FBI Investigating UCI Liver Transplant Center

Federal investigators have launched a criminal inquiry into problems with UCI Medical Center’s failed liver transplant program.

A spokesman for the university confirmed Saturday that the Orange hospital was served with a subpoena for documents by the FBI, which is working with the U.S. Department of Health and Human Services.

“We have received a Department of Justice administrative subpoena related to the liver transplant program,” UC Irvine spokesman James Cohen said in a prepared statement released Saturday. He declined to provide details but said the university would cooperate.

It was not immediately clear what aspect of the program’s failure was under scrutiny. A spokeswoman for the FBI declined to comment, and a spokesman for the U.S. attorney’s office could not be reached. Jeff Blair, a University of California lawyer handling the matter on behalf of UCI, did not return a call to his home seeking comment. News of the investigation was first reported Saturday by the Orange County Register.

UCI closed its liver transplant program in November after The Times reported that 32 patients on its waiting list died in 2004 and 2005, during a period when the hospital was rejecting viable organs from a donor network -- in part because it did not have enough surgeons on hand at the time to perform the operations.

By 2004, private insurance companies had begun steering their liver transplant patients away from UCI to other hospitals in the region. As a result, UCI was relying almost exclusively on patients whose insurance was provided under government coverage. All seven of the patients who received transplants from UCI in 2005 were covered by government insurance, including Medicaid, Medicare and the Department of Veterans Affairs, records show.

The Centers for Medicare and Medicaid Services withdrew certification of the program after the Times story, ending federal payments for the treatments.

In 2004, when regulators were considering closing UCI’s liver transplant program because of concerns about poor performance and understaffing, UCI administrators persuaded officials from the national organ donor network and the U.S. Health Resources and Services Administration to keep it open.

But the administrators, including Dr. Ralph Cygan, who was then chief of the medical center, and medical school Dean Dr. Thomas Cesario, falsely claimed they had recruited a full-time transplant surgeon to oversee the program. In fact, the new surgeon, Dr. Marquis Hart, was based at UC San Diego and had offered his services only part time.

Cygan and Cesario did not return telephone messages left at their homes.

The troubles in the liver program were the latest in a series of problems at UCI in recent years. The situation led to even more questions, including ones about kidney and bone marrow transplant programs, qualifications of cardiology department leaders and the hiring of close relatives of top administrators and a donor to the hospital.