O.C. Hospital Is Probed Anew

Troubled by problems that shut down UCI Medical Center’s liver transplant program, a federal agency is investigating the hospital’s operations from top to bottom to determine whether there are further shortcomings.

Federal and state inspectors arrived at the Orange hospital this week to investigate whether the medical center met federal requirements. If those standards are not met, hospital programs could lose their certification and Medicare funding, a devastating blow to an institution.

The U.S. Centers for Medicare & Medicaid Services withdrew certification and funding of the liver transplant program last month after The Times reported that 32 people had died awaiting livers, even as doctors turned down scores of organs. Many of those livers were then successfully transplanted elsewhere.

The federal action prompted the UC Irvine facility to shut down its liver program immediately.

The Medicare agency has a team at the hospital this week, but it also requested the assistance of the state, which sent nurses, a doctor, a dietitian, a pharmacist and other experts.

“We’re determining if the hospital is following its policies and procedures,” Lea Brooks, spokesman for the California Department of Health Services, said Wednesday.

Steve Chickering, a regional official with the federal agency, said the investigation would encompass the entire hospital, including record-keeping, the quality of the medical staff, the physical environment and pharmaceutical and surgical services.

State and federal officials will probably be at the hospital at least a week and hope to complete their report by early January, Chickering said.

“We believe our interaction with the [investigators] has been very positive,” said Kim Pine, a hospital spokeswoman.

She declined to comment further until the investigators’ report is made public.

Last year, the hospital passed its routine inspection by the Joint Commission on Accreditation of Healthcare Organizations. That agency also reviewed UCI Medical Center in 1998, giving it a score of 98 out of 100. On Wednesday, the family of a man who had died waiting for a liver transplant filed a wrongful-death lawsuit against the medical center, the UC Regents and Drs. David Imagawa and Sean Cao, the heads of the transplant program.

The suit says UCI hid the program’s shortcomings and that the patient would have sought treatment elsewhere had he known of the problems, including the fact that there was no full-time transplant surgeon and that it was rejecting offers of livers.

The patient, Roberto Vasquez, died May 31. The lawsuit says doctors told him many times that he was high on the priority list to receive a transplant and that shortly before his death, he was at the top of the list.

During the last month of Vasquez’s life, UCI rejected eight livers, three of them because there was no surgeon available, according to records of the United Network for Organ Sharing released this week.

UCI did not accept any proffered livers for transplants during that month, the records show.