Cathy Ramey

Associate Editor

What happened to Angela Hall...

by Cathy Ramey

It was June 11, 1991 and Angela Hall, well over two hours after undergoing an abortion, was lying on a gurney. Warm sticky moisture -- her own blood -- had moved its way up her back, and what wasn't pooled underneath her was relentlessly dripping down onto the floor. Throughout the $1800 procedure to kill her 22 week unborn baby the woman had seemed fine, but then, barely rousing from general anesthesia, Angela started having problems.
According to abortuary administrator Joy Davis, "Gaynell [a lab tech] and myself was just cleaning the room. At that time, as Angela started coming out of the anesthesia, she started having difficulty breathing. She was like gasping for air and the pulse oximeter that shows her oxygen intake started going off."
She goes on to say that, "The non-evasive blood pressure cuff alarm went off. I couldn't -- it would just show up zero. It wasn't printing out a blood pressure." It was at that point that Angela Hall's hired killer was alerted and asked to return to the "operating room."
The abortionist, one Tommy Tucker, reacted in a frenzy, cursing, throwing things, and pushing others in the room out of his way.
"He was screaming at us to 'shut the damn alarms off,' and those were his words. He was shaking. His hands were shaking. He was sweating. He just appeared to be, in my opinion, panicked," his long time employee remembers.
Tension and fear propelled him to inject epinephrine and another medication into Angela Hall's IV line. No record was made of how much medication was being given, and concerns that it ought to be measured and charted were waived aside. The Tucker emergency method was just to keep injecting as long as there was even the hint of a desired effect; the barely audible systole of a blood pressure.
Initially it worked. It was finally possible to get a blood pressure reading, and the woman was gasping less for air. The improvement was only fractional and temporary, still it gave Tucker opportunity to turn Angela Hall's life and death struggle over to others.
Angela Hall was placed on another gurney and wheeled down to "recovery room two" -- the further away of two rooms used to hold women coming out from under the affect of drugs administered before an abortion.
"She was having a lot of trouble breathing. She was having problems that we were having to work with her constantly, giving her medications to maintain a blood pressure; and because there were other patients in the recovery room. And there was not any patients in this recovery room. To keep from upsetting them, we put her in that room," reads the deposition testimony of Joy Davis taken two and a half years after the incident.
More directly, though it is difficult to construct a picture of Tucker providing any measure of real care, the choice of a back recovery room had nothing to do with keeping Angela Hall as close to emergency medical help as possible. The choice of rooms was made in order to prevent other clients from hearing the pandemonium that attended Angela Hall's last crisis.
The move into a back recovery room also freed up the "operating room" for another client. Tommy Tucker proceeded on, keeping the only licensed nurse -- an LPN -- with him, and leaving an office administrator and an office assistant to continue trying to stabilize Hall's condition.
Though it might seem an uncharacteristic team to be caring for a woman in Angela Hall's condition, in fact under the Tucker system there was consistency. These were the very people -- no professional medical qualifiers attached to them -- who had gone about the business of preparing Hall for the procedure to take the life of her baby.
Joy Davis, qualified to do nothing more than operate a sonar (ultrasound) machine had been instructed in the complex task of administering medications by Tucker himself. The occasion for training an office paper-pusher to give powerful drugs came one day after his nurse anesthetist failed to show for work.
"He told her he could not reschedule all those patients," Davis claims. Then, over the telephone, he "asked her how to do the general anesthesia...We did the anesthesia and continued to do it thereafter," Davis says. "She [the nurse-anesthetist] was never brought back to the office."
Davis in turn "trained" Tucker's only licensed employee, Vicky Frazier, an LPN, to do what the state allows only a licensed physician or nurse anesthetist to do -- put a patient to sleep under general anesthesia.
"Vicky was not qualified to give general anesthesia. She was an LPN," the less qualified Davis explains, "but I had trained her to do it due to what [Tucker] had trained me to do."
She also apparently trained the office assistant Floretta Moore. It was Moore who administered oral medications designed to minimize nausea and the possibility of vomiting during the abortion. It was Floretta Moore who helped wheel Angela Hall's gurney into recovery room two. And it was Floretta Moore, never trained as an RN or LPN, who stayed to help Davis monitor Angela Hall as her breathing and blood pressure signaled that she was in the throes of death.
