UC Irvine Medical Center Chief Executive Officer Ralph Cygan agreed to be placed on administrative leave without any presumption of wrongdoing after Chancellor Michael Drake created a blue-ribbon committee last fall to review the center’s substandard Liver Transplant Program. Although the committee’s investigation is not expected to be complete until next month, Cygan might as well begin searching for a new job.
Recently-uncovered facts show that Cygan and others at the Medical Center were well aware of problems with the transplant program years before it was shut down.
According to the Orange County Register, in July 2003, a peer review of the hospital found several critical problems with the program, including lack of surgeons, problems in patient management and a structure that made performing these transplants financially unwise for the hospital. The peer review was initiated after the United Network for Organ Sharing recognized that survival data showed transplant patients at UCI were faring worse than those at other hospitals.
In 2004, with transplant and survival rates still below federal standards, Cygan convinced UNOS to keep the transplant program operating by promising that a transplant surgeon from UC San Diego would join the UCIMC staff full time. However, the surgeon never had any intentions of moving to UCI full time.
The findings from Medicare’s audit from July to August 2005 show that the UCIMC did little, if anything, to fix the problems that were identified in years past. Among other problems, Medicare stated that ‘there was no documentation of any discussion or development of specific action plans to actively recruit transplant surgeons.’
Although he recognized ‘deficiencies’ in the transplant program, Cygan told Medicare on Oct. 31 that the Medical Center was in negotiation to hire another transplant surgeon to join the program by early 2006. But it was too little, too late. Medicare decided to stop funding liver transplants at the UCIMC and consequently the program was voluntarily shut down.
Problems associated with the Liver Transplant Program have drawn scrutiny from the federal government. After news broke about the UCIMC, Iowa Sen. Chuck Grassley, chairman of the Senate Finance Committee, said that he wanted the government to investigate the UCIMC and why problems were ignored for so long. After decertifying the Liver Transplant Program, Medicare began an investigation of the entire hospital last month and their findings should be released shortly.
The UCIMC will also have to respond to Lawrence Eisenberg, an Irvine attorney who recently filed several lawsuits in the Orange County Superior Court representing 17 patients who were on the waiting list to receive a liver transplant from UCI. Twelve of those patients died while waiting for a transplant and are represented in their wrongful death lawsuits by their respective families. Eisenberg plans to file more lawsuits on behalf of other patients.
Eisenberg is no stranger to UCI. He represented approximately 50 families in a lawsuit against UC Irvine in the late 1990s and negotiated a $10 million settlement for them over the infamous fertility scandal where UCI doctors transplanted eggs without consent to other patients.
‘Patients need to be given full disclosure so they can make an intelligent decision about which liver transplant program they should enter,’ Eisenberg said. ‘My clients and families have indicated that if they had been given the information that UCI failed to disclose, they would have left UCI and sought treatment elsewhere.’
These current lawsuits allege medical negligence, as well as fraud, misrepresentation and concealment.
‘I think what you have here is a program that had insurmountable problems, with some overzealous physicians and administrators who put the alleged prestige of the university and Medical Center ahead of those of the patients,’ Eisenberg added. ‘The evidence already available is revealing against UCI but will only become bolstered as time goes on and depositions under oath are taken.’
Speaking on behalf of UCI, Director of Media Relations Jim Cohen declined to comment on the lawsuits.
‘The university is evaluating these lawsuits and does not believe it is appropriate to comment further on them at this time,’ Cohen said.
Eisenberg believes the lawsuits will take a year to be resolved. In addition to monetary compensation for his clients, he would also like to see changes at the Medical Center in Orange.
‘I would like to see the Medical Center clean house, clean up their act, so to speak,’ Eisenberg said. ‘The hospital provides needed services and health care to residents of Orange County but they can’t continue to operate as they have been in the past.’