In the fourth day of testimony in the case, in which Gosnell, 72, is charged with the murder of a woman who sought an abortion and seven babies by delivering them alive and cutting their spinal cords with scissors, Pennsylvania Department of Health employee Elinor Barsony explained conditions in the clinic during a 2010 surprise inspection, WCAU-TV, Philadelphia, reported.
"There was no privacy, no quiet rooms, nothing," she said, adding she saw crowded waiting rooms, sedated patients without proper care, an anesthesiologist with only a sixth-grade education and staff members visibly nervous when asked to describe their credentials.
The clinic was shut down the following day. The inspection was the first conducted by the state since the early 1990s, Barsony said.
Monday's testimony involved the death of Karnamaya Mongar, 41, who died during an abortion procedure at the clinic, the news website philly.com said.
A fire lieutenant testified Gosnell seemed "confused and discombobulated" when fire fighters answered a 911 call at the clinic late on Nov. 19, 2009.
"We were perplexed when we responded to a clinic. What kind of clinic is open this late at night?" Lt. Don Burgess said.
Burgess said they were led through a "maze to a room where we found a female, nude from the waist down and with her feet in stirrups," and no sign emergency resuscitation had been attempted.
"The doctor was confused. I asked him happened and he blurted out something I didn't understand," Burgess said.