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visit. … After taking the chemical abortion drugs, she began having very heavy bleeding followed by significant abdominal pain and a fever. When I saw her in the emergency room, she had evidence of retained pregnancy tissue along with endometritis, an infection of the uterine lining. She also had acute kidney injury, with elevate creatinine. She required a dilation and curettage (D&C) surgery to finish evacuating her uterus of the remaining pregnancy tissue and hospitalization for intravenous (IV) antibiotics, IV hydration, and a blood transfusion. I spent several hours with her the day of her surgery/hospital admission, keeping me from my primary patient responsibilities in the labor and delivery unit and requiring me to call in an additional physician to help cover those responsibilities.
PI App. 194–95. As a result of FDA’s failure to regulate this potent drug, these doctors have had to devote significant time and resources to caring for women experiencing mifepristone’s harmful effects. This harm is sufficiently concrete.
A second independent injury from the adverse effects of mifepristone is the “enormous stress and pressure” physicians face in treating these women. PI App. 215. One doctor said the strain “is some of the most emotionally taxing work I have done in my career.” PI App. 880. Thus, this is an independent injury because FDA’s actions “significantly affect[]” the doctors’ “quality of life.” Sierra Club v. Morton, 405 U.S. 727, 734–35 (1972).
The doctors offered specific facts to explain this stress. Women who take these drugs are susceptible to “torrential bleeding.” PI App. 170, 215. In fact, “the risk of severe bleeding with chemical abortion is five times higher than from surgical abortion.” PI App. 879. And these situations can quickly go from bad to worse. As one doctor testified:
One of my patients, who was about nine weeks pregnant, had previously been treated by hospital staff for a pulmonary
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