Operation Rescue caught late-term abortionist James S. Pendergraft IV and his Maryland accomplice, Harold O. Alexander, red-handed operating an illicit late-term abortion mill in Forestville, MD. Listen to Pendergraft — who is not licensed in Maryland — describe his shady operation in his own words.

An Operation Rescue Investigative Report

Forestville, MD — A seven-month undercover investigation conducted by Operation Rescue has revealed scandalous details of a late-term abortion scheme involving one of the nation’s most notorious abortionists that is shockingly similar to one run by disgraced abortionist Steven Chase Brigham.

Beginning on November 8, 2011, Operation Rescue staff members, posing as potential late-term abortion customers, began recording a series of conversations with James Scott Pendergraft, IV, of Florida, which document a suspicious bi-state abortion business aggressively advertized on the Internet as LateTermAbortion.net.

“Documentation that Pendergraft is operating a late-term abortion operation in Maryland confirms that state as the Late-term Abortion Capital of America,” said Troy Newman, President of Operation Rescue and Pro-Life Nation. “Pendergraft joins the likes of New Jersey’s Steven Brigham and Nebraska’s LeRoy Carhart, who targeted Maryland for their late-term businesses because of the state’s reputation of allowing abortionists to operate without regulation or accountability, something we hope will be remedied by Maryland’s new clinic regulations that are set to go into effect on July 23.”

Pendergraft is best known as the owner of five Florida abortion clinics, including his flagship office, the Orlando Women’s Center. Currently, Pendergraft is prevented from practicing medicine there while he serves his fourth career suspension. Pendergraft has no active medical license in any other state. Nevertheless, Pendergraft continues operate his five Florida abortion clinics as well as LateTermAbortion.net, holding out his own 25 years of experience as a reason for women to trust the safety of the procedures they will receive.


While Pendergraft specializes in highly lucrative late-term abortions, the State of Florida prohibits abortions past 24 weeks. He admits he established LateTermAbortion.net in 2010 to evade the laws in Florida and fill the void in late-term services he believes was created when George Tiller’s late-term abortion clinic in Wichita, Kansas, closed in 2009.

According to the website, Pendergraft boasts that he runs an abortion clinic using “intracardiac injection of medication into the fetal heart” prior to the induction of labor at a “private facility in the Washington, D.C. area.” He carefully guards the facility location and the abortionist with whom he works, saying it is to protect the patients and clinic staff.

However, it is more likely that Pendergraft is so secretive about his operation because he holds no active license anywhere, making the entire enterprise legally suspect. His Florida medical license was suspended for the fourth time in September, 2010.

Pendergraft has a long history of Board disciplinary action and lawsuits that have placed him in a desperate financial situation. Last year, he was slapped with a stunning $37.7 million judgment for injuries he inflicted on a pre-born baby during a failed abortion ten years ago. Then, in April, 2012, the State of Florida Department of Health filed notice against Pendergraft, demanding that he pay a total of $122,303.21 for fees, fines, and costs incurred by the state during its disciplinary actions against him.

His bi-state late-term abortion scheme allows him to earn maximum profit from minimum effort.

Pendergraft’s Maryland Accomplice

Operation Rescue’s investigations led to the discovery that Pendergraft is working with Harold O. Alexander at Integrated OB/GYN Services, located at 7610 Pennsylvania Avenue, #305, in Forestville, Maryland. Pendergraft’s representative at Integrated OB/GYN Services in Forestville is a woman named Kay, who handles the logistics of making arrangements for Pendergraft’s late-term patients.

Alexander is an abortionist currently facing medical board action in Maryland that resulted, in part, from complaints filed by Operation Rescue.

Alexander has been charged with violations of the Maryland Medical Practice Act, listing a number of shocking allegations that could cost him his medical license, including “sexual boundary” violations, botched abortions, shoddy or non-existent record keeping, and the illegal prescribing of large amounts of Viagra and other drugs to himself and non-patients. He also faces a charge that he illegally shredded a medical record of a late-term abortion patient that was related to his association with Pendergraft.