The respite for Tucker, as the non-medical took care of the medically needy Hall, was short-lived though. As Angela Hall's condition continued to deteriorate Tucker was called in again and again to evaluate her breathing and blood pressure. In an effort to further delegate Hall's care to unlicensed personnel, Tucker encouraged Davis to simply inject medication into the IV line herself. But Davis, apparently overwhelmed with the dynamics surrounding Angela Hall's abortion and perhaps afraid of what she had become involved in -- the death of a born person -- refused. "Well, I just told him that I didn't want to give it because we were -- I was not trained on it. I hadn't read anything on it," Joy Davis recalls.
According to the Davis deposition, at no time did abortionist Tucker examine Angela Hall. Not before she was scheduled to kill her 22 week baby; not before she slipped into unconsciousness from the anesthetic; and now, not even when her own life was on the line. The absence of a blood pressure surely alerted the abortionist that there was some type of serious blood loss, yet according to Davis, Tucker responded to each summons to, "administer the medication through the IV," and then "He would leave the room again."
After one of those exits from Angela Hall's bedside Davis pulled back the blanket that covered the woman's body.
"At that time I noticed a large amount of blood in the bed and that she was bleeding very badly," Davis says. "So I ran and got Dr. Tucker again and told him that she was bleeding."
The report could only have confirmed what any medical student would have known based on the radical fluctuation and often absence of a blood pressure. Tucker, it is argued, must have been at least somewhat prepared for the fact that a woman was bleeding to death in his back recovery room. His response to the latest twist in Angela Hall's condition might indicate something of the cold-blooded and calculated manner in which he viewed her failing health.
Tucker was in the "operating room" killing another baby for another client when Davis interrupted.
"He instructed me to take her to the exam room and examine her and see if I could tell where the bleeding was coming from."
Davis then explains that Tucker at one time told her that there are two possible areas where an abortion client might experience profuse bleeding. Blood might be coming from Hall's cervix, but if the bleeding didn't appear to originate there, it would mean that the blood was coming from the uterus.
"We put her back on a gurney, rolled her down this hall into the lab and into the exam room," Davis says. "When we got to the exam room, we put her on the exam table, put her legs in the stirrups. I got a speculum and put the speculum in to see if I could tell where the bleeding was coming from," she continues.
Davis then relates how she concluded that the bleeding was coming from the uterus. Massage to the area failed to stem the flow. It was then that she packed Angela Hall's vagina with sterile four by four surgical gauze. If she had been trained in nursing or medicine she might have understood the theory behind such a procedure. The hope was that the gauze would facilitate clotting by giving the blood a fibrous mat to coagulate around. The problem was that the bleeding was emanating from an area not in contact with the material. The packing was more likely to simply absorb blood as it exited through the cervix but never staunch the hemorrhaging at its source. What Davis knew even without sophisticated medical training was that Angela Hall was in serious trouble.
"After I packed her, I then told Dr. Tucker that she was bleeding very heavily and I went and called an ambulance," Davis relates in her deposition. "He was still in the procedure room," she testifies.
"And he was doing another abortion?" the attorney asks her.
"Yes, sir," Davis responds.
"Was he...still doing the same abortion or had he started another abortion?"
"He had started another one," Davis explains to the attorney.
After calling for an ambulance Joy Davis went back to the exam room where Angela Hall was laying. It was there that Tucker found her only moments later.
"I went back into the exam room where Angela was and started trying to clean her up and clean the room up to get ready for the ambulance to come," she says, and Tucker came into the room.
"He was very angry with me, obviously, very angry at me...He said he was the [expletive] doctor and that if anybody was going to call an ambulance, it was going to be him...He instructed me at that time that he had canceled the ambulance that I had called and that he felt she was going to be fine."
Davis then explained to Tucker that Angela Hall was bleeding profusely. Fresh packing and the clean appearance of the room belied the fact that only moments before the woman on the table was laying in a puddle of blood. Still, Tucker did not attempt any kind of examination of Angela Hall.
