Klvana Didn’t Realize His Shortcomings Were Deadly, Defense Argues

An attorney for Dr. Milos Klvana told a jury Tuesday that the Valencia obstetrician is at worst guilty of manslaughter in a case in which he faces nine counts of second-degree murder in the deaths of eight infants and a fetus that he treated at his clinics instead of at hospitals.

Defense attorney Richard A. Leonard, in his closing arguments before a Los Angeles Superior Court jury, conceded that Klvana was a terrible practitioner of high-risk medicine but did not know his shortcomings were deadly--knowledge that is a legal prerequisite for Klvana to be found guilty of murder.

“I’m not going to stand up here and tell you Dr. Klvana is Dr. Marcus Welby,” Leonard said. “But he’s not a murderer.”

Klvana, 49, is charged with nine counts of second-degree murder in the deaths of eight infants and a fetus between 1982 and 1986.

The prosecution has alleged that Klvana caused the nine deaths by mismanaging high-risk pregnancies in which complications arose during delivery. In each case, Klvana failed to recommend hospital treatment when it became necessary, Deputy Dist. Atty. Brian R. Kelberg said.

Six of the nine deaths resulted from Klvana’s misuse of Pitocin, a labor-inducing drug that expert witnesses have testified should only be used in hospitals equipped with proper monitoring devices. Klvana’s clinics in Valencia and Temple City lacked such equipment.

Klvana is being prosecuted under the same legal theory as that used to obtain second-degree murder convictions against drunk drivers who cause fatal traffic accidents.

Under that theory, known as implied malice, a defendant can be convicted of murder if the prosecution proves that the defendant knew his actions could cause someone’s death.

Kelberg has maintained during the six-month trial that the Czechoslovakian-trained doctor’s failed obstetrics residency at a New York City hospital and a subsequent residency in anesthesiology at Loma Linda University Medical Center--during which he was blamed for the 1976 death of a healthy patient--made Klvana aware that he was incapable of handling risky medical situations. Kelberg said the deaths of the babies for which he is being tried further alerted him to his inadequacies.

On Tuesday, Leonard acknowledged that Klvana was negligent in the nine deaths. But he suggested that Klvana’s negligence was at worst manslaughter in five of the nine deaths. He said that others also were to blame for the deaths.

Leonard suggested that in several deaths the infants’ parents were partly negligent because they did not rush their babies to the hospital when they turned blue or had trouble breathing. He also attacked the credibility of two mothers whose babies died, alleging that one had participated in insurance fraud and another had undergone seven abortions.

He attacked doctors at Loma Linda for not reporting to medical authorities Klvana’s poor record of treating patients. He also noted that the state Board of Medical Quality Assurance reviewed several of Klvana’s cases but took no action against his license.

In addition to the murder charges, Klvana is charged with more than 40 other felonies, including insurance fraud, grand theft, perjury and conspiracy. Leonard said those felony charges were added to the case to “dirty up” Klvana and to make it easier for the jury to view him as a murderer.

In the prosecution’s rebuttal argument Tuesday, Kelberg said that Leonard’s pejorative characterizations of some of the parents were irrelevant. He noted that Judge Judith C. Chirlin had instructed the jury not to consider the acts of any others in determining whether Klvana had been criminally negligent.

Responding to Leonard’s point that doctors at Loma Linda and elsewhere should have reported Klvana’s poor record, Kelberg said Loma Linda doctors had tried to steer Klvana away from high-risk medicine. He added that state medical board investigators “deserve lambasting” but alleged that Klvana’s lies to investigators made it difficult for them to reach a proper conclusion.

During Kelberg’s rebuttal, Klvana jumped to his feet and said, “I want to testify, this man is crazy.” While a bailiff forcibly escorted him from the courtroom, Klvana’s wife, Svata, stood up in the spectators’ area and denounced Kelberg. Chirlin ordered her to leave.

Klvana, who earlier had waived his right to testify, made a similar outburst last Thursday, and Chirlin instructed the jury to ignore it.

Jury deliberations are expected to begin today. A single count of second-degree murder carries a penalty of 15 years to life in prison.