The “Intracardiac Injection”

LateTermAbortion.net offers “Intercardiac Injection”, in other words, a lethal injection into the baby’s heart that is made with a long spinal needle through the wall of the woman’s abdomen that is guided by ultrasound. This injection is meant to kill the pre-born baby. The purposes for this are many, not the least of which is to avoid any legal entanglements with the 2003 Federal ban on Partial-Birth Abortions, which was upheld by the U.S. Supreme Court in 2007.

“Once the fetal heart beat has stopped, the process of removing the fetus from the mother’s womb is no longer defined as an abortion,” stated Pendergraft. He offers this as a way to force hospitals and physicians that otherwise may balk at abortion to finish the abortion process since the woman now faces a serious life-threatening condition.

“Pendergraft is using women by placing them in harm’s way in order to make a political point in states that ban his pet procedure,” said Newman. “This shows he is willing to push an ideological agenda at the expense of women’s health and safety. That alone makes him dangerous.”

Even Pendergraft admits a misstep in performing the injection can be “catastrophic.”

“Though it may sound simple to perform an intra-cardiac injection, it is not,” writes Pendergraft on his website. “Misplacement of the spinal needle and injection into the wrong area can possibly be catastrophic.”

According to Pendergraft’s website, the injection process takes only 2-3 minutes. The patient is monitored for approximately 15 minutes before being released. Now carrying a dead child, the woman is sent away to her personal physician or other facility to have the dead fetus surgically removed. Delivery of the dead baby takes place at a separate location, which may be in another state or country.

“What is to prevent the woman from going into labor or having some other medical emergency during her travel back to her home? This scheme is extremely dangerous and is designed for maximum profit of minimum effort,” said Troy Newman, President of Operation Rescue.

Pendergraft agrees there are dangers:

Generally when most fetuses die in utero, there are enzymes released that cause an inflammatory reaction to occur which leads to labor which is followed by delivery of the tissue. The problem is if you do not go into labor for a few days, not only can the patient’s blood become severely infected, but this can lead to a clotting disorder where the patient’s blood does not clot, severe low blood pressure, bleeding constantly from needle sticks, internal bleeding, multiple organ failure which can lead to maternal death. This is nothing that should be taken lightly.

Pendergraft solicits patients for his intracardiac injection clinic from all over the world. That means a woman could conceivably come to Maryland to initiate fetal demise, only to be forced to travel hours back to her home state or country while carrying a dead fetus all the while risking all the horrible possibilities Pendergraft mentions. This process poses dramatic dangers to the life and health of the woman.

Operation Rescue has learned through its investigation that Pendergraft has expanded his services to now include induction of labor after fetal demise and the delivery of the dead child.

Dangerous RU486 and Cytotec in Second and Third Trimester Abortions

Pendergraft’s Maryland LateTermAbortion.net operation boasts that it is “able to provide the expertise from a physician with over 25 years of experience performing late term abortions, and the first in the United States to induce labor using RU486 and Cytotec in second trimester and late term abortions.”

The Food and Drug Administration does not recommend the use of RU486 after 7 weeks gestation. The company that manufactures Cytotec has warned the public that the drug, which is meant to treat ulcers, is dangerous when used for abortions. At least 17 women have died from RU486 abortions.

“Pendergraft’s off-label use of RU486 and Cytotec on second and third trimester abortion patients is exceedingly worrisome,” said Newman. “It is astounding how he keeps finding frightening new ways to endanger the lives and health of women.”

Pendergraft uses the “Brigham” Business Model

Pendergraft’s late-term operation is very similar to that of Steven Chase Brigham, whose medical license was suspended in 2010 after the discovery he was operating a clandestine late-term abortion clinic in Elkton, Maryland, without a valid medical license there. Brigham would start the abortions in New Jersey, then caravan women in full-blown labor to the Maryland location, where he would act as “consultant” for the abortionist who was actually licensed in that state. His associate, Nicola Irene Riley, was charged with practicing medicine with an unauthorized person and posing a danger to the public.

