Damber Ghalley remembers seeing his unconscious sister on an ambulance stretcher, being taken out the back door of the West Philadelphia clinic where she had undergone an abortion.
Ghalley and his niece - the woman's daughter - were stunned.
"I asked the doctor, 'What happened?' " Ghalley recalled yesterday during a phone interview. "He said: 'Her heart stopped. The procedure went well, but her heart stopped.' "
Ghalley's sister, Karnamaya Mongar, 41, developed a fatal heart arrhythmia after being given painkillers and other drugs at the clinic at 3801 Lancaster Ave., which is owned and run by Kermit B. Gosnell, according to a state order suspending his medical license.
The suspension, issued Monday by the state Board of Medicine, followed a raid of the clinic by federal and state drug agents who are investigating Gosnell, 69, on suspicion of illegal distribution of prescription painkillers. Drug Enforcement Administration spokesman Brian Dougherty said yesterday that he could not comment.
The suspension order describes "deplorable and unsanitary" conditions such as "blood on the floor and parts of aborted fetuses in jars." It also says an employee with no medical license routinely dispensed prescription drugs and performed medical exams while Gosnell was out of the clinic.
The suspension is the latest trouble for Gosnell, who has been named as a defendant in 46 civil suits - 10 of them medical-malpractice cases - since 1981.
Calls placed to Gosnell's home and office yesterday went unanswered.
The clinic - a block away from Penn Presbyterian Medical Center - has big black letters proclaiming dental care, family practice, geriatrics, and physical therapy, but the order suspending Gosnell's license says it "specializes in abortions and pain management."
The unlicensed employee, according to the order, gave Mongar a round of painkillers Nov. 20, then called Gosnell because the patient was still experiencing severe cramping from drugs to induce labor. Gosnell directed that another round of drugs be administered. After he arrived at the clinic to perform the abortion, Mongar was given yet more medication.
Ghalley says he was told nothing as he sat in the waiting room with his 21-year-old niece, Yashoda Mongar.
Ghalley explained that his sister; her husband, Ash; and their three children were living with him in Woodbridge, Va., a suburb of Washington. They had arrived in the United States only five months earlier from their native Bhutan, a poor, mountainous, landlocked nation between China and India.
Ghalley, who has been in the United States for a decade and speaks English fluently, became their interpreter, guide, and chauffeur.
He did not question his sister when she asked him to drive her to an abortion clinic in Virginia.
"In our culture, they [the couple] cannot talk about it with relatives," Ghalley said. "She was depressed. I figured she has three children, she has grandkids also, maybe she did not want another child."
Because Mongar was more than 12 weeks pregnant, the Virginia abortion clinic referred her to one in Maryland.
"They didn't want to do it either," Ghalley said. "They gave the name of the Philadelphia clinic."
Mongar was about 18 or 19 weeks pregnant on that November night, Ghalley said. Her husband could not accompany her because "he just got a job in a chicken factory."
Ghalley's first impression of the Philadelphia facility - a shabby, three-story brick structure with a two-story annex - was not good.
"So dirty. Dirty, bloody, a lot of people waiting," Ghalley recalled. "I was thinking at that time, maybe he [the doctor] was cheaper."
Later, as Ghalley watched his sister being put in the ambulance, a clinic employee and his niece began crying.
"I was crying, too," Ghalley said. "There was no other disease. My sister was fine before that."
All through the night and half the next day, Ghalley and his niece waited at the Hospital of the University of Pennsylvania, where Mongar was put on life support.
"They got her heart beating," he said. "I was hoping. I was praying. In the morning, I saw [Gosnell] and asked him if something went wrong."
Gosnell's answer was reassuring, and Mongar's family decided that her death was "in God's hands," Ghalley said.
This is not the first time Pennsylvania has suspended Gosnell's license. In 1996, he temporarily lost it for allowing a physician's assistant to treat patients. He got it back after paying a $1,000 penalty.
This time, however, the violation is more egregious.
"In this case, the worker had absolutely no medical training or license whatsoever," said Basil Merenda, state commissioner of professional and occupational affairs.
Gosnell also skirted the state's abortion control in 2007 when he performed an abortion on a minor without her parents' consent. It became public when the parents brought a civil suit for assault. Gosnell paid $10,000 to settle the case.
Ghalley said he was still waiting for the autopsy report on his sister. He was not aware that Gosnell's license had been suspended.
"Thank you from the bottom of my heart for telling me," Ghalley said.
Contact staff writer Marie McCullough at 215-854-2720 or firstname.lastname@example.org.
Staff writer Allison Steele contributed to this article.