"The doctors at UAB [Univ. of Alabama in Birmingham] were not very friendly with Dr. Tucker," according to Joy Davis. In fact, "any time that we sent a patient to UAB with complications, they would give him a lot of trouble over it," she said.
As part of the business of killing their babies, Tucker was performing invasive and dangerous procedures on clients without having admitting privileges at any hospital in the Birmingham area. Now, faced with another bungled abortion, it was uppermost in his mind to avoid conflict with the UAB or any other hospital. Meanwhile, Angela Hall, fading in and out of consciousness, perhaps even aware of Tucker's irritation at her emergency, would just have to wait.
Joy Davis tried one last time to convince Tucker that the situation was critical. Again she mentioned that she was unable to get a blood pressure reading on Hall. Not only was the woman in respiratory distress, it appeared that her circulatory system was rapidly collapsing as well.
"He told me that I was not pumping the cuff up high enough, that he could hear it very clearly," Davis claims.
After scolding her for failing to find a blood pressure Tucker left the room. Davis discussed Angela Hall's condition with another assistant who had followed Angela Hall from operating room, to recovery room, and then to the exam room where she remained.
Joy Davis continues, "Odessa Harris, who had stayed with Angela the entire time, told me, she said, 'He's lying. He could not hear that blood pressure and if you don't do something, she's going to lay right here and die.'"
Afraid of challenging Tucker's orders and confronting him again, Davis waited a a short while longer with Angela Hall, talking to her in the hope that she would wake up and be able to participate in the decision-making process about what to do next. After getting no response she went about the mechanical task of trying to determine if the bleeding was slowing down.
""I went back around to check to see if she had bled through the packing and obviously she had. It was running down the table. It was pooling on the floor and running down in behind her back," Davis testified.
"When you say 'it,' what do you mean?" her attorney probes.
"The bleeding," Davis answers.
"Were the sheets soaked?" he asks.
"Yes, sir."
"Was her gown soaked?" he continues.
"Yes, sir."
"Was there blood on the floor?" he wants to know.
"Yes, sir," Joy Davis responds.
"How much?"
"A lot. I couldn't tell you in c.c.'s how much, but it was a lot."
At that point Davis claims she left the room in search of abortionist Tucker and found him chatting with his wife -- the facility bookkeeper -- in her office.
"I just told him that she was bleeding really bad," Davis said, "that she had bled through the packing and he had to do something." To which Tucker is alleged to have responded, "What the hell do you want me to do?"
"I said, 'I don't know, but I want you to do something. She's going to lay here and die."
At this point, according to Joy Davis' testimony, Tucker finally agreed to allow an ambulance to be called. Only moments later, before emergency medical personnel ever arrived at the facility, he left the premises, but Davis and others scurried about in an effort to arrange the environment, get rid of some of the blood, before EMT's arrived.
"I got the other come in and help Odessa and myself clean the room up and clean Angela up," Davis says. With the help of the others Davis hurried to "change her gown and get her presentable so it wouldn't look so horrible when the ambulance [that she had already called] arrived."
Finally, when it appeared that the crisis was coming to an end, Angela Hall went into another severe episode of respiratory distress. Unable to get a blood pressure reading, and afraid that she might die before the ambulance arrived to take her to the hospital, Joy Davis called Tucker on his car phone.
Ordered to administer another dose of medication through her IV line, Davis saw some improvement in Angela's condition. Only moments after Angela had been "just gasping really hard for air" EMT's arrived to transport her on to the hospital where she was eventually declared dead. An autopsy report would note that upon arrival at the hospital her blood supply was nearly completely gone.
Davis recalls the atmosphere at the abortuary on the day following Angela Hall's abortion.
"The very next day Dr. Tucker came in and said that he had called UAB and that Angela was fine, that she was getting a lot better and that I had over-reacted terribly, and that I needed to get control of my emotions."
Only "a good bit later," as Davis describes time, while working in Tucker's Jackson, Mississippi mill, did Joy Davis and others find out that Angela Hall had actually died. Tommy Tucker was willing to sacrifice her with her child rather than run the risk of conflict with any hospital that might question another botched abortion.