Susanne Renee Logan was three months pregnant when she went to Hillview Women's Medical Surgical Center for an abortion. She was given Brevital, an anesthetic meant to lull her to sleep during the procedure.

Minutes after the drug entered Logan's system, her throat tightened, restricting her breathing and cutting off oxygen to her brain, rescue records show. Eight minutes later, paramedics at the District Heights Volunteer Fire Department received a high priority call: A woman was unconscious; she had no pulse.

What the emergency workers saw when they got to Logan prompted the director of the Prince George's County paramedics program and the Prince George's Medical Society to ask the Maryland Physicians Quality Assurance Board to investigate. County officials were also concerned about other incidents at the Suitland clinic in the past two years, in which emergency workers have rushed women to area hospitals with problems including hemorrhaging, shock, breathing trouble and cardiac arrest.

In sworn statements contained in a lawsuit Logan has filed, paramedics said that the 32-year-old woman was blue and in cardiac arrest when they arrived. Paramedics said clinic personnel attempted to revive her with a medicine that medical experts say has no effect on reversing the reaction to Brevital. Clinic workers had tried to resuscitate her with oxygen equipment that was not working. An oxygen mask placed over her nose and mouth was upside down.

Furthermore, there was no anesthesiologist on duty to administer the drug or monitor Logan's vital signs, according to interviews with clinic personnel. A warning on the drug states that Brevital should be administered by people "qualified in the use of intravenous anesthetics," and that "cardiac life support equipment must be immediately available" during use of the drug.

After four months in a coma, Logan, who suffered extensive brain damage in the Sept. 9 incident, is almost completely paralyzed. The former waitress cannot walk or talk and communicates by tapping out her messages on an electronic keyboard with her left hand, over which she has limited control.

Logan and her family have filed suit against clinic owners Barbara P. and Benjamin Lofton and physician Gideon M. Kioko, alleging that clinic workers were not sufficiently trained to treat and monitor her while under the anesthetic or to resuscitate her during an emergency. The suit also says that emergency equipment was not available or working.

In a response to the lawsuit, Hillview's owners denied the allegations in the Logan case. Barbara Lofton, who is also the clinic administrator, contended in an interview that Hillview provides "a good service" and that complications at the clinic are very rare.

"If you provide a certain number {of abortions}, no matter how good you are, no matter what the qualifications are, there are sometimes circumstances," Lofton said. "There are probably no facilities without some complications."

The Physicians Quality Assurance Board and Maryland Attorney General's Office are investigating the Logan case. Kioko and Lofton said they have also been interviewed by board investigators about the death of Debra M. Gray, a 34-year-old woman who, according to a medical examiner's report and paramedic records, went into cardiac arrest while under general anesthesia at the clinic.

Maryland has no laws specifically regulating clinics where abortions are performed, including requirements for handling emergencies. Nor does the state have rules governing ambulatory care centers or regulations for those centers that use anesthesia, a spokeswoman for the state Health and Human Resources Department said. Only ambulatory surgical centers that are reimbursed under the Medicaid and Medicare programs are regularly inspected.

The Accreditation Association for Ambulatory Health Care Inc. requires that anesthesia be administered only by anesthesiologists, other qualified physician or dentist anesthetists or qualified nurse anesthetists. Some facilities ask for certification from the national association, although it is not a legal requirement. Under the association's recommendations, the operating surgeon or anesthesiologist must evaluate the patient immediately before surgery to assess the risk of the anesthesia.

The Maryland Physicians Quality Assurance Board is empowered only to evaluate the practices of the physicians who work at clinics, and neither Barbara nor Benjamin Lofton is a physician. Three physicians work at the clinic part time. The Loftons opened the clinic in Prince George's in 1987 after the District's Department of Consumer and Regulatory Affairs ordered a clinic they owned in the District to stop performing abortions without a license.

