Has abortion provider Steven Brigham opened a new clinic in Pennsylvania, even though the state has barred him from doing so, and even though abortion clinics are being scrutinized under a recently enacted state law?
His critics think so.
The new clinic, Integrity Family Health, is on Bustleton Avenue in Northeast Philadelphia. The state Department of Health did an initial inspection and issued a permit, called a registration, eight weeks ago, then added the facility to its online list of abortion clinics in the Keystone State.
The new clinic's connections to Brigham are circumstantial but were enough to concern some longtime critics of his operations - in this case, other abortion providers.
After getting a call from a patient, staff members at Philadelphia Women's Center Googled the name and found a newspaper article about Brigham's Maryland clinics that mentioned "Integrity Health in Pennsylvania."
Then they called the toll-free number for Brigham's multistate abortion company, American Women's Services, and found that appointments were being made for Integrity Family Health. They also got Integrity's prices, directions, and heard a recorded abortion-counseling message.
Then they alerted state health officials.
"Here we have someone who had his medical license revoked in several states, and was told never to operate again in Pennsylvania, allegedly opening a facility in Philadelphia," said Jen Boulanger, communications director at Philadelphia Women's Center in Center City. "This, despite the massive amount of time and money Pennsylvania has spent enacting some of the most stringent abortion regulations in the country."
State Health Department spokeswoman Aimee Tysarczyck e-mailed that regulators were investigating "the matter."
Joseph M. Gorrell, one of Brigham's lawyers, declined The Inquirer's request to talk to him or his client.
Public records show that Brigham, 57, has a two-decade history of battling medical boards, regulators, the IRS, landlords, creditors, and, most recently, criminal prosecutors in Maryland.
Not long after he got his Pennsylvania medical license, he gave it up in a 1992 agreement with the state. He later lost his medical privileges in New York, Florida, and California.
He is now in hearings before an administrative judge in New Jersey, fighting for his last license. Three years ago, New Jersey suspended it when he was caught - after a critically injured patient went to the police - doing what he was disciplined for in the mid-1990s: starting late-term abortions in New Jersey and finishing them in another state.
Brigham came up with the strategy, prosecutors say, because his N.J. clinics do not meet the state's outpatient surgical safety requirements. (He performed the surgical parts of the bistate abortions in a clandestine clinic in Maryland, where he has never had a license. He said in legal papers he was acting as a medical consultant there.)
Throughout Brigham's legal turmoil, American Women's Services has waxed and waned.
Lately, it's mostly waned.
Although the enterprise has 11 clinics in New Jersey, Virginia, and Florida, five facilities in Maryland - including the secret one - have been shuttered by that state. In Pennsylvania, where Brigham formerly had four clinics, the state last year ordered the closure of the remaining two, in Pittsburgh and Allentown.
The closures culminated years of state efforts to get Brigham to stop flouting laws, especially by employing people who were unlicensed or unqualified.
The state's efforts haven't always been consistent. For example, in 2010, Pennsylvania barred Brighamand his business entities from registering an abortion clinic. But soon afterward, the state registered his Pennsylvania clinics in the name of his mother, Judith Fitch of Ohio, to whom Brigham had transferred ownership.
In any case, regulators seized the chance last year to shut him down for "infrastructure failures," legally defined as an event that could seriously compromise patient safety. Specifically, the Allentown clinic lost its lease, and the obstetrician-gynecologist serving both Pittsburgh and Allentown quit.
In April 2012 letters to Brigham, state Health Department Deputy Secretary Anna Marie Sossong wrote, "The Department of Health has long witnessed a chronic inability to comply . . . even with the most basic requirements of the law established to assure the health and safety of patients."
She ordered Brigham to let the public know the clinics were gone, including changing his website.
American Women's Services' website says those clinics are "temporarily closed." Brigham is fighting to reopen them.
In legal papers, Brigham's lawyer says the clinics did have an ob-gyn on staff: Vikram Kaji, 77.
Not mentioned is the fact that Brigham was sanctioned in the 1990s for employing Kaji while the ob-gyn's Pennsylvania license was suspended for sexually abusing patients.