A doctor who has been performing abortions in the District since the mid-1950s is facing actions to remove his medical license as well as the license to operate his downtown Washington abortion center, the Laurel Clinic.
The D.C. Commission on the Healing Arts voted last month to initiate disciplinary proceedings against Dr. Milan Vuitch, 69, who has held a District medical license since 1955, according to commission investigator Fred Pickney. The case is in the D.C. Corporation Counsel's office waiting for formal charges to be written.
In a related matter, the D.C. Office of Consumer and Regulatory Affairs has issued a proposal to deny the Laurel Clinic's license renewal because of its inspections and several malpractice judgments against Vuitch, as well as a complaint filed by a doctor at George Washington University Medical Center.
Vuitch, a veteran of legal attacks against his practice, said he is appealing all of the city's charges against him. "I stand behind my work. No one's talking about revoking the licenses of all the other doctors and hospitals who have malpractice suits."
He added, "I think it's all fabricated, political and part of the general confusion surrounding abortion."
In the '60s and early '70s, Vuitch was arrested 16 times by District, Virginia, Maryland and federal authorities on charges he performed abortions before most abortions were declared a matter of legal right by the Supreme Court in 1973.
Vuitch was never jailed in connnection with the charges, many of which were dropped and one of which resulted in a conviction that he unsuccessfully challenged to the Supreme Court. Since 1960, he has operated an abortion clinic in downtown Washington, and in the past he operated clinics in suburban Marlyand and Virginia.
According to Laurel Clinic's records, its last license, for 1982, was issued by the city in August 1983. Vuitch said that his clinic's license problems arose only after he called District officials to complain because he never received a 1983 or 1984 license.
Joyce McCray, a spokeswoman for the D.C. Office of Consumer and Regulatory Affairs, said she could not comment on the license delays. The city began regulating abortion clinics in 1979.
The city charges that several malpractice cases show a pattern of "significant violations" of the city's licensure law. Specifically, the city cited a 1980 case in which it was charged that Vuitch, and not a trained anesthesiologist, gave anesthesia to a patient who died. The case resulted in a $150,000 settlement to the woman's estate. The city's complaint also cites a 1982 malpractice award of $125,000 in a case where Vuitch was alleged to have improperly repaired a lacerated uterus and a 1984 award of $100,000 in a case in which a woman claimed she was not given a local anesthetic during an abortion, as requested.
Vuitch, who said he has not had malpractice insurance for his practice for two decades, said he is appealing all of the malpractice awards.
City authorities also cited a 1983 case, in which a patient underwent part of an abortion procedure in which Vuitch delivered a premature baby who died a day later. Dr. John W. Larsen Jr., the doctor who handled the case in the emergency room of George Washington University Medical Center, sent a letter of complaint to city authorities, detailing Vuitch's treatment of two patients who later sought hospital care.
Larsen's clinical summaries, which were submitted to the Commission on Healing Arts, the government board that licenses physicians in the District, "demonstrate an unacceptable pattern of care for patients seeking abortion" and a failure to hospitalize patients who needed it, the complaint letter states.
The city cited Vuitch's testimony in the 1980 malpractice case, which it said showed a pattern of staff members other than trained anesthesiologists giving anesthesia. Vuitch said yesterday that the five-doctor clinic employs three anesthesiologists.
The clinic has violated city law by allowing patients to stay overnight, according to an investigator's report. D.C. law states that ambulatory clinics such as Vuitch's cannot keep patients overnight. Vuitch said that until Maryland authorities complained about the practice, he frequently drove patients to the basement of his Silver Spring home to spend the night.
"In my basement, next to the swimming pool, I had organized a little infirmary, an annex to the clinic," Vuitch said Friday. "Many of the patients come in from out-of-state and I don't want them traveling back right away." He said he gave up the practice three years ago after Maryland authorities told him he was operating an unlicensed hospital from his home.
The city's complaint also states that during an August 1983 inspection, drugs were being used past their expiration date and medications were not labeled properly. Patient records also showed the improper strength of one general anesthesia, according to the complaint. Investigators claimed that anesthesia was not freshly prepared and could not properly be measured by the existing equipment.
Further, the clinic had been warned during three past inspections to improve its storage of medicines and its anesthesia records, and it promised in a "plan of correction" to do so, but had not, according to the complaint.
No date has been set for a hearing by the Board of Appeals and Review on the fate of the clinic's license. But a newly formed coalition is asking the city to close the clinic immediately, before any appeal is heard.
"He should not be allowed to practice, said Ricki V. Grumberg, a member of the D.C. chapter of the National Organization for Women, who helped form the Coalition to Protect Women's Health. "It's ironic that he helped so much to get abortion legal in this city, but he's hurting women now. We're in favor of safe and legal abortions."
The coalition was formed to counter antiabortion picketers who have demonstrated every Saturday for the past year outside of 1712 I St., NW, the office building that houses the Laurel Clinic. An unrelated abortion clinic, the Women's Health Center, which has an up-to-date license, is located in the building and has been the subject of antiabortion pickets.
"We realized that most of the women we were helping to get in in the building were going into his office," said Grumberg. "After we heard of the proceedings against him, we felt we had to act."
The Board of Appeals and Review has not responded to the coalition's written request. Vuitch said that he would be denied due process if the city forced the clinic to close before his appeal. "How can a group be that political that they want to prevent a hearing and stop due process?" he asked.
Vuitch said many of his patients are poor women who need his services. The D.C. Medicaid office said that the clinic is not registered with the program, but that its individual doctors are. Vuitch received $10,785 in Medicaid money for July, August and September, billings which rank him 58th among the 1,200 doctors receiving District Medicaid money, according to the program director. Vuitch also receives money from the Maryland Medicaid program, which restricts abortion payments to those cases involving a danger to the life of the mother. It could not be determined Friday how much money Vuitch receives from Maryland.
Vuitch estimated that 6,000 women were treated at the clinic in the past year -- about 3,000 sought abortions, between 2,000 and 3,000 sought contraceptive information or aids and about 300 sought sterilizations.
Vuitch said he will fight the District's efforts to restrict or revoke his license. "It's a tedious and long-lasting process to revoke a license of a physician," said Vuitch, who received his initial training in his native Yugoslavia and in Hungary before a two-year surgical residency at Doctors Hospital in the District. "I'm accustomed to fighting . . . . This is nothing new for me."
Vuitch said he also holds medical licenses in Maryland, Virginia and New York.