Cluster of abortion deaths at a single facility

This report describes a cluster of four abortion-related deaths at a single facility from 1979 to 1983. The deaths followed curettage abortions at eight to 18 weeks' gestation. One death was attributed to a prolapsed mitral valve, and one was attributed to spontaneous ventricular fibrillation. Two deaths, which occurred within three weeks of each other, were caused by hemorrhage from uterine perforation. The person who allegedly performed the last two abortions was not licensed to practice medicine, nor was he under the supervision of a licensed physician. The estimated death-to-case rate at this facility (57 per 100,000 abortions) is significantly higher than the national rate (1.2 per 100,000 abortions, P less than .001). To prevent such situations, prompt treatment of abortion complications and community-based surveillance of serious morbidity should be performed.