A Woman's World Medical Center

A Woman's World Medical Center abortion business premises at 2264 SW Halissee St., Port St. Lucie, Florida

A Woman's World Medical Center is an abortion business located in Fort Pierce, Florida.

As at Dec. 9, 2011, abortionists worked at the business on Wednesdays and Saturdays.^[1]

As at Nov. 16, 2011, the waiting room doubled as the recovery room where mothers would rest subsequent to their abortion.^[1]

Many of the following personnel were obtained from

• Candace Dye, administrator, co-owner^[2]
• Arnold Guerrero, co-owner, "lab-tech"
• Kellie Farnell (Candace's niece), former worker
• Briann Farnell (ex-husband of Kellie)
• Hazel Harding
• David Feld, abortionist
• Carlito Arrogante, abortionist

Attorneys

• Michael K. Spotts
• Charlene Miller Carres

In 1999 the facility was the subject of a federal lawsuit, Lotierzo v. Woman World Medical Center Inc that, although overturned by the 11th Circuit Court of Appeals, alleged physical harassment of sidewalk counselors and “altercations” with crisis pregnancy center workers by employees of A Woman’s World Medical Center, allegedly at the direction and encouragement of owner Mrs. Guerrero.^[3]

As at July 2010, Dye owed two years property taxes to St. Lucie County for A Woman’s World Medical Center ($9,201.36).^[3]

From Nov. 16 - 17, 2011, the Florida Agency for Health Care Administration conducted a survey of A Woman's World Medical Center. Below is a list of deficiencies found at the time of the visit:^[1]

