "without regard to actual medical need." He "justified wuch unnecessary cryotherapy treatments on the basis that all patients should have cryotherapy because that is a way of raising the bill for Medicaid, and that all Medicaid patients have some form of 'cervical erosion or abnormality.'"
The commission found that Sherman routinely used instruments that were too small to completely remove the fetus and would then instruct women to return for a second visit to complete the abortion, for which he charged an additional $150. Only one visit should have been necessary, the commission said.