Doctor indicted in '07 death of abortion patient

Prosecutors allege he delayed resuscitating her

Eileen Smith struggled in Hyannis as she recalled memories of her adopted daughter, Laura Hope Smith, 22. At the time of her death, Laura Hope Smith was working in retail management. (Paul Blackmore/ Cape Cod Times/ File 2007)

A Harvard-affiliated obstetrician has been indicted on a manslaughter charge after an abortion he performed last year on Cape Cod ended in the death of a 22-year-old woman, prosecutors said yesterday.

Dr. Rapin Osathanondh, a research associate at the Harvard School of Public Health, allegedly failed to monitor Laura Hope Smith of Sandwich while she was under anesthesia during the procedure in September at Women's Health Center in Hyannis. Prosecutors allege he delayed trying to resuscitate Smith after she stopped breathing and then lied about his actions and the equipment he had available after the state began investigating.

Physicians usually do not face a criminal charge when a patient dies of alleged negligence, but Michael O'Keefe, district attorney for the Cape and Islands, said in a phone interview that the indictment came after an investigation by Barnstable police, State Police, and the Massachusetts Board of Registration in Medicine found Osathanondh's conduct to be "willful, wanton, and reckless."

"Suffice it to say, there was an inattention to the kinds of procedures of a lifesaving nature that one would expect in a place where an operation with anesthesia is being performed," O'Keefe said. "There was nobody monitoring her, long enough to result in her death. There were a number of other shortcomings that make up the willful, wanton, and reckless conduct."

Paul Cirel, a Boston lawyer representing Osathanondh, said his client will plead not guilty. O'Keefe said Osathanondh will be arraigned within a week in Barnstable Superior Court.

"I expect he will be exonerated," Cirel said. "He has been practicing medicine in this field for over 40 years and has performed thousands of similar procedures without any significant incidents. This is a tragedy that sometimes happens in medicine, but it happens; patients die inexplicably in the course of even routine procedures. . . . This is not a matter that belongs in the criminal courts."

David Frank, a former prosecutor who writes for Massachusetts Lawyers Weekly, called it "definitely unusual" for such a case to result in an indictment. "It's not every day that a physician is charged with criminal conduct in connection with something that took place in performance of their job."

Osathanondh, 65, resigned his medical license in February after the medical board accused him of misconduct, and he was permanently barred from practicing medicine in Massachusetts.

He graduated from a medical school in Thailand and was licensed in Massachusetts in 1974. He became a visiting scholar at the Harvard School of Public Health in 2002 and is a research associate there, a school spokesman said.

The medical board said in a Feb. 20 order that Osathanondh engaged in "conduct that calls into question his competence to practice medicine," including conduct that "has the capacity to deceive or defraud" and "undermines the public confidence for the medical profession."

The board alleged that Osathanondh had placed the patient under sedation without any means to monitor her heart rate, blood pressure, or the oxygen level of her blood. The board said the doctor had no qualified person assisting him while Smith was under anesthesia. The only other person in the room was an office worker who had no CPR or other training in lifesaving procedures.

The board added that Osathanondh "failed to timely initiate a call to 911," "failed to maintain an adequate airway," and "failed to adhere to basic cardiac life support protocol."

Osathanondh also allegedly made a variety of false statements to board investigators, telling them that he had administered Smith oxygen and monitored her oxygen levels and that his office worker was certified in lifesaving procedures. He allegedly tried to deceive investigators by expanding the size of his treatment room and bringing in new equipment, which he maintained was there at the time of the abortion.

The board said he also "fraudulently obtained renewal of his medical license by providing false information."

David Angueira, a Boston lawyer representing Smith's parents in a civil suit they filed against the doctor in March in Barnstable Superior Court, said the family was relieved to learn of the indictment.

"They are delighted to know that justice has listened to their cries," Angueira said.

Angueira said Smith was born in Honduras and abandoned. She was adopted by an American couple, who allegedly abused her and gave her up. He said she was later adopted by Tom and Eileen Smith, who raised her in Sandwich.

Angueira said she graduated in 2004 from Upper Cape Cod Regional Technical School, where she studied cosmetology. At the time of her death, she was working in retail management, he said.

Smith's parents could not be reached for comment.

Karen Trott, a close friend who was with Smith when she had the abortion, said Smith was engaged and 13 weeks' pregnant. She said that Smith's fiancé was overseas serving in the military at the time and that she did not want to have the baby by herself.

"He didn't have the correct equipment and he tried to hide everything after the fact," Trott said of Osathanondh. "She was 22 years old, healthy, and this shouldn't have happened. I think he should go to prison."

David Abel can be reached at dabel@globe.com.