Like Brigham, Pendergraft is not licensed in the State of Maryland, yet travels to Alexander’s office on as little as a day’s notice to join his late-term abortion patients for their procedures. Abortions are initiated there, after which at least some patients are sent to a secondary location – sometimes out of state – for the completion of their abortions. In these cases, Pendergraft and Alexander have no part in providing services during the final part of the abortion.

The arrangement between Pendergraft and Alexander appears to be one that mirrors the arrangement between Steven Chase Brigham, Nicola Riley, and George S. Shepard, Jr. Brigham conducted his enterprise in Maryland to avoid abortion laws in his home state, as does Pendergraft. Brigham used Riley’s and Shepard’s Maryland medical licenses to give his scheme legitimacy. Pendergraft uses Alexander’s medical license in Maryland in the same way, to make everything appear legal, when in fact, it is dangerous and in violation of the standard of care.

The Sting

On November 8, 2011, Troy Newman called Pendergraft at the number on the LateTermAbortion.net web site, which turned out to directly connect to Pendergraft’s cell phone. Newman recorded the conversation in two parts. Newman posed as the husband of a woman seeking a late-term abortion due to fetal anomaly.

During that conversation, Pendergraft instructed Newman to wire $6,000 cash to his personal account at a Bank of America in Florida. During the conversation, Pendergraft worked hard to close the “sale”.

Listen to audio excerpts of this conversation (3 min. 13 sec.):

Pendergraft indicated that the abortion-bound couple would be met and escorted to the clandestine late-term intracardiac injection clinic where Pendergraft would see them. He refused to disclose the location of the clinic or the name of the licensed physician who would be doing the procedure until he received electronic confirmation that the wire transfer was safely in his Florida bank account.

A second call to Pendergraft’s website phone number was placed by me on December 7, 2011. Cheryl Sullenger posed as the mother of a 19-year old college student who had concealed her pregnancy from her parents and wanted to abort a 28-week pregnancy because she broke up with her boyfriend.

Pendergraft offered to meet her in the DC area the following day at the cost of $10,000 for a 28 week abortion. When she expressed shock at the price, he quickly reduced it to $8,500. He indicated that his would be a “fetal anomaly” abortion, even though he was never told there was anything wrong with the pregnancy. He discussed his experience with this procedure. When asked, he admitted he would not be doing the abortion himself and that the entire abortion would be done at the “DC area” clinic.

Pendergraft assured the caller that while other places offering the same procedure over three to four days, he could do it in just two days.

“Women that give birth in hospitals at 28 weeks stay for longer than that,” said Newman. “He offers no follow up care, has no hospital privileges, and will rush the procedure through to save money. It is hard to express how dangerous this is for the women.”

In one conversation recorded in June of this year, Pendergraft seemed to put up a pretense of attempting to establish a medical basis for a very late-term abortion. Once the caller indicated that her boyfriend was in jail, Pendergraft discussed her anxiety over the situation as an adequate mental health basis to justify the abortion. He then proceeded to tell the caller the next step in the scheduling process.

Additional calls placed over the next few months confirmed Pendergraft’s procedures for soliciting and booking late-term abortion appointments in Maryland, as well as the pre-requisite wire payments to his Florida bank account.

Operation Rescue has produced a video with clips from these recorded conversations that can be viewed above or on YouTube.com.

“Pendergraft is charging women exorbitant prices for late-term abortions. He says the process is ‘not inexpensive’ but does not list his fees, perhaps because he is more than willing to haggle over the abortion price in order to ensure the customer does not take her business elsewhere,” said Newman. “This is not about helping women. It is about helping his bank account, and making a political statement about late-term abortions at the expense of women’s lives and health. It’s frankly despicable.”

