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Philadelphia • A filthy abortion mill where prosecutors say babies were delivered alive and killed with scissors would have been shut down long ago if not for extraordinary failures by state regulators, who hadn't inspected it since 1993, a grand jury report says.

Kermit Gosnell, 69, a family practice physician with no certification in gynecology or obstetrics, was charged Wednesday with eight counts of murder in the deaths of seven babies and one patient. Nine employees were also charged, including four facing murder counts.

In its report, the grand jury said failures of the Pennsylvania Department of Health (DOH) and other agencies allowed Gosnell's "house of horrors" to persist for decades, with body parts on shelves and clogging the plumbing, a 15-year-old high school student performing intravenous anesthesia, and Gosnell's wife, a cosmetologist, performing late-term procedures.

"Had state and local officials performed their duties properly, Gosnell's clinic would have been shut down decades ago," the grand jury wrote. "If inspectors had looked solely for violations of Pennsylvania's abortion regulations, there would have been ample grounds to revoke the approval of Gosnell's clinic as an abortion provider — as was demonstrated when DOH inspectors finally entered the facility in February 2010."

Complaints about Gosnell to state regulators went nowhere, even though 46 lawsuits had been filed against him. State officials, who arrived to testify with lawyers in tow, "enraged" the grand jury, said Philadelphia District Attorney Seth Williams. Williams said he was "disgusted" by the lack of oversight but could find no criminal charges to bring against them, in part, because of the time that had elapsed.

State officials, including at the Health Department, haven't commented despite repeated requests.