A medical examiner says he couldn't fully analyze a woman's death following a 2009 abortion until the clinic was raided months later.
Assistant Philadelphia Medical Examiner Gary Collins says he initially ruled it an accidental overdose death. But he says he changed the cause to homicide after getting clinic records and witness statements.
Dr. Kermit Gosnell is charged with third-degree murder in the alleged overdose death of Karnamaya Mongar, a 41-year-old refugee. Prosecutors say he let untrained staff administer controlled drugs.
Defense lawyer Jack McMahon has suggested that Mongar had undisclosed respiratory problems that could cause fatal complications.
But a toxicologist testified this week that Mongar died of an overdose of the painkiller Demerol.
Prosecutors say Gosnell let patients choose, for a price, the amount of anesthesia they wanted. They were broken down into four categories -- local, heavy, twilight and custom. Anesthesiologist and expert witness Dr. Andrew Herlich called the practice "reprehensible" in his testimony to the court earlier in the trial.
Mongar received a custom dosage of anesthesia, according to prosecutors. The drug cocktail included at least 75 mg of Demerol, 12.5 mg of Promethazine and 10 mg of Diazepam.
McMahon will continue to cross-examine Collins Thursday.
Gosnell is also charged with killing seven babies allegedly born alive. If convicted, he could face the death penalty.