The Texas Medical Board has reprimanded three doctors previously investigated by ProPublica whose patients died after treatment for pregnancies was delayed or treated inappropriately under the state’s strict abortion ban.
Two doctors failed to intervene appropriately as a pregnant teenager repeatedly sought treatment for life-threatening complications, a committee has found. In the third case, the miscarriage patient’s uterus was not dilated or curetted to empty it, and she ultimately died from exsanguination.
When ProPublica investigated these preventable deaths and five others in three states over the past few years, reporters found that abortion bans have affected how doctors and hospitals respond to pregnancy complications. Doctors, facing the risk of prison time and professional ruin, have delayed critical interventions until they can prove that the fetus’ heart is no longer beating or that the case meets narrow legal exceptions. Some doctors say their colleagues discharge or transfer pregnant patients without taking responsibility for their care.
Doctors and lawyers have questioned why the medical board, which oversees medical licensing and investigates substandard care, has not taken a more active role in guiding doctors on how to uphold medical standards within the constraints of the law. When asked by ProPublica in 2024 what recourse a miscarriage patient has if a doctor denies needed treatment, the president of the Texas Medical Board said that while they have no say in criminal law, patients can file a complaint and “vote their vote” to seek treatment from another doctor.
Since then, the Texas commission has taken more steps than other states, issuing guidance this year setting out examples of how doctors can legally provide abortions to patients with certain comorbidities. The state Legislature ordered the board to develop training materials as part of the Life of the Mother Act, passed after reporting by ProPublica, and made modest adjustments to the state’s abortion restrictions to prevent further maternal deaths.
Georgia, where doctors died after doctors refused to empty Amber Thurman’s septic womb for 20 hours, has not reconsidered its ban or disciplined the primary doctors involved.
Maternal care experts say health care providers will continue to be reluctant to provide standard care as long as the ban carries serious criminal consequences — under Texas law, doctors can face up to 99 years in prison. But officials who spoke to ProPublica said the health board’s sanctions are one of the few countervailing forces to encourage hospitals and doctors to provide standard care despite uncertainty about the vaguely written law.
Michelle Maloney, who represents the families of both patients in a Texas medical malpractice suit, said she was pleasantly surprised by the board’s recent actions. “Throughout my career, I have experienced many tragic and tragic death cases. It is extremely rare to receive disciplinary action from a medical board, especially when litigation is ongoing,” she said.
In 2024, ProPublica reported on the case of 18-year-old Nevaeh Crane. She started experiencing severe pregnancy complications in 2023 when she was six months pregnant. Although she was showing obvious signs of infection, doctors at two hospitals sent her home. By the third visit, Crane’s condition had worsened, and doctors did not send him to intensive care until two ultrasounds confirmed the death of the fetus. Texas law requires doctors to complete additional documentation before performing any procedure that could end a pregnancy. There was no fetal heartbeat at the time doctors recorded the baby’s heartbeat, and medical records said Crane was too unstable for surgery. She died with her fetus still in her womb.
ProPublica reports that Dr. Ali Mohamed Osman, the emergency medicine doctor who examined Crane during her first emergency room visit at Baptist Hospital in Southeast Texas, sent her home with a prescription for antibiotics for strep throat without testing her for stomach cramps. The medical committee accused him of failing to properly treat the infection and check on the baby’s health.
Hours later, Dr. William Noel Hawkins, the obstetrician and gynecologist who examined Crane during a second emergency room visit at CHRISTUS Southeast St. Elizabeth Hospital in Texas, was cited for discharging Crane even though he had a fever of 103 degrees, a positive sepsis screening test, and the baby’s heart rate was abnormally high.
“This delay in treatment ultimately resulted in the death of both the patient and the fetus due to pregnancy complications,” the committee wrote for both Mr. Osman and Mr. Hawkins.
A board spokesperson would not say whether it investigated Dr. Marcelo Totorica, who examined Crane on his third visit to Christus Hospital’s ER, but requested two fetal ultrasounds 90 minutes apart before transporting Crane to the ICU for surgery. The commission does not publicize unresolved investigations or cases in which doctors are acquitted of wrongdoing. Totorica did not respond to requests for comment.
ProPublica also investigated the case of Porsha Gumezi, who died at Houston Methodist Sugar Land Hospital in 2023 after suffering massive bleeding during a miscarriage at 11 weeks. Dr. Andrew Ryan Davis, the obstetrician-gynecologist overseeing her care, gave her misoprostol, a drug that can be used to complete a low-risk miscarriage. But more than a dozen experts who reviewed the case for ProPublica said it was a high-risk incident and she should have received an immediate D&C. The process is difficult in states that ban abortion. Cleaning the uterus is standard treatment to stop bleeding. Misoprostol only makes the bleeding worse.
The commission’s investigation confirmed these findings, citing Davis’ failure to quantify blood loss and choosing to monitor Gumezi’s condition rather than immediately administering a D&C procedure. “This delay in treatment led to the patient’s death,” the committee wrote. He added that it was not possible to determine whether Ngumezi would have survived if he had undergone an emergency D&C.
The commission has the power to impose fines of up to $5,000 and, in the most extreme cases, suspend or revoke medical licenses. However, in these cases, each physician was required to complete an eight-hour continuing education course within one year. While complying with the terms of the order, all must notify their employers of the Commission’s findings. Davis and Hawkins were disciplined in October, and Osman was disciplined in March. None of the doctors or hospitals responded to requests for comment. The medical committee’s order neither admits nor denies the committee’s findings, but agrees to abide by the discipline.
Porsha Gumezi’s husband, Hope Gumezi, said the board’s order felt like a “slap in the face.”
“What kind of justice is that for Porsha?” he said. “I don’t think doctors should work as doctors anymore.”
The board said Hawkins failed to meet the standard of care in Crane’s case, but had previously been disciplined by the board for inadequate care in several other cases, including failing to perform a tubal ligation and failing to diagnose a syphilis infection. The board issued an order overseeing Hawkins’ medical practice in 2015. It was lifted two years later.
Reproductive rights advocates welcomed the Texas Medical Board’s recent actions, but said it and other state medical boards should do more. For example, Texas’ disciplinary orders do not directly sanction doctors who fail to offer or provide abortions for high-risk medical conditions.
The commission has reprimanded some doctors in recent years for failing to educate patients after a miscarriage was confirmed or for substandard care of pregnant patients in emergency situations, and the orders are usually lifted quietly. Molly Duane, litigation director at Amplify Legal, a member of the reproductive rights advocacy group Abortion in America, said the board could issue a public statement and share stronger guidance to remind doctors of the consequences.
“They need to say out loud that if we don’t provide care in these situations, this can happen,” Duane said. At the Center for Reproductive Rights, Duane represented 20 Texas women in lawsuits against the state alleging that doctors improperly refused abortions during medical emergencies. The Texas Supreme Court sided with the state and accused the doctor of misinterpreting the law. Mr. Duane is not aware of any physicians who have been disciplined by the board for these incidents.
ProPublica reported on the deaths of other Texas women, including Josely Barnica and Tierra Walker, who experts said could have been prevented if the women had been offered abortions due to high-risk medical conditions. Data analysis by ProPublica also showed that sepsis rates and blood transfusions skyrocketed among women who miscarried after the ban went into effect, an indicator of dangerous delays in care across the state.
The committee has not said whether it has opened investigations into the doctors involved in those cases or others in which pregnant patients may have received substandard care due to abortion restrictions.
