Dr. Kermit Gosnell is on trial, charged with murder, in the deaths of a female patient and four babies prosecutors say were born alive at the abortion clinic he ran. A look at the facts in the case:
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THE INVESTIGATION
In 2010, federal agents who were raiding Gosnell's clinic in search of drug violations instead stumbled upon "deplorable and unsanitary" conditions, including blood on the floor and parts of aborted fetuses in jars.
State regulators shut down the Women's Medical Society clinic in west Philadelphia and suspended Gosnell's license.
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THE GRAND JURY REPORT
A nearly 300-page grand jury report released in 2011 described Gosnell's clinic as a filthy, foul-smelling "house of horrors" that was overlooked by regulators.
Prosecutors said Gosnell made millions of dollars over three decades performing thousands of dangerous abortions, many of them illegal late-term procedures. The clinic had no trained nurses or medical staff other than Gosnell, a family physician not certified in obstetrics or gynecology, yet authorities say many administered anesthesia, painkillers and labor-inducing drugs.
The grand jury report stated furniture and blankets in Gosnell's clinic were stained with blood, instruments were not properly sterilized and disposable medical supplies were used repeatedly. Bags, jars and bottles holding aborted fetuses were scattered throughout the building, which reeked of cat urine because of the animals allowed to roam freely.
State regulators ignored complaints about Gosnell and the 46 lawsuits filed against him and made just five annual inspections since the clinic opened in 1979, investigators said. Several state employees were fired and two agencies overhauled their regulations after the allegations.
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THE CHARGES
Gosnell was charged with eight counts of murder until a judge threw out three of the charges Tuesday. He still stands accused of first-degree murder in the deaths of four newborns and third-degree murder in the 2009 death of a 41-year-old Bhutanese refugee who prosecutors say received lethal doses of sedatives and painkillers at the clinic while awaiting an abortion. He also is charged with violating Pennsylvania abortion law by performing abortions after 24 weeks, operating a corrupt organization and other crimes.
He pleaded not guilty and has remained held without bail since his arrest. Prosecutors are seeking the death penalty in the infant deaths.
Prosecutors estimated Gosnell ended hundreds of pregnancies by inducing labor and cutting the babies' spinal cords and caused scores of women to suffer infections and permanent internal injuries, but they said they couldn't prosecute more cases because he destroyed files.
Eight clinic workers including Gosnell's wife, a beautician accused of helping him perform illegal third-term abortions, have pleaded guilty to a variety of crimes. Three of Gosnell's staffers, including an unlicensed medical school graduate and a woman with a sixth-grade education, pleaded guilty to third-degree murder for their roles in the woman's overdose death or for cutting babies in the back of the neck to ensure their demise.
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THE DEFENSE
In an interview with the Philadelphia Daily News after the clinic was raided, Gosnell described himself as someone who wanted to serve the poor and minorities in the neighborhood where he grew up and raised his six children, who include a doctor and a college professor.
Gosnell's defense lawyer, Jack McMahon, disputes that any babies were born alive. He has suggested that the woman who died, Karnamaya Mongar, had undisclosed respiratory problems that could have caused fatal complications.
McMahon has accused officials of "a targeted, elitist and racist prosecution" and "a prosecutorial lynching" of his client, who is black, and of applying "Mayo Clinic" standards to Gosnell's inner-city, cash-only clinic. He said Gosnell performed as many as 1,000 abortions per year, and at least 16,000 over his long career, with a lower-than-average complication rate.
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THE TRIAL
The trial began March 18 and is expected to last about two months.
Gosnell's former employees have testified that they were just doing what their boss trained them to do and described long, chaotic days performing gruesome work for little more than minimum wage paid under the table. An assistant testified she snipped the spines of at least 10 babies at Gosnell's direction, sobbing as she recalled taking a cellphone photograph of one baby she thought could have survived, given his size and pinkish color.
Mongar's 24-year-old daughter testified about the labor-inducing drugs and painkillers her mother was given as she waited hours for Gosnell to arrive for the procedure. She said her mother was later taken to a hospital, only after firefighters struggled to cut bolts off a side door of the clinic, but she died the next day.
Prosecutors wrapped up their five-week case April 18 with a former worker at Gosnell's clinic who testified that she saw more than 10 babies breathing before they were killed.
On Tuesday, the first day of defense testimony, the judge in the case threw out three of the first-degree murder charges against Gosnell. Common Pleas Judge Jeffrey Minehart did not explain the reasoning behind his ruling but apparently had not heard sufficient evidence from prosecutors that the three babies were viable, born alive and then killed.