Obstetrician Convicted of Murdering 8 Babies, Fetus

Dr. Milos Klvana, a Valencia obstetrician, was convicted Monday of second-degree murder in the deaths of eight infants and a fetus he cared for, in a case the prosecutor said raises questions about the ability of California medical authorities to monitor the competence of doctors.

Klvana, 49, faces the prospect of spending the rest of his life in prison. Each murder count carries a sentence of 15 years to life in prison.

The nine deaths with which Klvana was charged occurred between 1982 and 1986. Eight infants died during childbirth or within a few days of their delivery. The ninth case involved a fetus that died in its mother’s womb.

During Klvana’s nine-month trial in Los Angeles Superior Court, the prosecution contended that he lacked the medical skill and the facilities at his clinics in Valencia and Temple City to perform out-of-hospital births and to deal with common but high-risk prenatal or childbirth complications.

The jury deliberated 15 days before returning the verdicts last week. They were announced Monday.

After Klvana was found guilty, prosecutor Brian R. Kelberg said outside the courtroom that the case shows that the public should not place an unwavering faith in a doctor simply because he has a valid medical license.

“The best thing that can come out of this trial is an awareness by the public that merely because a doctor has a license to practice, or may have hospital privileges, or may have a great bedside manner, and merely because there is a medical board that is supposed to monitor the competence of doctors, that in no way assures that a doctor is in fact competent,” said Kelberg, head of the medico-legal section of the Los Angeles County district attorney’s office.

“Patients should be willing to ask questions and not be intimidated because they may not have been to medical school,” Kelberg said.

In the Klvana case, the state Board of Medical Quality Assurance investigated four of the deaths but did not revoke Klvana’s license as a result of the probes. The reason, Kelberg said, was Klvana’s ability to manipulate Board of Medical Quality Assurance investigators. The prosecutor has said these investigators “deserve lambasting.”

Ron Kraemer, the board’s assistant chief of enforcement in Sacramento, said the agency will have no comment “until we see what the prosecutor said.”

The nine deaths all had two things in common: medical complications that prosecution experts testified required hospital treatment and Klvana’s failure to recommend hospitalization.

Kelberg called the complications “bread-and-butter” matters, such as prolonged labor, abnormal positioning of the baby, a diabetic mother and a baby that had ingested its own fecal material. Six of the deaths were attributed by the prosecution to Klvana’s misuse of Pitocin, a labor-inducing drug that put deadly pressure on babies’ heads as they were forced through the birth canal.

“You cannot view any one of these cases in isolation,” Kelberg said, “because you see the same type of care or lack of care in case after case after case.”

In addition to the nine murder counts, Klvana was convicted on 28 counts of insurance fraud, five of practicing medicine without a license, two of grand theft, two of perjury and one count of conspiracy. All of the charges are felonies.

Richard A. Leonard, one of Klvana’s two court-appointed attorneys, argued during the trial that Klvana was at worst guilty of manslaughter, not murder.

After the verdicts were announced, Leonard said his client was “tough” to defend because “there were nine dead babies and with nine all together I didn’t stand a chance.”

Leonard added, “It looked terrible. There were no facts for the defense. Everywhere we checked we came up dry. I didn’t have one doctor to put up on the stand.”

Jury foreman Jaime Pulido, 30, of East Los Angeles said it became clear during jury deliberations that there was “no defense” for Klvana, who was arrested in October, 1986.

“We had experts from all over the county who were called in to testify against him,” Pulido said. The defense “had the same right to use those experts, but they chose not to.”

“We tried to give him the benefit of the doubt, but to no avail. The evidence against him was overwhelming,” Pulido said.

Klvana was prosecuted on the same legal basis used to obtain second-degree murder convictions against drunk drivers who cause fatal traffic crashes. Under the concept known as “implied malice,” a defendant can be convicted of murder if the prosecution proves that he knew his actions could cause someone else’s death.

Klvana was born in Czechoslovakia and received his medical training there. Following the Soviet Union’s 1968 occupation of his native country, Klvana fled to Canada and then the United States. He began practicing in Southern California in 1975.

The Board of Medical Quality Assurance first investigated Klvana’s involvement in a baby’s death after Amy Johnson died on Christmas Day, 1982. Klvana had delivered the baby the day before. But in this and three other baby deaths involving Klvana that the board investigated, the agency took no action against his medical license.

The board was sharply criticized earlier this year by the state’s watchdog Little Hoover Commission and the University of San Diego’s Center for Public Interest Law. Alluding to the University of San Diego report, which recommended that physician licensing fees be raised to beef up the board’s investigative staff, Kelberg said: “I am not confident that merely by adding money and personnel the medical board can do the kind of investigation that may be necessary to ensure that doctors like Dr. Klvana do not practice medicine.

“The first thing that is necessary is public awareness.”

Kelberg also criticized hospitals that allowed Klvana to resign without reporting his substandard care to the medical board, which then had to “operate in the dark.” Those hospitals included Northridge Hospital Medical Center, Valley Vista Hospital in San Gabriel and Granada Hills Community Hospital, he said.

Judge Judith C. Chirlin scheduled Klvana’s sentencing for Jan. 12.