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State health officials say they will closely monitor operations at a southeast Charlotte abortion clinic that has reopened after briefly losing its license.


A Preferred Woman’s Health Center on Latrobe Drive reopened May 15 after the N.C. Department of Health and Human Services lifted its order suspending operations. State investigators in April revoked the clinic’s license after determining that staffers were orally administering the liquid drug methotrexate, which is used to induce abortions.


The drug is meant to be injected or taken in pill form, according to the state report and health officials.


State records show A Preferred Woman’s Health Center is one of only two abortion clinics in the state to have its license suspended in the past 14 years.


During that time, the Charlotte clinic has been shut down twice. The clinic’s license was revoked in February 2007 after state investigators found as many as 16 safety and regulatory issues, documents show.


Before then the only other clinic suspended by the state was A Woman’s Choice of North Carolina in Greensboro in 1999.


A Preferred Woman’s Health Center was allowed to resume operations after the state received affidavits showing that physicians and staffers had changed their policies and “ceased the use of methotrexate in an oral manner,” documents show.


“There will be ongoing monitoring of A Preferred Woman’s Health Center to ensure compliance,” said a DHHS official.


When reached by phone, a clinic secretary told the Observer that owner Lois Turner declined to comment.


The most recent investigation of the Charlotte clinic began after state health officials received a complaint that an injectable version of methotrexate had been administered orally. Health officials say that is dangerous to patients and ineffective.


“This is the first case in which the route of administration (of methotrexate) was contrary to the manufacturer’s recommendations,” the DHHS official said.


The medication had been drawn up in a syringe and then put into a cup for patients to drink, according to a clinic nurse interviewed by state investigators.


In one case, a 19-year-old woman came to the clinic for an abortion procedure and was given methotrexate orally. A month later, she returned to the clinic, still pregnant, and had to undergo a surgical abortion procedure, according to state documents.


Dr. Mitchell Creinin, a California-based obstetrician who was among the first to study methotrexate abortion procedures, questioned the practices at the Charlotte clinic.


“There is sufficient data to be using methotrexate but not the way they used it,” said Creinin, who is the chairman for the University of California Davis’ Department of Obstetrics and Gynecology. “It’s no different than hearing about an orthopedic surgeon cutting off the wrong leg.”


But National Abortion Federation medical director Dr. Matthew Reeves said the Charlotte clinic’s use of methotrexate wasn’t as risky as Creinin implied.


The National Abortion Federation, a professional association representing abortion providers, recommends A Preferred Woman’s Health Center as one of three abortion clinics in Charlotte.


Reeves noted that a Canadian physician a couple of decades ago studied the effectiveness of orally giving patients liquid methotrexate to induce abortions. That study found the method to be safe and effective, Reeves said.


But Creinin said one study is not sufficient to support the drug’s use in that way.


The drug’s manufacturer, the assistant director of the Carolina Poison Center and the medical adviser for the Division of Health Service Regulation don’t recommend the oral administration of methotrexate.


Planned Parenthood, which refers women to local abortion providers, does not refer patients to A Preferred Woman’s Health Center and is “not affiliated with that clinic at all,” according to spokeswoman Melissa Reed.


Turner, the clinic owner, also operates clinics with the same name in Raleigh and Augusta, Ga.


Both of those clinics remained open during the Charlotte office’s recent suspension, documents show.


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