Legal and Safety Concerns

Pendergraft’s personal involvement in the actual abortion process is sketchy. It is clear, however, that he does not own the Forestville clinic, but is using its facilities. He does own Latetermabortion.net, the business through which he solicits late-term abortion patients based on his professional expertise. Money must be wired to his back in Florida, not to the Maryland facility where the abortions are done. He flies to Maryland from Florida with as little as one day’s notice to see patients, yet he says he is not the one doing the abortions. He is fundamentally involved in the process to some extent, often referring to his vast personal experience with this kind of procedure as a means of putting potential customers at ease.

It is clear that Alexander plays a primary role in providing medical services for Pendergraft’s late-term abortion business. Alexander has no part in soliciting customers, but does provide his office and his staff to coordinate appointments for Pendergraft’s business. It is inconceivable that Alexander is unaware that Pendergraft is unlicensed in Maryland. Alexander’s license is used to give legitimacy to Pendergraft’s operation.

There are several concerns with Pendergraft’s and Alexander’s Maryland late-term fetal injection operation:

1. Health and safety of women.
– Injection only patients: Women are placed into potentially life-threatening conditions then sent away to have someone else deal with them.
– Full abortion patients: Conducting a 3-4 day procedure in 1-2 days is ill-advised and increases risks to the woman’s life and health.
2. Truthfulness of claims that the Latetermabortion.net operation is completely legal and operated by licensed physicians. Pendergraft himself has no active license that allows him to practice in Maryland or any other state.
3. Pendergraft’s scheme is in possible violation of the Federal Unborn Victims of Violence Act of 2004.
4. The secrecy under which Pendergraft and Alexander operate is troubling and lends itself to abuse and accountability issues. This further endangers the safety of women.

The Complaints

After Newman and Sullenger’s initial calls to Pendergraft and the discovery of his relationship with Alexander, Operation Rescue filed two separate complaints with the Maryland Board of Physicians in December, 2011, against Pendergraft and Alexander, asking for a full investigation.

“We didn’t say anything about our discoveries publicly in order to give the Maryland investigators an opportunity to catch these men red-handed,” said Newman. “We did not want to tip Pendergraft off and have him cover his tracks.”

Meanwhile, Operation Rescue continued on occasion to call Pendergraft to confirm he was continuing to conduct his business in the same manner that was reported to the authorities. Those calls were forwarded to the Board investigator on June 13, 2012.

Apparently that silence paid off.

Shredded Abortion Record

show that a Board investigator questioned Alexander about his business dealings with “unauthorized provider” Pendergraft. He admitted that there were three patients that had been seen as a result of Pendergraft’s referrals. The Board subpoenaed those records. Alexander provided the Board with three patient records, but only two were originally identified by Alexander during the interview. According to charging documents filed by the MBP on May 14, 2012, Alexander stated that he had shredded one of the medical records for Patient X “in response to threats that had been made to the patient and himself by the patient’s family members.” Alexander said that his staff reminded him of another patient involved in his affiliation with Pendergraft that he had forgotten to mention to the investigator, so he included that record instead.

The Board charged Alexander with “unprofessional conduct in the practice of medicine” for illegally shredding Patient X’s medical record. A hearing on the matter was held on July 3, 2012, but the Board has yet to release the results of that hearing, as of this writing.

“It is more likely that Alexander shredded the documents because of something grossly incriminating, than because of any so-called threats. In any case, no matter the reason, it was against the law for him to destroy that record, and the Board of Physicians agrees,” said Newman.

Inadequate State Action Endangers Women

Inexplicably, Alexander was not with charged with practicing medicine with an unauthorized person and continues to practice without restriction. The investigation into Pendergraft’s role in the abortion process is still open. That inaction has allowed Pendergraft and Alexander to continue to operate in tandem, committing late-term abortions of dubious legality and placing the lives and health of women at risk.

“We don’t know if the board is stalling out of political pressure from the pro-abortion side that wants to keep abortionists unaccountable in Maryland, or if they are stalling until the new clinic regulations take effect on July 23, 2012,” said Newman. “We know that Alexander is already facing the Board’s wrath, and Pendergraft has years and years of legal troubles. It may be that this pair of offenders will be unwilling or unable to comply with the new safety rules. That is our hope should the Board not act to protect women.”