Laura Hope Smith was 22 years old and 13 weeks pregnant when she went to see a Cape Cod doctor for an abortion. She was pronounced dead later that day.
Prosecutors charged the doctor with manslaughter, alleging that he failed to monitor her while she was under anesthesia, delayed calling 911 when she went into cardiopulmonary arrest, and later lied to try to cover up his actions.
Dr. Rapin Osathanondh, an obstetrician who was also a research associate at the Harvard School of Public Health, goes on trial Monday in Barnstable Superior Court. The trial begins on the third anniversary of Smith’s death.
Experts say it’s unusual for a doctor accused of negligence to be charged criminally. Most cases are handled through lawsuits in civil court.
“Civilly, you only need – for a doctor to be held accountable – evidence that he was careless and negligent in his care,” said Andrew Meyer, a Boston attorney who specializes in medical malpractice cases.
“That would not normally be enough for a prosecutor to bring a criminal action. However, the more extreme the action, the more extraordinary the negligence, the more likely it is that it may cross over that line where it also becomes criminal.”
Cape & Islands District Attorney Michael O’Keefe, whose office is prosecuting Osathanondh, would not discuss the case right before trial, but after Osathanondh was indicted in 2008, O’Keefe called his conduct “willful, wanton and reckless.”
Osathanondh, 67, resigned his medical license the same day the state Board of Registration in Medicine issued a scathing list of charges against him, alleging that he had “engaged in conduct that calls into question his competence to practice medicine.”
The board said Osathanondh did not have any means of monitoring Smith’s heart, and did not have oxygen or a functioning blood pressure cuff in the room during Smith’s abortion. The board also alleged that he “failed to adhere to basic cardiac life support protocol” and did not call 911 in a timely manner.
Osathanondh was also accused of deceiving staff members by claiming he gave Smith oxygen during the procedure and by saying that Smith was monitored by a pulse oximeter during her procedure. Neither step was taken, the board said.
Osathanondh’s lawyer, Paul Cirel, called Smith’s death a tragedy, but said Osathanondh gave her good care.
“It’s an unfortunate fact of medicine that rarely – but sometimes – patients die, even when they are being given the best of care,” Cirel said.
Osathanondh, who is originally from Thailand, had been licensed to practice medicine in Massachusetts since 1974. He became a visiting scholar at the Harvard School of Public Health in 2002 and was a research associate there when Smith died. He is now permanently barred from practicing medicine in Massachusetts.
Smith was born in Honduras and raised on Cape Cod, in Sandwich, after she was adopted by Tom and Eileen Smith. She studied cosmetology at the Upper Cape Cod Regional Technical school and was working in retail at the time of her death.
Attorney David Angueira, who represents Smith’s parents in a lawsuit they filed against the doctor, called the criminal case the family’s “quest for justice.”
“They firmly believe that this man is responsible for the death of their beautiful daughter and that he should be punished in accordance with the law for what he did,” Angueira said.
“They want to make sure that the medical community gets a very clear message that when you engage in medical procedures, they must be done properly and safely for the benefit of patient safety.”
Meyer said potential jurors are likely to be carefully questioned about their attitudes on abortion and doctors who perform the procedure.
“Of course, there are some jurors who think that just the fact that someone is performing this procedure, the doctor is guilty of some criminal act, but that is not what he’s charged with,” Meyer said.
“In picking jurors, one must be “extraordinarily careful that that hot-button issue doesn’t bleed into the actual underlying case for which this doctor is being tried,” he said.