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webbage

Doctor loses license after aborting wrong twin
Tuesday, April 13, 2010 5:28 AM
By Letitia Stein

St. Petersburg Times
After an exceedingly rare and shocking medical error, Florida officials have taken away the medical license of a Sarasota ob-gyn who aborted the wrong fetus in a woman carrying twins, mistaking a seemingly healthy girl for a boy with congenital defects.

Dr. Matthew J. Kachinas performed abortions but never before had attempted this procedure, known as selective termination, in which a chemical injection terminates one fetus in a multiple pregnancy.

But in January 2006, he agreed to treat a woman identified in state records as K.M. She was roughly 16 weeks' pregnant with twins conceived through in vitro fertilization, a procedure used to help couples who have difficulty reproducing.

Doctors had counseled her that selective termination was an option after learning the male fetus had multiple problems, including a possible heart defect and Down syndrome. The female twin appeared normal.

"It seemed like something that was within my purview, that I would be able to do safely and appropriately," Kachinas said yesterday in a telephone interview after his license was revoked at a meeting Friday of the Florida Board of Medicine in Tampa.

"I have never, ever in my entire career ever said 'no' to a patient," he added. "And that was my downfall."

The 50-year-old physician said K.M. and her husband were informed of his lack of experience with this procedure, but asked him to do it anyway.

Kachinas said he took his time examining the twins. He thought that he had correctly identified the fetus with the abnormalities before terminating it.

A week and a half later, K.M. returned to the doctors at Florida Perinatal Associates monitoring her high-risk pregnancy. An ultrasound revealed that the fetus still alive was the one with congenital issues and Down syndrome. She returned to Kachinas several days later to terminate the second twin.

Dr. Mark Evans, a New York ob-gyn and geneticist who pioneered the procedure, said in a phone interview yesterday he has not in 25 years heard of another case in which the wrong twin or fetus was terminated.

While records are not kept on how often the procedure is performed nationally, Evans said it requires significant expertise that few physicians possess.

"In my hands, it's not complicated because I do it every day of the week," said Evans, noting that half of his patients, including some from Florida, travel by plane to his Manhattan office, Comprehensive Genetics.

The procedure is done for different reasons, he said. In pregnancies involving multiples, selective termination may be performed when one of the fetuses is diagnosed with an abnormality, often in the second trimester.

Selective reduction, by contrast, is conducted when the concern is that the woman is carrying so many fetuses frequently the result of fertility treatments she may not be able to carry them safely. It can occur during the first trimester.

Both are distinct from a standard abortion, when a pregnancy is ended and the uterine cavity emptied.

"Selective termination and reduction are done in multiple pregnancies with the specific aim of preserving the pregnancy," Evans noted.

In such cases, the fetus is terminated with a chemical injection that stops its heart. It shrivels up and disappears, Evans said, while the other is left to develop.

Kachinas blamed his mistake on ultrasound equipment that did not allow him to view the fetuses with the high resolution possible with newer, more expensive machines. Experts called by the state, however, disagreed with his assessment in a November administrative hearing.

Kachinas represented himself during the state proceedings. He said he plans to appeal the license revocation, a disciplinary action issued to just seven other doctors last year in Florida. However, he did express remorse, saying in his November testimony, "I am haunted every day by the outcome on this case."

Kachinas said in the interview yesterday that there was a financial settlement with K.M. State records show a $250,000 liability settlement for an incident on the day of her selective termination.

After his state hearing Friday, where he was also charged with two less serious complaints stemming from separate incidents in 2002 and 2004, Kachinas told a reporter he was going to kill himself. Police were summoned, and he was involuntarily taken to St. Joseph's Hospital for psychiatric evaluation.

Kachinas said yesterday he was making a flip remark. Calling the incident a "great misunderstanding," he said he was released after talking to a psychiatrist.


My thoughts.. You need to have a complicated procedure done and you have a freakin rookie do it? Not only that.. you GO BACK to him and have the other one done? What a moron.

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The 50-year-old physician said K.M. and her husband were informed of his lack of experience with this procedure, but asked him to do it anyway.

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You would think the couple would have done the research and looked at a 2nd opinion if the Doc informs them this would be a dificult procedure. Also maybe Doc shouldnt be doing things he isnt very capable of doing. This is your classic coulda, woulda, shoulda. I dont hold anyone accountable.

Wow. This is really terrible.

I wonder if he can be charged with manslaughter.

I know you are being sarcastic but I am serious. I know that people have been charged with double murder when the kill a pregnant woman. This is a tragic mistake but he did end the life that the woman wanted to come into this world.

Would you have to charge the woman with something too ... since she's the one that "ordered" the death?

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I wonder if he can be charged with manslaughter.

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Let's see, it would have been ok to kill the unwanted defective child, but charge him with manslaughter because he killed the preferred one? I don't think anybody wants to open that can of worms.

That was my thought...

Personal feelings aside, according to the supreme court it's not murder or manslaughter. It is what it is. A medical procedure (an abortion in this case) that was botched. Imagine needing your right foot amputated but the surgeon amputates the left one.

He won't have legal charges against him but I am sure he will pay out the wazoo in malpractice. The hospital too. Especially if they sanctioned the procedure. To perform a procedure in a hospital you need to be awarded "privileges". What that involves is performing that procedure a certain number of times under the supervision of another MD who is well qualified to perform it himself. That doctor then signs off that the required number was performed in a satisfactory manner. I find it hard to believe that this was really the 1st time he ever performed the procedure. Then again that may be why he lost his license.

That's just terrible all the way around... I feel bad for everyone involved.

Pretty much shows why "legal abortions" are a joke. If it's okay to kill an "unwanted" fetus but not a "wanted" one ... then why can't a person kill an unwanted child? Can. Worms. Open.

that sucks....

guess they shouldn't be having abortions...

