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Originally published Thursday, March 28, 2013 at 11:28 AM

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Med. examiner, lawyer clash at doc's murder trial

A Philadelphia medical examiner battled a defense lawyer in court Thursday as he justified changing an abortion patient's death from accidental overdose to "homicide."

Associated Press

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PHILADELPHIA —

A Philadelphia medical examiner battled a defense lawyer in court Thursday as he justified changing an abortion patient's death from accidental overdose to "homicide."

Dr. Gary Collins finished two days of medical testimony at the capital murder trial of Dr. Kermit Gosnell.

Gosnell, 72, is charged with third-degree murder for allegedly letting his untrained staff overmedicate a petite, 41-year-old patient during a November 2009 abortion.

Collins said he classified Karnamaya Mongar's death as an "accident" the following August, based on the available evidence. But he changed it to "homicide" in December, as a grand jury investigated Gosnell's clinic practices and he toured the shuttered facility.

"From the get go, the circumstances (described) were inaccurate - totally inaccurate," Collins insisted. "That made it sound like everything was being done above board."

He said he never would have imagined the abortion occurred in a clinic that lacked trained staff, up-to-date drugs and equipment, and rescue equipment to revive patients in distress.

"You would think you would have people trained in CPR and actual nurses, registered nurses, if you are doing abortions," Collins said.

At one point, Collins startled observers by jumping down from the witness stand and tearing off a large timeline McMahon had prepared on an easel. Collins then grabbed a marker and started his own outline for the jury, before McMahon protested and the witness was reined in.

The deputy medical examiner later apologized. Common Pleas Judge Jeffrey Minehart told the jury that emotions often spill over at the criminal courthouse.

McMahon was trying to show Thursday that no one on staff recalled Mongar getting more than 100 milligrams of Demerol throughout the day, despite the higher autopsy findings. Prosecutors argue, though, that the hand-scrawled clinic records of her care are unreliable.

In addition to Mongar's death, Gosnell faces seven counts of first-degree murder for allegedly killing late-term babies who were born alive. Prosecutors are seeking the death penalty on those counts. Gosnell denies the charges.

Three clinic workers have pleaded guilty to third-degree murder for their role in Mongar's death, or for cutting babies in the back of the neck to ensure their "demise." One is an unlicensed medical school graduate, another a woman with a sixth-grade education who administered anesthesia drugs.

Collins, a physician, testified that there is no medical justification to stab babies in the neck with scissors, as described. A medical expert is slated to testify later about proper abortion techniques.

Gosnell was known for offering second-term abortions at his inner-city, cash-only clinic, which catered to poor women, teens and other vulnerable populations. Mongar, a refugee from Bhutan, had been in the U.S. only a few months.

Prosecutors believe he violated the state's 24-week limit by performing abortions on women as late as 30 weeks into their pregnancy.

The trial resumes Monday.

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