(AP) PHILADELPHIA - An anesthesiology professor called it "reprehensible" that an abortion provider, Dr. Kermit Gosnell, medicated women based on their ability to pay, as alleged at the doctor's murder trial.
Gosnell is charged in the drug overdose death of a 41-year-old patient, and the deaths of seven babies allegedly born alive at his West Philadelphia clinic. The woman, a recent immigrant, weighed only about 100 pounds and did not speak English.
Hand-scrawled clinic notes show she received two heavy doses of sedatives and narcotics during a 2009 abortion, despite signs of respiratory distress after the first dose. She was later pronounced dead at a hospital.
Prosecutors allege that Gosnell's untrained staff let patients pick between "local," ''twilight," ''heavy" or "custom" anesthesia based on how much they could pay. And they say he did little to monitor patients afterward, failing to utilize blood pressure cuffs, oxygen machines, a pulse monitor and other standard surgical equipment.
"All bets are off (without monitoring)," said Dr. Andrew Herlich, a professor at the University of Pittsburgh School of Medicine.
The amount of drugs given to Karnamaya Mongar - at least as suggested by the nearly illegible clinic note - was likely to put her in a coma, Herlich said. He also said the procedure should have been stopped at the first sign of respiratory distress, to address that problem.
Continuing with the surgery, and giving her more drugs, "is not what we would do under any circumstances," Herlich said.
Gosnell, 72, allegedly used cheaper, outmoded painkillers on patients, who paid anywhere from a few hundred dollars cash for a one-day, first-trimester abortion to nearly $3,000 for a three-day late-stage procedure.
Authorities found $250,000 in cash under a mattress when they raided his home in 2010, although they believe he also made significant sums through a separate "pill mill" at his street-corner clinic, where they say a steady stream of people sought painkiller prescriptions.
Defense lawyer Jack McMahon was cross-examining Herlich on Thursday afternoon.
The capital murder trial began Monday and is expected to last about two months. In graphic testimony this week, the jury heard from a former employee who admitted killing 10 babies and a woman hospitalized after a botched abortion when she was 17. Prosecutors allege the woman was about 30 weeks pregnant - well beyond the state's 24-week legal limit - and that her baby was born alive.
McMahon argues that all seven babies died in the womb during the abortion process.
Mongar, a native of Bhutan, had spent 20 years in refugee camps before arriving in the U.S. four months before her death. Her husband, who worked on a chicken farm in western Virginia, and three children, have filed a wrongful-death suit against Gosnell, the city of Philadelphia and others.
Prosecutors say city and state health officials failed to inspect Gosnell's clinic for nearly a decade before an unrelated 2010 federal drug raid turned up chaotic, foul-smelling and even macabre conditions.
FBI Agent Jason Huff testified that agents found fetal bodies stored beside staff lunches in a refrigerator; jars containing the tiny feet of aborted fetuses; and rubber, disposable medical tubing waiting to be rinsed and reused.
Gosnell also faces federal drug distribution charges stemming from the FBI raid.
He has pleaded not guilty in both cases.