Doctors Blame Klvana for 1976 Patient Death : Woman Stopped Breathing, Went Into Coma During Surgery on Index Finger

Two doctors testified Tuesday that a Valencia obstetrician, on trial for second-degree murder in the deaths of eight infants and a fetus, was responsible for the 1976 death of a woman after an operation at Loma Linda University to repair a tendon in her index finger.

Dr. Milos Klvana did not watch the woman, Dorothy Wilson, closely enough after administering two anesthetic drugs during the low-risk operation, the doctors said before a Los Angeles Superior Court jury. As a result, she went into a coma and died several days later, they said.

The incident showed that Klvana displayed an indifference to details critical to the safety of his patients at Loma Linda University School of Medicine, where he was forced to resign from a residency in anesthesiology, said Drs. Bernard J. Brandstater and Floyd S. Brauer.

The case involving Wilson, said to be in her early 30s, was introduced in Klvana’s trial to show that Klvana possessed poor medical judgment and was warned that high-risk medicine, such as obstetrics, was beyond his abilities, said Deputy Dist. Atty. Brian R. Kelberg.

Klvana is charged with second-degree murder in nine deaths between 1982 and 1986.

Klvana, 48, is being tried with unlicensed midwife Delores Doyle, 36, of Montclair. She is charged with second-degree murder in three of the deaths. Both face other felony charges, including insurance fraud, conspiracy and grand theft.

In the nine deaths, the prosecution is alleging that Klvana, and in some cases Doyle, did not recommend hospitalization for the mothers or newborns after common but potentially dangerous complications arose. In several cases involving prolonged labor, deaths resulted from Klvana’s administration of a labor-inducing drug without monitoring the fetal heartbeat or the dosage, Kelberg said.

Klvana and Doyle have pleaded not guilty. Klvana’s attorneys have hinted that other doctors turned on him because he avoided hospitals. Doyle’s attorney has said the midwife played only a peripheral role in the care of the mothers whose babies died.

Brandstater was chief of anesthesiology at Loma Linda in 1976 and now holds that position at White Memorial Medical Center in Los Angeles. Brauer is the anesthesiology chief at Loma Linda now and was among the staff doctors who supervised Klvana’s residency in 1976.

During the operation, Wilson’s armpit was injected by another doctor to deaden the feeling in her arm, Brauer said. But the injection was not completely effective so a nurse anesthesiologist administered more sedatives, he said. Brauer said Klvana relieved that nurse and gave Wilson more anesthetics.

After Klvana injected the drugs, Wilson stopped breathing for about 20 minutes, Brauer said. The lack of oxygen to Wilson’s brain led to a fatal heart attack, Brandstater said.

Both doctors said they believe that Klvana was responsible for the death by not detecting Wilson’s breathing problem the moment that it happened. But Brandstater, in a 1977 letter to a hospital where Klvana had applied for staff privileges, did not mention the death.

Judge Judith C. Chirlin allowed the jury to hear testimony about Wilson’s death despite the objections of Rita-Jane Baird, one of Klvana’s attorneys. His other attorney, Richard A. Leonard, said outside the courtroom that Kelberg is using the death to “dirty” Klvana. The hospital agreed to a large settlement with Wilson’s family, and “they had to put the blame on somebody,” Leonard said.