"Some of this information is second-hand and cannot be verified by us; however, this is the most accurate information that we have about this patient to date," the letter said.
Shachnovitz described the woman in the letter as an immigrant from a remote area in a Third World country who hadn't seen a doctor in years and probably didn't know she had the fatal heart condition cardiomyopathy — a heart muscle deterioration that leads to heart failure.
The woman received a first-trimester surgical abortion and was sedated, but conscious during the procedure, which was completed in eight minutes with no complications, the letter said.
During recovery, the patient began having problems breathing. The doctor ran into the room and performed mouth-to-mouth resuscitation, the letter from the clinic said.
Clinic spokeswoman Bridget Wilson said the doctor hadn't renewed her CPR certification, but knew how to perform the procedure.
"Our physician's fast response and proper care temporarily saved the patent's life, and resulted in her safe transport to the hospital," Wilson said in an email.
Shachnovitz wrote that the patient stayed in the hospital for several days before dying. She said the patient arrived at the hospital with pulmonary edema — fluid on the lungs that can cause trouble breathing. The edema was likely caused by a pulmonary embolism — a blockage of an artery in the lung — or "some other respiratory insult," she wrote in the letter.
While in the hospital the patient also developed pressure in the brain, which, the letter said, led to the patient's death.
Shachnovitz contended in the letter that it is not certain the patient's death was even related to the abortion, suggesting that her condition might have made it inevitable that she would release a blood clot.
"The mere fact that it occurred while she was sitting in our facility recovering after an abortion procedure may possibly have been simply a coincidence," she wrote.
Wilson could not confirm what information was secondhand and what was confirmed, except that the clinic doctor said there was no cardiac arrest.