Leader of Troubled UCI Hospital Quits

The head of UCI Medical Center resigned Tuesday as the university announced changes to improve oversight at the troubled Orange hospital as it struggles to recover from recent scandals.

In announcing the resignation of Dr. Ralph Cygan as the hospital’s chief executive, UC Irvine Chancellor Michael V. Drake said the hospital’s “lapses have impeded our rise to the next level” and promised to “fundamentally change how business is conducted and service is provided.”

“I apologize on behalf of the entire institution to every patient and patient family, government agency, community member or UCI faculty, staff member or student who may have been misled, confused or otherwise served poorly by the statements or activities of anyone representing the university,” Drake said.

Drake said he and Cygan mutually agreed Tuesday that the hospital’s top official would resign.

Drake, who came to UCI in July after serving as vice president of health affairs for the UC system, also announced the creation of the position of vice chancellor for health services to oversee the medical center and School of Medicine. A search committee will be appointed within a month.

UCI will be the only campus in the UC system with this position.

A full-time ombudsman will be hired to handle complaints and concerns raised by the medical center staff. Both new positions will report to Drake.

A number of UCI staff members have said they are hesitant to speak up out of fear of intimidation and retaliation by managers. That was not the impetus for the new position, Drake said.

“We just want to make sure people have an easy way of bringing concerns forward,” he said

UCI has been under fire since November, when The Times reported that 32 patients died awaiting livers in 2004 and 2005, even as doctors turned down organs that were successfully transplanted elsewhere.

Other problems have surfaced. Doctors failed to perform enough bone marrow transplants in all but one of the last 11 years to meet state standards. Doctors also turned down kidneys at a higher rate than nearly all other adult transplant centers in the country.

In addition, three associate medical school deans are investigating whether the son of a donor to the radiology department received preferential treatment when he gained a position in the residency program. And the hospital’s top two cardiologists are drawing criticism from colleagues for not holding state medical licenses or American board certifications.

UCI’s medical programs have been hit with scandal after scandal since 1995, when fertility doctors stole eggs and embryos from patients and implanted them in other women.

The latest problems come at an especially bad time for the medical center, which is trying to raise $50 million toward the construction of a new hospital.

Drake’s announcement is similar to actions UCI took the last time a major flaw was revealed in its operations, when it was discovered that cadavers in its willed-body program were misidentified and donated body parts were sold. A panel of experts recommended the appointment of an administrator who would provide oversight and ensure that rules were being followed.

But the person hired to fill that position, Iris Ingram, was in the job less than three years. She left in 2003, believing her position was “window dressing,” she said in December. It has not been filled.

The new positions, Drake said, are “not a panacea, but I think it’s the right approach. And we hope to do better this time.”

Drake first announced his changes at a staff meeting at the medical center, in a room so packed that people were turned away.

Cygan has been on administrative leave since shortly after the liver transplant unit problems were made public and after Drake voiced displeasure at not being informed of the shortcomings before they hit the newspaper.

The Times subsequently reported that Cygan misled federal health regulators about staffing levels, saying UCI had hired a new full-time transplant surgeon, when all the hospital had was a part-time surgeon based at UC San Diego.

Cygan could not be reached for comment but issued a statement that his resignation was “in the best interests of the medical center and our patients.”

Cygan, whose specialty is internal medicine, was appointed chief of the hospital in 2000. He has worked at the medical center for nearly 30 years and plans to continue as a faculty member.

The task force investigating the liver transplant program is expected to complete its report in two weeks. On Tuesday, a team of four UCI officials, led by interim UCI Medical Center Chief Executive Maureen Zehntner and transplant surgeon Clarence Foster, were in Chicago to discuss the findings of their internal review into the failure of the liver program. The group met with the membership and professional standards committee of the United Network for Organ Sharing, the national overseer of transplantation.

Drake said that once the report was complete, he would “move forward from there.”

Drake did not rule out more staff changes. The new health sciences vice chancellor will have authority to choose heads of divisions within the hospital and medical school.

Medical school dean Dr. Thomas C. Cesario will stay in his position to provide continuity, Drake said. Cesario had been aware of problems in the liver transplant program and did not pass the information along to Drake. He was at the same meeting in which UCI officials told the organ oversight group that the liver transplant program staffing problems had been solved.

During an interview on Monday, UC President Robert Dynes did not directly respond to a question about whether he had confidence in Cesario but reiterated his confidence in Drake.

Dr. Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania School of Medicine, said he had been watching events at UCI for the last decade.

“They have been trying for some time to secure the right kind of oversight and management that would let them grow, compete and move into the first tier of the UC system and nationally,” he said. “But they have not been able to follow through in the past. The clock has sort of run out here.”

Times staff writer Charles Ornstein contributed to this report.