A group of pro-choice organizations, including the National Abortion Federation (NAF), on Tuesday called on the Virginia State Health Commissioner Dr. Marissa J. Levine to permanently close any abortion clinics in that state associated with the troubled abortion provider, Steven Chase Brigham.

The calls follow the release last week of a damning inspection report from Virginia’s Department of Health, based on a two-day survey of the American Women’s Services facility in Fairfax.

State inspectors found filthy and dangerous conditions in the clinic that posed a substantial risk to the safety of patients, staff, and visitors, according to Erik Bodin, the director of the Office of Licensure and Certification, which conducted the inspection.

Among the findings in the 52-page report were observations of dirty equipment, smeared with “foreign material” and yellow and brown “splatter” that had dried in place. Surveyors reported that a staff member went into a bathroom and unblocked a patient toilet, and then participated in an abortion procedure—even holding the patient’s hand—without first changing clothes or properly cleaning his or her hands.

A doctor whose gown was smeared with blood after performing an abortion held up the gown and hung it on the back of the door for future use, saying of the soiling, “Oh, it’s not that bad.” Inspectors found expired medications and discovered that annual maintenance checks on key machinery had not been completed.

In her letter to Levine, Vicki Saporta, president and CEO of NAF, said that these findings were “just the latest assessment of Brigham, who has come under fire from state licensing boards and health departments throughout his career.”

“Evidence of wrongdoing at Brigham’s American Women’s Services facility in Fairfax is part of a clear pattern of repeated and serious misconduct that poses a significant threat to patient safety, and which cannot be allowed to go unchecked in Virginia,” Saporta wrote. “In an area of medical practice populated by highly qualified and professional providers, Steven Brigham is an egregious and dangerous exception. NAF urges the Department of Health to act swiftly to protect the health and safety of Virginia women by permanently closing Brigham’s clinics in the state.”

Brigham, in a phone interview with Rewire, rejected the notion that he was directly involved in the provision of abortion care services at the Fairfax clinic, claiming that he was neither an employee nor an owner of that clinic. Brigham said his only connection with the Fairfax location was in giving staff occasional advice.

He said that he hadn’t visited that clinic in at least three years, and that he derived no profit from that clinic. He characterized Saporta’s letter as an ad hominem attack.

Courtney Rice, a spokesperson for American Women’s Services, provided an email statement to Rewire in which she confirmed that Brigham is not a physician or employee in that office.

Rice said that the clinic was making efforts to comply with regulations and regain its license.

“We are disappointed that our Fairfax office temporarily fell below the high standards it has long adhered to and we are cooperating with the Department of Health to correct any deficiencies identified, starting with the termination of our Administrator,” she wrote.

Despite his claims to Rewire, various public records suggest that Brigham retains some formal connections to the Fairfax clinic, the legal name of which is Virginia Health Group.

Virginia’s State Corporation Commission lists Brigham as the registered agent for the company, and the Virginia Secretary of State’s site lists him as the company director. Yet his precise role with American Women’s Services remains murky; he did not directly answer Rewire’s questions as to exactly what he did with that company, or whether he holds any ownership or control.

Brigham’s role in connection with abortion clinics in multiple states has long been a subject of controversy among regulators and other abortion providers.

Over three decades, he has encountered frequent troubles with health department authorities in New York, New Jersey, Pennsylvania, and Maryland, among others, and has faced multiple allegations of substandard practice, including contributing to the serious injury of several patients.

New Jersey in 2014 revoked Brigham’s medical license in connection with multiple allegations of misconduct, including an incident that resulted in serious injuries to a patient who had been transported from New Jersey to Maryland for a surgical abortion.

Reputable abortion providers have spent years trying to bring Brigham and his clinics to the attention of regulators in the states in which he worked, as Rewire reported in 2013. 

Providers expressed frustration that despite disciplinary actions being brought against him, Brigham has been able to continue working in abortion care, either by practicing in different states or by taking a behind-the-scenes role in clinics that he controlled through American Women’s Services. With at least 14 clinics in multiple states, American Women’s Services remains among the country’s largest chains of abortion clinics.

Even if Brigham owns all or part of American Women’s Services, that would make little difference to the Fairfax clinic’s chances of regaining its license, Bodin said, because there is no requirement in Virginia that the owner or operator of a medical clinic possess a medical license. Rather, the health department must simply assess whether the clinic meets the standards set forth in regulations governing abortion clinics.

Bodin said that representatives of Virginia Health Group are scheduled to appear before an administrative law judge on May 11, where they will have an opportunity to show that they have fixed the many deficiencies cited in the inspection report.