Doctor Lost Deadly Gamble, Prosecutor Says : Justice: In closing arguments, Dr. Milos Klvana was described as knowing he couldn’t handle high-risk deliveries.

A Valencia obstetrician played Russian roulette with the lives of eight infants and a fetus who died in his care, a prosecutor said Monday during closing arguments in the doctor’s trial on charges of second-degree murder.

Dr. Milos Klvana “was willing to put the gun to the head, or the uterus, and pull the trigger because he knew the odds were that he would get away with it,” Deputy Dist. Atty. Brian R. Kelberg told the Los Angeles Superior Court jury.

Klvana chose to be absent from the courtroom during closing arguments, disregarding the advice of his attorneys and Judge Judith C. Chirlin, who told him his absence could prejudice the jury against him. Klvana also declined to be placed in an area where he could listen to the proceedings through a speaker.

Klvana, 49, is charged with second-degree murder in the nine deaths that occurred between 1982 and 1986. The doctor, who operated clinics in Valencia and Temple City, also faces numerous other felony charges, including insurance fraud, grand theft, perjury, conspiracy and practicing medicine without a license.

The murder charges stem from Klvana’s alleged failure to recommend hospital treatment for woman and babies in pregnancies with common but dangerous complications. In six of the deaths, Klvana administered a labor-inducing drug without using equipment to monitor the fetal heartbeat or regulate the drug dosage, the prosecution maintains.

Kelberg told the jury Monday that the case is comparable to the prosecution of a drunk driver who kills someone in a traffic accident. He said Klvana committed second-degree murder, rather than manslaughter, because he knew he lacked the medical skill to perform out-of-hospital deliveries in high-risk cases.

“Dr. Klvana knew. It would take more than a blind person not to know,” Kelberg said. “But Dr. Klvana didn’t care.” Klvana continued his obstetrical practice and told woman not to go to hospitals so he could make more money, Kelberg said.

During the six-month trial, Kelberg called about 135 witnesses and introduced more than 10,000 pages of documents. The defense called five mothers who had successful deliveries by Klvana, but attorneys Richard A. Leonard and Rita-Jane Baird have conceded that they could find no medical expert who would testify that Klvana provided quality medical care. Kelberg, who will continue his closing arguments today, made note of that before the jury Monday.

Leonard, whose closing arguments will follow Kelberg’s, said outside court he plans to argue that Klvana is guilty of manslaughter, not murder, because he simply possessed no medical judgment at all. But Leonard said the defense’s position was severly undermined by Klvana’s refusal to appear in court during closing arguments.

Chirlin sternly advised Klvana against that move. Outside the presence of jurors, she told him the case will be won or lost during closing arguments. She said: “If you walk out of here . . . the jurors are going to say, ‘He doesn’t care, forget it.’ ”

An exasperated Chirlin compared her role in the trial to clinging to Klvana as he dangled from the open door of an airplane.

“You are your own worst enemy,” the judge told Klvana. “Have you ever heard that expression? Well, listen to it and think about it. . . . I’m trying to prevent you from committing suicide.” At one point she pleaded with him to sit through the arguments.

Klvana replied: “I’m just refusing to sit here like a stone.” He told the judge he would probably disrupt the proceedings if he had to listen to what he called Kelberg’s lies and said Chirlin would need to have him handcuffed he if he were forced to stay.

Klvana is in custody in lieu of $750,000 bail.