UCI Medical Center on Transplant Probation

The national group that oversees organ transplants placed UCI Medical Center on probation Thursday after a scandal that closed its liver transplant program, but stopped short of a more severe penalty that could have closed other transplant services.

This marks just the second time the United Network for Organ Sharing, a federal contractor, has publicly disciplined a transplant center. The probationary status means the UC Irvine hospital, in Orange, will be allowed to continue performing kidney and pancreas transplants but will have to ensure that it has adequate staffing and meets patient care standards. The probation will last until UCI can show it has corrected its problems.

The group had considered declaring UCI a “member not in good standing,” which could have led to the closure of all of the hospital’s transplant programs. But Dr. Francis L. Delmonico, president of the organ network, said Thursday that although UCI showed “poor judgment,” it did not deserve such a harsh rebuke.

Separately, UCI released documents showing that Dr. Marquis Hart, a UC San Diego surgeon retained to act as the director of transplant services at UCI, worked far fewer hours overseeing the programs than were called for in his contract.

The contract said Hart would be expected to work 40 to 60 hours per month in the administrative role, for which he was paid $200 per hour. The records show he averaged about 18 hours per month and never met the minimum requirement. He put in the most time in December 2004, when he worked 34 hours; last July, he worked none at all.

Time cards show that Hart was absent from UCI for long stretches. He worked no hours between April 12 and May 26 last year and was gone again from June 25 to Aug. 18. His time cards were marked “Not here.”

The time cards bear a notation saying, “Accuracy of this document is unknown.” UCI officials could not provide an explanation, and Hart declined to comment on his work hours.

“That’s in the past,” UCI spokeswoman Susan Menning said. “To continually go back and address these little issues doesn’t make sense at this point.”

UCI closed its liver transplant program in November after The Times reported that 32 patients had died awaiting operations in 2004 and 2005, when the hospital turned down scores of organs, sometimes because no surgeon was available. Though the hospital often cited poor organ quality or patient unsuitability in the rejections, most of the organs were successfully transplanted into patients at other facilities.

A group of UCI officials -- including the medical center chief executive at the time, Ralph Cygan, and medical school Dean Thomas Cesario -- told the United Network for Organ Sharing in 2004 that the hospital had hired Hart to serve as a full-time liver transplant surgeon. But he was based at UC San Diego and his contract retained him only for on-call service.

A U.S. senator who has been investigating transplant oversight applauded the action against UCI.

Sen. Charles Grassley (R-Iowa), chairman of the Senate Finance Committee, issued a statement Thursday saying he planned to ask the Government Accountability Office to review how well the organ network and two federal agencies were overseeing the organ procurement system.

“I hope the [organ network] board will closely scrutinize UCI to assure patient safety and quality of care at UCI’s transplant programs,” he said. “It’s important that patients and their loved ones have the highest confidence and trust in our organ procurement system.”

UCI released a statement saying it would work with the network “to continually improve our programs.”

In imposing probation, the network cited UCI for “submission of documentation that contained potentially false representations” about its staffing.

The network’s board acted in a closed-door session in Long Beach on Thursday morning. Delmonico said its members debated whether the troubles at UCI were comparable to those at St. Vincent Medical Center, near downtown Los Angeles, which closed its liver program last fall and was declared a “member not in good standing” this month. That designation opens the door for the federal government to withdraw funding for Medicare patients and allows health insurers to cancel contracts. The network has not asked the government to close any of St. Vincent’s other transplant programs.

St. Vincent conceded in September that its doctors had improperly arranged for a liver transplant to a Saudi national, bypassing 50 people on a regional waiting list whose conditions were more dire, and that hospital staff falsified records to hide the arrangement. The Saudi Embassy paid $339,000 for the operation, as much as 30% more than the hospital would have received from the government or insurance.

Delmonico said the lying made the St. Vincent case worse than UCI’s. “It was the intentional falsification of data which was so egregious about St. Vincent,” he said.

Separately, the organ network board took steps to increase its oversight in light of the problems at St. Vincent and UCI. It will require transplant centers to notify the network within five days when regulators take action that threatens the programs’ ability to perform transplants. UCI had not notified the network of a highly critical inspection last summer by federal regulators.

The board also decided to increase monitoring of each transplant center’s organ rejection rate and require hospitals to have full-time access to surgeons. UCI was turning down a far greater percentage of organs than other hospitals, and the network had not looked at the numbers. The hospital also did not have full-time surgical coverage, despite what it told patients and regulators.

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Times staff writer Tracy Weber contributed to this report.