1. The clinic did not ensure that their license was displayed in a conspicuous place within the premises where it could be viewed by patients. The license was in fact noted to be in a frame on the wall; above eye-level; over the counter area; and facing the reception desk and not the lobby or patients approaching the reception window. Candace Dye stated that the license had always been in that location. She stated that they could not put their license in the lobby as it could be stolen or destroyed. This was a breach of Chapter 59A-9.020(4), F.A.C.
2. The clinic did not meet minimum requirements when providing second trimester abortions, specifically related to providing adequate privacy in the consultation room. The consultation room was nothing more than a desk located behind the reception desk. In this area, vitals and weight are obtained, an Rh test is conducted; and procedures are discussed. The two desks are separated by two six-foot tall shelves. This was a breach of Chapter 59A-9.022, F.A.C.
3. The clinic did not ensure the provision of all essential supplies and equipment; a breach of Chapter 59A-9.0225(1), F.A.C.These included the following:
   1. A portable oxygen tank in the surgery room, containing a sticker dated 03/10/2010. Dye confirmed that the tank was overdue to be checked. She stated that there were no backup oxygen tanks.
   2. Resuscitation bags were labeled as being last checked on 10/28/2009.
   3. The oxygen tank and resuscitation bags were not located in the equipment maintenance section of the facility's policy and procedure manual which was developed on 10/10/2009.
4. The clinic did not ensure emergency equipment was maintained in functional condition for immediate use, and capable of providing inhalation therapy. This was a breach of Chapter 59A-9.0225(2), F.A.C.
5. The clinic did not ensure written preventative maintenance programs were developed and/or implemented, specifically related to patient monitoring equipment; anesthesia and surgical equipment; and all surgical instruments. The surveyor was unable to locate any specific written preventative maintenance programs. This was a breach of Chapter 59A-9.0225(7), F.A.C.
6. The clinic failed to ensure each staff member was adequately trained and capable of providing appropriate service and supervision to the patients specifically related to the lack of appropriate qualifications for staff assisting with abortions; assisting in the recovery room; conducting ultrasound procedures; and some lab procedures. This was a breach of Chapter 59A-9.023(1), (2), and (3), F.A.C. The following concerns were noted:
   1. Employee #1 (date of hire: April 21, 1991): The employee's file contained a copy of a certificate entitled "Successfully Completing a Course in the Operation of Ultrasound Equipment." This was dated 9/9/2010, however did not indicate the length or content of training. Evidence of completion of lab or phlebotomy training was not present. The employee's job description indicated: phlebotomy, lab technician, assist in recovery room, assist in procedure room, trains applicants in Rh typing, serum HCG testin, and hemoglobin testing.
   2. Employee #2 (date of hire: 1997) The employee's file contained a copy of a certificate entitled "Successfully Completing a Course in the Operation of Ultrasound Equipment." This was dated 9/9/2010, however did not indicate the length or content of training. Also included was a Certification of Completion (3 credit course), dated April 29, 1998 which noted successful completion of "Basic Concepts of Phlebotomy." The employee's job description indicated: assists doctors during procedures; assists in recovery room and procedure room; and performs urine PGTS/confirmations.
   3. Employee #3 (date of hire: Feb. 2010) This female employee's file contained a copy of a Florida Licensed Practical Nurse license with an expiration date of July 31, 2013. The surveyor learned that the clinic does not verify the status of licensed personnel (i.e. active, suspended or revoked). The employee's job description indicated: LPN; phlebotomy; 2nd trimester assistant; procedure counselor; assists doctors during procedures; monitors vital signs during and after second trimester procedures. Review of the employee's file revealed that she had two IPN (Intervention Project for Nurses) contracts that restrict access to narcotics. The second contract with a projected active monitoring (Feb. 10 2011 - April 26 2016) stated that this employee "has not been approved to engage in nursing practice at this time."
7. All three of the above employees conduct ultrasounds on patients without documentation of completion of a Sonography course that has been accredited (Rule 6A-14.030), as meeting the requirements, by the State of Florida.
8. Clinic owner/administrator Candace Dye confirmed that all staff conducted ultrasound screenings. A Woman's World Medical Center had previously been cited for staff conducting ultrasound screenings without appropriate training. Dye acknowledged that she recalled this. This was a breach of Chapter 59A-9.023(1), (2), and (3), F.A.C.
9. Dye confirmed that all staff conduct the Rh testing. Review of the three employee records revealed none of the three records contained documentation that the employee was qualified to perform this procedure. Rh testing is not listed as a waived test on the Center for Medicare and Medicaid Services (CMS) listing of "Tests Granted Waived Status Under CLIA."
10. Dye stated that sometimes a male "Lab Tech" would assist with "transferring" patients within the facility. The "lab-tech" is presumed to be Arnold Guerrero, Dye's husband. This involved the "lab tech" picking up a patient and carrying her to another room. Dye was asked if the "lab tech" had a personnel file. She stated that he did not, but that he "had a Home Health Aide certificate." She stated that they did not know where it was because it was a long time ago. Review of the clinic's policy and procedure specifically related to staff responsibilities and duties, dated Oct. 10, 2009, described the "lab tech's" responsibilities as: obtaining the specimen bottle after the procedure and verifying that all products of conception were identified. He then places the specimen in a Ziploc bag labeled with the patient's name and date, and how many weeks LMP. He cleans the specimen bottles and returns them to the doctor's assistant. He also cleans and sterilizes surgical instruments and is responsible for maintaining the Dry Heat Sterilizer temperature log.
11. The clinic did not have all of the required written policies and procedures to implement and to assure that patient care shall relate specifically to the functional activities of clinic services (and be reviewed and approved on an annual basis by the clinic's medical director). The cover sheet of the clinic's policy and procedure manual which was prepared by Candace Dye on Oct. 10, 2009 did not include any documentation showing that the medical director had in fact reviewed the manual in the last two years. This was a breach of Chapter 59A-9.024, F.A.C.
12. The clinic did not ensure the formulation and adherence of written patient care policies, specifically related to admission criteria and procedure and identification in the medical record of the abortionist and nurse(s) involved in the procedure. The surveyor reviewed the clinical records of five patients that had received second trimester abortions. The administrator was not able to provide a legible name of the physicians on the procedure form documents. This was a breach of Chapter 59A-9.025(1), F.A.C. The administrator confirmed the following:
    1. Patient #1: procedure was signed by LPN on Oct. 9, 2011. The license status of the LPN was in question.
    2. Patient #2: procedure was signed by Candace Dye who was not qualified to assist with the procedure.
    3. Patient #3: signed by previously employed "lab tech" (Arnold Guerrero), who was also not qualified to assist with the procedure.
    4. Patient #4: signed by Candace Dye who was not qualified to assist with the procedure.
13. The clinic did not follow the appropriate precautions for the establishment of intravenous access (at least for the patients undergoing post-first trimester abortions) for 5 of 5 clinical records of patients that received 2nd trimester abortions. In addition, the clinic did not have documentation to reflect appropriate monitoring of patient's vital signs by professionals licensed and qualified to assess the patient's condition throughout the abortion procedure and during the recovery room period. The clinic further failed to provide any monitoring of vital signs by a qualified individual for the 6 patients identified as receiving first trimester abortions. The surveyor noted that neither the unlicensed nurse who was present, nor any other staff member were observed to monitor vitals at any time for any of the 6 patients present. The unlicensed nurse was observed to provide 2 pills and a cup of water to one of the patients in the recovery room. This was a breach of Chapter 59A-9.026 F.A.C.

• Address: 2264 SW Halissee St., Port St. Lucie, FL 34953

1. ↑ ^{1.0 1.1 1.2} Florida Agency for Health Care Administration: Statement of Deficiencies and Plan of Correction for A Woman's World Medical Center, dated Dec. 9, 2011
2. ↑ LinkedIn.com: Candace Dye's profile (accessed on Aug. 22, 2012)
3. ↑ ^{3.0 3.1} Forerunner.com: South East - Fort Pierce - A Woman's World Medical Center, by Jay Rogers, July 8, 2011 (accessed on Aug. 22, 2012)