The Texas Medical Board has sanctioned three doctors that ProPublica previously investigated whose patients died after receiving delayed or inappropriate pregnancy care under the state’s strict abortion ban.
Two of the doctors failed to properly intervene as a pregnant teenager repeatedly sought treatment for life-threatening complications, the commission found. The third did not provide a dilation and curettage procedure to empty the uterus of a patient experiencing a miscarriage, and she ended up bleeding out.
Like ProPublica investigated those preventable deaths and five others in three states In recent years, journalists have discovered that the abortion ban has influenced the way doctors and hospitals respond to pregnancy complications. Faced with the risk of prison and professional ruin, doctors have delayed key interventions until they can prove that the fetal heart is no longer beating or that a case meets a narrow legal exception. Some doctors say their colleagues fire or transfer pregnant patients instead of taking responsibility for their care.
Doctors and lawyers question why medical boards, which oversee the licensing of doctors and investigate substandard care, have not taken a more active role in guiding doctors on how to uphold medical standards within the constraints of the law. Asked by ProPublica in 2024 what recourse was available to miscarriage patients when a doctor denied them necessary treatment, the president of the Texas Medical Board said he had no say in criminal law, but that patients could file a complaint and “vote with their feet” to seek care from another doctor.
Since then, the Texas board has taken more action than those in other states, post tips this year which provides case studies on how doctors can legally provide abortions to patients with certain medical complications. The state legislature directed the board to create the training materials as part of the Mother’s Life Actwhich passed after ProPublica’s reporting and made modest adjustments to the state’s abortion restrictions in an effort to prevent additional maternal deaths.
Georgia, where Amber Thurman has died after doctors failed to attempt to empty her septic uterus for 20 hours, failed to review her ban or sanction the main doctors involved.
Maternal care experts say health care providers will continue to be reluctant to offer standard care as long as bans carry serious criminal consequences: Texas law can put a doctor behind bars for 99 years. But those who spoke to ProPublica say medical board sanctions are one of the few levers that can provide a check, pushing hospitals and doctors to provide standard care despite uncertainty over vaguely written laws.
Michelle Maloney, who represents the families of the two Texas patients in malpractice suits, said she was pleasantly surprised by the board’s recent actions. “Over the course of my career, I have encountered many cases of horrific deaths. For someone to be sanctioned by the medical board, especially when there is ongoing litigation, is just extraordinarily rare,” she said.
In 2024, ProPublica reported on the case of Nevaeh Crain, 18 years oldwho began suffering serious pregnancy complications when she was six months pregnant in 2023. Although she showed clear signs of infection, doctors at two hospitals sent her home. On his third visit, as Crain’s condition deteriorated, a doctor did not send him to the intensive care unit until he could confirm fetal death with two ultrasounds. Texas law requires doctors to create additional documentation before performing procedures that could end a pregnancy. By the time the doctor recorded there was no fetal heartbeat, medical records show, Crain was too unstable for surgery. She died with her fetus still in her womb.
Dr. Ali Mohamed Osman, an emergency room doctor who saw Crain at Baptist Hospitals in Southeast Texas during her first emergency room visit, sent her home with a prescription for antibiotics for strep throat without investigating her stomach cramps, ProPublica reported. The medical commission quoted him for not properly treating her infection or checking the health of the fetus.
Dr. William Noel Hawkins, an obstetrician-gynecologist who saw Crain at Christus Southeast Texas St. Elizabeth Hospital during his second emergency room visit a few hours later, was cited for releasing Crain even though she had a fever of 103 degrees, a positive sepsis test and a fetus with an abnormally high heart rate.
For Osman and Hawkins, the board wrote, “this delay in care ultimately resulted in the death of the patient and her unborn child due to pregnancy complications.”
A board spokesman would not say whether it had investigated Dr. Marcelo Totorica, who saw Crain during his third visit to the emergency room, in Christus, and required two fetal ultrasounds, 90 minutes apart, before taking Crain to the intensive care unit for surgery. The board does not disclose open investigations or cases in which a doctor has been cleared of wrongdoing. Totorica did not respond to a request for comment.
ProPublica also investigated the case of Porsha Ngumezidied at Houston Methodist Sugar Land Hospital in 2023 after bleeding profusely during a miscarriage at 11 weeks. An obstetrician-gynecologist overseeing her care, Dr. Andrew Ryan Davis, gave her misoprostol, a drug that can be used to achieve low-risk miscarriages. However, more than a dozen experts who reviewed the case for ProPublica said it was a high-risk case and she should have immediately received a D&C — a procedure that has become cumbersome in states that ban abortion. Cleaning the uterus is standard care to stop bleeding; misoprostol would only make the bleeding worse, they said.
The board of directors’ investigation confirmed these findingsciting Davis for failing to quantify the volume of blood loss and choosing to monitor Ngumezi’s condition instead of immediately taking him for a D&C procedure. The board wrote: “This delay in care led to the patient’s death. He added that he could not determine whether Ngumezi would have survived if she had received emergency treatment.
The board has the power to impose fines of up to $5,000 and, in the most extreme cases, suspend or revoke doctors’ licenses. In these cases, however, each doctor was required to complete eight hours of continuing education courses within a year. Under the terms of the order, all must inform any employer of the commission’s findings against them. Davis and Hawkins were sanctioned in October and Osman in March. No doctors or hospitals responded to requests for comment. In medical commission orders, doctors neither admit nor deny the commission’s findings and agree to comply with discipline.
Hope Ngumezi, Porsha Ngumezi’s husband, said the board’s order felt like “a slap in the face.”
“What kind of justice is this for Porsha? he said. “I feel like the doctor shouldn’t be practicing anymore.”
Hawkins, who failed to meet standards of care in Crain’s case, according to the board, had previously been sanctioned by the board for improper care in several other cases, including failure to perform a tubal ligation and failure to diagnose a syphilis infection. The board issued an order requiring oversight of Hawkins’ medical practice in 2015; it was lifted two years later.
Reproductive rights advocates praised the Texas board’s recent actions but said it and medical boards in other states should do more. For example, none of Texas’ disciplinary orders directly sanction a doctor for failing to provide or perform an abortion for a high-risk medical condition.
The board has sanctioned some doctors in recent years for failing to provide D&Cs to patients after a confirmed miscarriage or for substandard care to pregnant patients facing emergencies, and the orders are usually issued quietly. The board could make public statements and share stronger guidance to remind doctors of consequences, said Molly Duane, litigation director of Amplify Legal, part of the reproductive rights group Abortion in America.
“They should say loud and clear: This is what can happen if you don’t provide care in these circumstances,” Duane said. At the Center for Reproductive Rights, Duane represented 20 Texas women in a case against the state that alleged doctors inappropriately denied them abortions during medical emergencies. The Texas Supreme Court sided with the state and blamed the doctors for misinterpreting the law. Duane does not know of any doctors in these cases who have been subject to disciplinary action by the board.
ProPublica has reported on the deaths of other Texas women, including Josseli Barnica And Tierra Walkerwhich experts say could have been avoided if women had been offered abortions due to their high-risk health conditions. And data analyzes by ProPublica showed that sepsis rate And blood transfusion increased among women who miscarry after the ban took effect — an indicator of dangerous delays in care across the state.
The Commission would not say whether it has opened investigations into the doctors involved in these cases or any other cases in which pregnant patients may have received substandard care because of abortion restrictions.