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Let's see, it would have been ok to kill the unwanted defective child, but charge him with manslaughter because he killed the preferred one? I don't think anybody wants to open that can of worms.

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Just wanted to re-post what you said.

This whole story is disgusting. First, selecting one to abort and one not to. 2nd, screwing up big time by aborting the wrong one (or killing, as I call it). Nice job, doctor.

Atheist here, and in 99 per cent of all cases, anti-abortion, too.

Sounds like a tragic medical error... I'm sure the doctor feels terrible...

Nothing more, nothing less

There's no indication that anything near criminal happened - sometimes medical procedures go wrong...

There might be a civil lawsuit, and the doctor might lose his license, depending on how bad the mistake was (something none of us have any clue about)

~Lyuokdea

This is a sad and tragic story, especially for me. I have a 3 month old perfectly healthy little boy. Thank god for that. And I cant beleive some idiots want to use this as a spring board to discuss abortion. Go mind your own business, and stay out of other peoples health choices.
Im sure none of you have ever had to face the financial, emotional and every other drain that would come from being in a situation like this, wichever choice is made. To abort or not, yet you want to spew about some BS opinion about it. Give me a break.
My Wife worked in a daycare program for mentally and or physically challenged people. We are talking about 50 year olds that still live with their parents, 50 year olds and some are older. You have no idea how sad it is to see a 70 year old woman trying her best to take care of a 50 year old invalid son or daughter.
Come back with your BS preaching when you have had to take care of an invalid adult for the last 50 years in your home with your money and with your life.

First, the story is about an abortion gone wrong.

Second, these parents had invetro so I don't think it was a financial issue.

Third, you are entitled to your opinions. So are those that dislike the fact that they wanted to kill one baby because it had Downs Syndrome and possibly a heart defect.

I really don't give a crap about these people. I know what my opinion is but I am not discussing it. I chose to discuss what kind of ramifications this case can have when it comes to criminality of a fetus being killed that the mother planned on taking to term.

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I cant beleive some idiots want to use this as a spring board to discuss abortion. Go mind your own business, and stay out of other peoples health choices.

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The article itself is about an abortion gone wrong. How can you discuss it without discussing abortion? Some people strongly feel that fetuses are living beings and that all life is precious. They have as much right to their opinion as you do yours.

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Go mind your own business, and stay out of other peoples health choices.

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A health choice might be one thing - depending on circumstance, but a lot of times an abortion is a lifestyle choice.
Oh and BTW, this doctor needs to get another job. He's clearly incompetent.

Boy, that's rich. I don't think most people will see that as neutral.

lol...no not really.

And to think that it's already been integrated into the AP style book.

All I can say....accountability journalism

So what's the problem here?

He got paid to abort a "fetus" .... and that'e exactly what he did. Sure he got the wrong one .... but they can just abort the other one and start over. No human life was lost here, right? Why cry over a few stray cells that were accidently stopped from potentially becoming a person someday? Those stray cells aren't a human being until they pass the 8 month barrier (or so) through the birth canal anyway ... so why should the doctor be suspended, or lose his license? It would be like a doctor being hired to kill a tumor .... and accidently killing the wrong one. Ooops. Mibad. Move along folks .... nothing to see here .......

I just really don't see why anyone would get worked up over this. He is an abortionist ... and he carried out an abortion. Stop persecuting the poor guy already .........

That's very sad

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And, the thread title is misleading.

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Agreed.

I agree.

Also, note the parents choice after the first abortion:

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An ultrasound revealed that the fetus still alive was the one with congenital issues and Down syndrome. She returned to Kachinas several days later to terminate the second twin.

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Yes, this child had possible heart defects and Down Syndrome. But, I don't know how you make the decision to abort unless there are serious health risks presented to the mother and other child.

Then, the other child is aborted, and instead of seeing that as a sign and going through with the pregnancy and hoping for the health of the second child, you still abort?

Again, we don't know all the details here, it's possible they had little or no choice, but I do not get a good feel about the parents from this article.

Yea yea, I know, you guys who have no clue what it is like to have to care for a 50 year old 200 pound invalid, who cant walk, cant eat, cant use the bathroom or take care of themselves in any real meaningful way is like, yet you got an opinion that the mother should just deal with it.
And of course their isnt just the burden on the parents, the state, at least here in Pa has multiple helper type programs for those parents, so we also spend about 100Gs a piece on them, paying for transportation, day programs, group homes, in home respits and on and on.
You go on sticking to your high ground there though, wasting away your carefree time on message board with your "opinions" about what others should and shouldnt be allowed to do.

yet you know for certain that we do not know?

and, the most fulfilling things in life are often the most difficult.

So then I assume that you do have first hand experience ?

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the most fulfilling things in life are often the most difficult.

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I don't know about that but I have witnessed the efforts required to take care of special needs people both children and adults and to me it seemed a daunting experience indeed. I would like to think that I would handle it half as well as the people that I saw that lived that life every single day but man , I just don't know . I will say that I saw absolute and pure love in some of those efforts though and it kind of renewed what little faith I had in my fellow man . I also saw from the disabled some of the most honest emotions I have ever witnessed .

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I also saw from the disabled some of the most honest emotions I have ever witnessed .

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Isn't that the truth. No covering up, no faking....it's something to behold.

Who said there is only Downs syndrome ? The story said Downs and many other ailments. And my particular reference to what my wife does and the people she works with has absolutely nothing to do with Downs. Some of her clients did have downs, those are the good ones. They can usually at least still interact, move and speak to some degree. There are alot worse ailments out there than that though.
The majority of her clients could only dream of Downs being the only ailment they had to deal with.