A Valencia physician was charged Monday with 34 criminal counts, including five of murder, stemming from the deaths of four newborn babies and one fetus in 1983 and 1984.
His midwife assistant was charged with 24 counts, two for murder, in a case described by a state medical official as one of "gross, gross negligence."
Prosecutors contend that Dr. Milos Klvana, 46, provided shoddy care to mothers with high-risk pregnancies, many of whom sought natural childbirths. At clinics in Valencia and Temple City, the obstetrician allegedly assigned an untrained and unlicensed midwife, Dolores Doyle, 34, of Montclair, to deliver babies at home.
No Hospital Privileges
Klvana handled difficult cases at his offices or in patients' homes because "he has been unable to obtain and hold hospital privileges," Deputy Dist. Atty. Brian R. Kelberg said.
Klvana also operated clinics in San Fernando and Montebello.
In a separate action Monday, the state Board of Medical Quality Assurance filed a 34-page "accusation" against Klvana, a first step in revoking his medical license.
Klvana and Doyle were arrested Friday and are each being held on $1 million bail.
"Even when the babies upon birth showed signs of respiratory distress, he failed to send the babies immediately to an appropriate hospital equipped to handle the life-threatening situation," Kelberg said. "Rather, Dr. Klvana commonly sent these babies home with their parents, following which the babies died within a few hours to a few days."
Klvana and Doyle were scheduled to be arraigned Monday in Los Angeles Municipal Court, but the proceeding was put off until Wednesday. During a brief appearance in court Monday, Klvana was supported by about 15 of his patients, several with their children.
Santa Monica attorney Gerald Chaleff, representing Klvana, said the turnout showed that his client was seen as a competent physician by many patients.
Cites Inherent Risk
"If his conduct was so horrendous, why did it take two years to investigate this?" Chaleff asked. "There's a risk in any pregnancy."
According to the state medical board, Klvana received his medical education in his native Czechoslovakia and came to the United States in 1971, receiving his California medical license in 1975.
In 1978, he was convicted of 26 counts of illegally prescribing drugs without fully examining patients, Kelberg said. The medical board placed Klvana on five years' probation but in 1983 granted his petition to suspend the probation, said Ken Wagstaff, the board's executive director.
Wagstaff said the latest criminal case was prompted by the medical board's investigation. The board's formal accusation against Klvana cites his care of 21 patients, including infants, who allegedly suffered under the doctor's "record of astonishing irregularities," Wagstaff said.
The accusation alleges that Klvana advised mothers not to seek hospitalization after their babies were born with poor color and respiration, allowed untrained midwives to deliver children at home, failed to fully examine expectant mothers and used "primitive means" of attempting to revive babies.
The criminal counts additionally allege that Klvana and Doyle filed false insurance reports claiming that Klvana had provided care to mothers when he had not. Kelberg said that insurance companies paid out $2,774 for two deliveries claimed by Klvana but which, in fact, were performed by Doyle.
In an October, 1983 delivery at Klvana's Valencia office, he decided against hospitalizing the mother despite the fetus's abnormal position in the womb and her prolonged labor, Wagstaff said.
Klvana administered drugs to hasten childbirth without proper medical equipment, and when the newborn infant failed to breathe, tried to revive it through mouth-to-mouth resuscitation and the "primitive means" of pouring warm water on the baby for 20 minutes, Wagstaff said.
When those efforts failed, "he then declared the baby to be dead," the state medical official said.
In another 1983 incident, Wagstaff said, Klvana assented to a woman's having natural childbirth despite her illness in the last three months of pregnancy and a weight gain of 72 pounds. Klvana assigned Doyle, who was not trained or licensed as a nurse midwife, to deliver the child, he said.
On Sept. 11 of that year, the woman complained of hemorrhaging, and the fetal heart beat became "imperceptible," Wagstaff said. The next day, Klvana administered labor-inducing drugs, then sent the woman home, he said.
The baby was stillborn in the woman's home hours later, he said.
In a 1984 delivery of a stillborn infant, according to the medical board, Klvana "disposed of the infant in an unknown manner" and destroyed medical records of the pregnancy and delivery.
The state's investigation took two years, Wagstaff said, because "the process of making sure you have all the material you need is a long and frustrating one. You don't want to lose this one."
In the criminal complaint filed Monday, Klvana is charged with 5 counts of murder, 3 counts of aiding Doyle in practicing medicine without a license, 18 counts of insurance fraud, 2 counts of grand theft, 3 counts of perjury and 3 counts of involuntary manslaughter. The manslaughter counts involve three of the deaths also covered by murder counts.
Doyle is named in 2 counts of murder, 3 counts of practicing medicine without a license, 16 counts of insurance fraud, 1 count of grand theft and 2 counts of involuntary manslaughter.