Kioko would not go into detail about the Logan case. But he said the decision on whether patients receive an anesthetic stronger than a drug that numbs the cervix is made between the client and clinic personnel based on the patient's ability to pay. He said the surgeons take no part in prescribing anesthesia.

In the cases of Logan and Gray, he said, no anesthesiologist was on duty, and Kioko said he was not aware of the qualifications of the people who administered the anesthetic. Kioko, who works part time at the clinic and served as its acting medical director until last month, said he banned the use of Brevital in November.

National statistics show that abortions in the first trimester (seven to 13 weeks) and early second trimester (13 to 16 weeks) are among the safest outpatient procedures done in the United States, resulting in complications less than one-half percent of the time, according to the Alan Guttmacher Institute, a reproductive health research center. Less than 1 percent of all legal abortions result in major complications.

Because clinics in Maryland are not required to report the number of abortions performed or whether there are complications, the exact percentage of abortion-related complications at Hillview could not be determined. Barbara Lofton estimated that the clinic performs 100 abortions a week.

Lofton said any time a woman is taken to a hospital from her clinic it is unacceptable. "Your system has somehow failed," she said. However, she attributed the investigations of her clinic to the chief of the county's paramedics program, who she said is against abortion.

"Obviously, the report from the paramedics was written by a pro-life person," said Lofton, whose clinic has been the target of antiabortion protests and bomb threats. "There were many fabrications in the report."

Joseph J. Colella Jr., an anesthesiologist and director of the county paramedic program, said Lofton's claim that he is antiabortion "couldn't be further from the truth."

"I'm not either a right-to-lifer or the other group," Colella said. He said he asked the state to investigate "because of {a} series of incidents in a short period of time involving the same group of people."

Barbara Lofton said most post-abortion complications are minor, but that is not the case in the incidents under investigation by the state physicians board.

In the case of Logan, paramedic Kimberly Dixon said in a statement contained in the lawsuit, clinic workers trying to give CPR "seemed to be very confused and did not seem to know what they were doing."

Paramedic Donna Stone said in a statement that clinic workers were mishandling the oxygen mask and bag they were attempting to put on Logan, and paramedic Dominic Mancinelli said the clinic's bag mask was not working. (Lofton denies that the mask was not working.) Stone asked clinic staff to intubate Logan, a procedure in which a tube is inserted in the throat to assist with breathing. Stone was told by clinic workers no such tube was available, the sworn statements said.

The statements from the paramedics said that a clinic doctor told them Logan had been given Narcan, a drug that, according to a spokesman for the American Society of Anesthesiologists, has no effect on reversing a reaction to Brevital. The emergency workers gave Logan the stimulant epinephrine intravenously, after which her heartbeat was restored.

Today, Logan lives at the Inns of Evergreen, a rehabilitative nursing home in Baltimore, after spending three months at Good Samaritan Hospital. Her father and stepmother, Robin and Peggy Logan, are trying to make arrangements to move her back to her home in California. Her medical bill, according to her father, is approaching $500,000; Medicaid will pay part of it.

The Physicians Quality Assurance Board is also looking at the case of Debra Gray, a secretary at the Naval Hospital, who went to the Hillview night clinic on July 12, 1989. She was about 13 or 14 weeks pregnant, family members said. She was given a fast-acting barbiturate as an anesthetic, according to the autopsy report. What happened next is uncertain.

Paramedics were called to the clinic, where Gray had gone into cardiac arrest; her brain was deprived of oxygen for at least 12 minutes, according to the autopsy records and family members. Gray, who was later found to have traces of heroin in her system, was rushed to Malcolm Grow Hospital at Andrews Air Force Base, where doctors detected no brain activity. Three days later, doctors disconnected life support systems.

"Nobody has made an effort to explain what happened to anybody," Gray's sister, Pamela, said in an interview. "We've been stalled for a year. It would be a relief if we could get to the bottom of this."

The Prince George's County Police Department's criminal investigation unit inquired into the death of Gray but closed the case after finding no criminal wrongdoing on the part of Kioko or the clinic.

