Gosnell, at his arraignment Thursday, said he did not understand why he was being charged with eight counts of murder.
"I understand the one count, because a patient died, but I didn't understand the seven counts," he told a magistrate.
The magistrate explained the other counts involved babies who prosecutors say were born alive, and she denied him bail.
Four other clinic employees are charged with murder for roles prosecutors say they had in the deaths of Mongar or the viable babies. Gosnell's wife was charged with performing illegal abortions and other crimes and is being held on $1 million bail.
Gosnell, in an interview with the Philadelphia Daily News after the clinic raid last year, 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, a college professor and two children who are still at home.
Defense lawyer William J. Brennan, who represented Gosnell during the investigation, said Gosnell "feels he has provided a general care medical facility in a fairly impoverished area for four decades."
"That's his belief," Brennan said, "and he's entitled to it."
Gosnell told the magistrate he's looking to retain another lawyer, and Brennan confirmed he's not representing Gosnell anymore.
"I wish him well, but I am not taking this case," Brennan said. "The doctor and I have had our run."
In one 1999 case, prosecutors said, 20-year-old Marie Smith was sent home after a Gosnell abortion unaware that he had been unable to remove the entire fetus from her uterus. Days later, vomiting and with a swollen abdomen and severe infection, Smith was taken to a hospital, where she was rushed into surgery.
Her mother, Johnnie Mae Smith, said she was shocked at the "nasty and dirty, filthy" conditions in the clinic. When her daughter took ill days later, she called Gosnell.
"I said, 'What did you do to my daughter? ... My daughter's about to die,' Smith said. "He said, 'Take her to the hospital.'"
Gosnell turned up at the hospital with his checkbook, she said, aiming to settle immediately. Instead, she chased him away, vowing to sue. Later, her daughter got $3,000, after lawyer fees, from a $5,000 settlement.
Johnson never sued over the abortion or ensuing venereal disease, but 46 other parties have, including the family of 22-year-old Semika Shaw, who prosecutors said died of sepsis at the Hospital of the University of Pennsylvania in March 2002 two days after Gosnell perforated her uterus and cervix during an abortion.
Gosnell's insurer later settled the family's lawsuit over her death for $900,000 and referred a complaint and the settlement to state health officials who oversee the clinic and Gosnell's medical license. The insurer's complaint brought no action, prosecutors said, because a Board of Medicine attorney said "the risk was inherent with the procedure."
Gosnell typically worked from about 8 p.m. until after midnight, arriving only after his pregnant patients were dilated, sedated and ready for the abortion procedure.
During the day, his untrained or undertrained staff ran the clinic and practiced medicine there, authorities said. They ranged from two supposed "doctors" who had finished medical school but had no licenses to Ashley Baldwin, the 15-year-old daughter of office manager Tina Baldwin, prosecutors said. The teenager came after school to administer anesthesia and assist with abortions, even past midnight, the grand jury charged.
"As Ashley's involvement in Gosnell's illegal practices became deeper — at one point she was working 50-hour weeks and well past midnight, while trying to complete high school — Tina did nothing to curtail her minor daughter's exploitation by Gosnell," prosecutors wrote in the report.
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