A judge has recommended yanking the medical license of Vikram Kaji, the 82-year-old, stroke-impaired director of a chain of abortion clinics in New Jersey, concluding he is not competent to practice medicine.

But the ruling says nothing about the implications for those clinics, which the state attorney general alleges were illegally transferred to Kaji by discredited abortion provider Steven C. Brigham.

Brigham, 62, whose record of botched procedures goes back decades in multiple states, lost his New Jersey medical license more than four years ago and was ordered to sell his clinics there, which are part of his multistate, Voorhees-based abortion network, advertised as American Women’s Services.

The attorney general has alleged that Brigham sought to keep controlling and profiting from the clinics by transferring ownership, for no money, to Kaji, a Mumbai-trained obstetrician-gynecologist who was disciplined in the mid-1990s for sexually abusing patients. Hearings were ordered three years ago to sort out whether Kaji was in effect Brigham’s puppet.

“Dr. Kaji ... has a history of heart disease, stroke, depression, and cognitive impairment,” Administrative Law Judge Thomas R. Betancourt wrote in the Jan. 25 ruling on Kaji’s competency. “He cannot perform the duties of a fully functioning physician."

The state’s Board of Medical Examiners, which licenses physicians, has 45 days to adopt, change, or reject the ruling, or it automatically goes into effect.

The law firm representing Kaji and Brigham did not respond to requests for comment.

A spokesperson said the Attorney General’s Office — which has said the state would “address the matter of ownership” after Kaji’s competency case was concluded — had no comment.

Public records and media reports going back to the early 1990s — when Brigham launched his abortion practice in Wyomissing, Pa. — have documented his history of trouble with regulators, tax collectors, landlords, creditors, and criminal prosecutors in Maryland.

It was Brigham’s unlicensed practice of medicine at a late-term, cash-only abortion clinic that he secretly set up in Elkton, Md., that led to the revocation of his New Jersey license, the last of six that he lost, let lapse, or gave up.

But lack of licensure has not necessarily been a barrier to Brigham’s business because most states allow doctors to own medical practices even if they are not licensed. In Pennsylvania, for example, Brigham relinquished his license in 1992, yet owned clinics until 2010, when his persistent flouting of health and safety laws led regulators to ban him. It took them two more years to actually shut him down because he transferred ownership to his mother in Ohio.

American Women’s Services' website now lists 15 clinics in three states, but several are closed. The site does not list a clinic in Florida and another in Washington, D.C., that records and media reports tie to Brigham.

At Kaji’s competency hearing in September, the New Jersey network — which Brigham has a contract to manage — was variously described as seven or nine clinics. Kaji said he traveled to seven, but could not name all the locations. Other employees said clinics are in Elizabeth, Voorhees, Woodbridge, Phillipsburg, Galloway, Hamilton, Englewood, Bridgewater, and Livingston. Neither Bridgewater nor Livingston is listed on the American Women’s Services' website — but it does list “now closed” offices in Toms River and Paramus.

Although the Englewood clinic is open, it filed for bankruptcy protection in May 2017.

Brigham has yet to pay any of the $561,000 in penalties and prosecution costs that New Jersey imposed following his 2014 license revocation, according to the Attorney General’s Office. At that time, Brigham owed almost $500,000 to the IRS for not paying employee taxes.

Brigham hired Kaji in the mid-1990s while the ob-gyn’s license was restricted in Pennsylvania and New Jersey for improprieties including having sex with a patient in his office and improperly prescribing controlled substances for her.

Over the last five years, regulators have scrutinized Kaji’s medical performance and required him to undergo neurological evaluations in response to complaints. In 2017, he agreed to stop practicing medicine pending the competency hearing.

Betancourt wrote that he found Kaji “slow to answer and at times unsure” of his own medical history.

Both supporters and opponents of abortion rights reacted the same way to the ruling.

“We hope the decision will bring Mr. Brigham’s charade one step closer to being shut down permanently,” emailed the Very Rev. Katherine Ragsdale, interim CEO and president of the National Abortion Federation. “Brigham is a rogue doctor who operates outside recognized standards for quality abortion care.”

“The Brigham/Kaji charade has gone on long enough,” emailed Marie Tasy, executive director of New Jersey Right to Life. New Jersey authorities “need to immediately shut down Brigham’s clinics.”