The state Medical Examiner's Office reported that Gray's death was precipitated by a reaction of the heroin in her system with the barbiturate.

Doctors who work regularly with anesthesia said a patient who has used street drugs runs a greater risk of complications but will not automatically suffer the extent of oxygen deprivation that Gray did.

Kioko, who was the gynecologist performing the abortion, said that a registered nurse mixed and injected the barbiturate into Gray, and that clinic personnel thought it would put her into a "twilight" state rather than under general anesthesia.

Barbara Lofton agreed with Kioko that no anesthesiologist was at the clinic during the time Logan and Gray underwent abortions, but she said physicians administered the anesthetic. Kioko denied that.

"None of the physicians who have worked there before have given the drug {Brevital} or were consulted about the drug," Kioko said. "Everybody was nervous with it {the anesthesia}. They just didn't know anything about it."

In another case, an 18-year-old woman went to Hillview when she was about 15 weeks pregnant. She borrowed $575 from a friend after making an appointment at Hillview because it was the least expensive of the clinics she called. Hillview offers a 10 percent discount to women with medical assistance cards, although they cannot be used to pay for abortions.

In an interview, the woman, who asked that her name not be used, said Kioko sent her home after the procedure was completed; she thought the pregnancy was terminated. However, a couple of days later, she was informed by the clinic workers that the abortion was not a success. After a second abortion attempt several days later, the woman said, she was in so much pain that clinic workers carried her to a cab and sent her home. Again, she was told the abortion was unsuccessful and she would have to undergo a third procedure.

Later that night, the woman checked into Washington Adventist Hospital, where doctors removed a bruised but otherwise intact fetus and discovered that her uterus had been perforated during the two abortion attempts, according to hospital records and the woman's doctor.

Kioko acknowledged there were two unsuccessful abortion attempts and said he offered to perform a third procedure at a hospital.

Hillview Women's Medical Surgical Center is unique in the Washington area because it performs abortions up to 24 weeks, about six months. Local clinics such as Planned Parenthood of Washington, which does not perform abortions after 18 weeks, refer women seeking late second trimester abortions to hospitals or a clinic sanctioned by the National Abortion Federation.

The federation has strict standards of care, including requirements that drugs and equipment be available to treat emergencies such as cardiac arrest and narcotic toxicity.

Barbara Lofton said her clinic, which is not affiliated with the federation, has a complete complement of emergency equipment, and all staff members, including office personnel, are trained in CPR.

Barbara and Benjamin Lofton have owned several health care clinics in the area since 1983. They operated a mental health day clinic in Southwest Washington under the name Metropolitan Care Centers Inc. The clinic closed in 1986 after city officials dropped it from the Medicaid program. City records showed the clinic had submitted false billings, allowed medicine to be administered by unqualified help and misrepresented the professional credentials of staff members.

The District's Health Care Financing Administration also found that Barbara Lofton was not a mental health professional, which is required by District regulations to act as a program manager. City investigators found that Barbara Lofton used resume's that listed a PhD in clinical psychology from Catholic University, although there was no record that she got a degree there.

In a recent interview, Barbara Lofton said she received her PhD in psychology from the University of California at Berkeley; however, a university spokeswoman said Lofton never received a degree there. A spokeswoman for Pacific Western University, a non-accredited university in Los Angeles, said that Lofton did receive a PhD in behavioral sciences. The university advises students, who do their studies mostly by mail, not to use their degrees for professional certification, the spokeswoman said. Lofton later said she didn't know why she told a reporter that she completed her doctoral studies at Berkeley.

In 1986, the Loftons opened a family planning clinic on the site of their closed mental health clinic, and in March 1987 they began offering abortions at the 25 M St. SW address, according to city records and Lofton. In an investigation, District officials found that the clinic did not have a license required under city law to perform surgery, particularly abortions.

Lofton said the clinic ceased performing abortions.

Three months after the District inspection, Hillview clinic opened at its new location on Silver Hill Road in Suitland.