Abortion doctor Steven Brigham's decades of disciplinary trouble came to a head Wednesday when the New Jersey Board of Medical Examiners yanked his last remaining medical license.
The board cited Brigham for doing late-term abortions that began in New Jersey and ended in Maryland, violating the laws of both states.
It ordered him to pay a $140,000 penalty and as-yet-unspecified costs of prosecution, even though Brigham revealed that he is in dire financial straits from IRS liens imposed on him for not paying employee taxes.
Without a New Jersey license, Brigham will lose his eight clinics in the Garden State, which have continued to operate while his license was suspended. The clinics make up the bulk of his multistate abortion business, American Women's Services.
The 16 board members voted unanimously that Brigham had engaged in professional misconduct, dishonesty and misrepresentations, and repeated acts of negligence, based on the records.
The board went beyond the ruling of an administrative law judge, who had recommended revocation of his license in August.
Brigham said he was disappointed by the outcome and maintained he was "a good doctor." He can appeal the decision to the Appellate Division of Superior Court.
Jeri Warhaftig, deputy attorney general, said Brigham "has had many bites of the apple. He is not entitled to leniency, nor is he entitled to pity because he is in debt. Time and again he has been slippery and disingenuous."
The case began more than four years ago. The prosecution found that Brigham was using a two-state scheme so he could perform late-term abortions for which his New Jersey clinics were not licensed or equipped. In addition, New Jersey requires that such risky surgeries be performed by an obstetrician-gynecologist, and Brigham, a general practitioner, was not credentialed to do them.
Brigham induced fetal death in his Voorhees clinic and, a few days later, surgically removed the fetuses at a clinic in Elkton, Md. - a facility so secret that even patients did not know where they were going until the last minute.
The scheme came to light in August 2010 because an 18-year-old patient was critically injured. She and the doctor who performed emergency surgery on her at a Baltimore hospital went to Elkton police.
At the hearing Wednesday, Brigham and his lawyer, Joseph M. Gorrell, spent much time reasserting that the doctor had been "consulting" at the Elkton clinic. Under Maryland law, that would have been permitted. They maintain that the clinic was run by a licensed OB/GYN hired by Brigham, George Shepard.
Shepard was 87 and partially disabled by a stroke, according to records in the case. Brigham said Shepard's "mind was sharp" and the consulting "was not a sham."
Warhaftig said Brigham's bistate scheme was the latest in what she called his 20-plus years of chicanery. She asked the board to consider that in the mid-1990s, Brigham was accused of the same scheme. He was then completing the abortions in New York state.
New York revoked his license after several patients were seriously injured. The case led New Jersey to suspend Brigham's license, but after a lengthy prosecution, a New Jersey administrative law judge restored Brigham's medical privileges and the Medical Examiners Board agreed.
Warhaftig also asked the board to consider that Brigham gave up his medical license in Pennsylvania in 1992 amid an investigation.
He also lost his license in California and Florida because of fallout from the New York revocation.
Among those speaking on Brigham's behalf Wednesday was Nancy Luke, chief financial officer for American Women's Services. She said the New Jersey clinics are unprofitable in part because they take many patients who are on Medicaid, which pays poorly for the procedure.
She said Brigham makes $48,000 a year and the IRS takes 75 percent of it to collect unpaid payroll taxes from 2001 to 2006. Luke blamed the tax problem on her predecessor, who she said was young and inexperienced.
There was some disagreement over how much Brigham owes the IRS. Luke says the liens were for $260,000, but Warhaftig presented documents putting the debt at $460,000.
American Women's Services still has two clinics in Virginia and one in Florida. Four other clinics appear to be operating in Maryland.
Pennsylvania barred Brigham in 2010 from owning clinics due to a history of hiring unqualified medical employees. He evaded that ruling for several years by putting his Pennsylvania clinics under a company owned by his mother.
In addressing the board Wednesday, Brigham alluded to his mother, now deceased. "I ask you to see me for who I am: A man who has taken up the cause of my late mother. I have a passion for women's rights."
He attributed his problems to antiabortion forces and laws that are not clear.
"It seems I have been misunderstood in multiple ways. To revoke my license would be to give in to the forces of hate. You know I am a good doctor," he said.
Warhaftig said he was anything but. "He breached patients' trust in his flimflam scheme," she said.