The clinic reeked of animal urine, courtesy of the cats that were allowed to roam (and defecate) freely. Furniture and blankets were stained with blood. Instruments were not properly sterilized. Disposable medical supplies were not disposed of; they were reused, over and over again. Medical equipment – such as the defibrillator, the EKG, the pulse oximeter, the blood pressure cuff – was generally broken; even when it worked, it wasn’t used. The emergency exit was padlocked shut. And scattered throughout, in cabinets, in the basement, in a freezer, in jars and bags and plastic jugs, were fetal remains. It was a baby charnel house.
There were no doctors at the clinic other than Gosnell himself. No nurses. He employed two people who didn't graduate medical school, but that didn’t stop them from making diagnoses, performing procedures and administering drugs . According to the report, the Women's Medical Society ran a highly-profitable prescription writing business during the day, when "patients" (who were never seen by an actual doctor) came in during the day and received prescriptions for drugs like Oxycotin written on blank Rx pads that Gosnell has signed and left lying around to be filled out by whoever was working. This brought in hundreds of thousands of dollars a year. But the real business of the Women's Medical Society was to provide abortions for women who couldn't get them elsewhere, either because these patients were too young or too far along in their pregnancies:
At the Women’s Medical Society, the only question that really mattered was whether you had the cash. Too young? No problem. Didn’t want to wait? Gosnell provided same-day service.
The real key to the business model, though, was this: Gosnell catered to the women who couldn’t get abortions elsewhere – because they were too pregnant. Most doctors won’t perform late second-trimester abortions, from approximately the 20th week of pregnancy, because of the risks involved. And late-term abortions after the 24th week of pregnancy are flatly illegal. But for Dr. Gosnell, they were an opportunity. The bigger the baby, the more he charged.
So when a woman came into the clinic, which couldn't even really be considered a clinic, it was more of a "last-resort" hell house, if you were a woman of color, usually African American or Hispanic, you received different care than if you were white:
Only in one class of cases did Gosnell exercise any real care with these dangerous sedatives. On those rare occasions when the patient was a white woman from the suburbs, Gosnell insisted that he be consulted at every step. When an employee asked him why, he said it was “the way of the world.”
In one case, The Women's Medical Society treated a patient, a 41-year-old refugee from Nepal named Karnamaya Mongar. Dr. Gosnell was not at the clinic when the patient arrived, and the staff had her fill out various medical forms that she couldn't even read. They administered Demerol, and after several hours Monager stopped breathing. Dr. Gosnell was called in and he briefly administered CPR, and he couldn't use the defibrillator because it was broken. When paramedics were finally called in it took them twenty minutes to get Ms.Monager out of the building due to all of the garbage and debris in the clinic hallways.
Doctors at the hospital managed to keep her heart beating, but they never knew what they were trying to treat, because Gosnell and his staff lied about how much anesthesia they had given, and who had given it. By that point, there was no way to restore any neurological activity. Life support was removed the next day. Karnamaya Mongar was pronounced dead.
There have been numerous other cases reported of women suffering from ruptured uteruses, failure to remove all fetal parts from uteruses, and various other maltreatment of patients, but Gosnell destroyed most of the medical records.
He trained his staff to administer ultrasounds in which they recorded the babies in positions where their fetal age would be easy to falsify, Because it is illegal to administer an abortion after 24 weeks gestation. If a woman came into the clinic and wanted an extremely late-term abortion, someone at the clinic would administer labor-inducing drugs. And a woman would give birth to a living baby.
Gosnell had a simple solution for the unwanted babies he delivered: he killed them. He didn’t call it that. He called it “ensuring fetal demise.” The way he ensured fetal demise was by sticking scissors into the back of the baby’s neck and cutting the spinal cord. He called that “snipping.”
According to the report these were not even the worst cases. The worst cases, where Gosnell referred to as the "really big ones" were performed on a Sunday, when the only other person he "trusted" to assist with these procedures was his wife.