La Jolla Eye Doctor Facing Probe Claims to Be God-Like

A La Jolla doctor accused of performing unnecessary eye surgeries on mostly elderly patients likened himself to God and described having a “gift from the Lord” that allowed him to earn millions of dollars, according to documents released Thursday.

“It’s great to be alive and have what I have,” Dr. Jeffrey Rutgard wrote in an entry of a journal, obtained by the state attorney general’s office.

“I have a gift from the Lord; He’s given me the ability to work and earn millions of dollars--billions to be accurate. He’s given me the ability to be all-knowing all the time and be not only excellent but nearly perfect like Himself.”

In one of the most egregious cases uncovered by authorities, Rutgard is under state and federal investigation for performing unneeded surgeries--including cataract operations--on at least 30 patients, bilking Medicare of millions of dollars, and paying $10,000 to keep an employee quiet about the details of his practice, officials said.

Rutgard also allegedly doctored patients’ records to justify his actions, operated on patients who didn’t realize they were undergoing surgery, and reused disposable suture equipment and needles during operations, according to court records.

In a hearing today, the attorney general’s office will request an immediate suspension of Rutgard’s lucrative medical practice.

“It appears he was willing to do anything to make money--from putting his patients at risk for unnecessary surgeries, to falsely billing insurance companies, to trying to alter records to justify what he’s done,” said Barry Ladendorf, a supervising deputy attorney general. “He’s violated about every medical ethic you can imagine--if the facts are true based on what we’ve seen.”

Rutgard, 41, who was seeing patients in his La Jolla office Thursday, did not return phone calls. His attorney, Cheryl Shapior Ruffier, said she had not seen the charges and could not comment.

According to a journal entry that was released among the court records, Rutgard believed he had a special relationship with God. The journal said:

“He’s shared w/ me the ability to react swiftly w/ the correct answers, to be able to lead thousands across a divided body of H2O, to control the lives and thinking of others and control the weather, to control not just my children but all the children of the earth so they do not annoy me when I have escaped from my own children.

“He has given me the power to control my own destiny and the destiny of others. He has given to me the choice of having any numbers of years on this planet that I choose. It’s so nice to possess life. Thank you Lord. Love your willing and controlling disciple, Jeff,” said Rutgard’s journal, which was seized after a search warrant was served April 27.

Rutgard--who owns about $6 million worth of houses, offices and condominiums in La Jolla and San Diego--had a soothing and reassuring manner, former patients say.

To promote his business, Rutgard dispatched unlicensed employees to conduct free eye tests at nursing homes and senior centers, where the elderly were often told they had cataracts and to make an appointment to see Rutgard, a former clinical professor at UC San Diego’s School of Medicine. Rutgard, who earned $4 million last year, also provided free transportation for them to reach his office.

Rutgard allegedly preyed upon the elderly, playing on their fears of losing their vision and their feelings of neglect, according to more than 400 pages of documents released Thursday afternoon.

His two offices resembled patient mills, according to court records. At his Hillcrest office, Rutgard purportedly examined 180 patients a day--plus 50 in a half-day at his La Jolla office, according to documents. On surgery days, he performed more than 30 cataract operations, charging $3,500 per eye.

The pages of the consent form explaining surgical procedures were not read to patients before they signed their consent. Sometimes patients were operated on who had not given consent, according to the petition filed Thursday in the state Office of Administrative Hearings.

Other times, the patients had to have their hand guided on the signature line “because they could not see well enough to locate it on their own,” according to court records.

After a brief examination lasting 3 to 5 minutes, Rutgard sometimes told patients he could correct their drooping eyelids in a 5-minute “procedure,” in which he would take a little tuck or stitch. He neglected to tell them it was a surgery that would require hours in the office as well as sedation and anesthesia, the state claims.

Rutgard also lied to some patients, saying he would make no incision in their inner eyelid when, in fact, he would, according to the documents. To help promote the image of painless procedures, he instructed his staff not to use certain words, including “surgery,” “blood,” and “pain,” the documents said.

Photographs of patients’ eyelid-impaired vision were staged and sent to Medicare to substantiate the necessity of operating on eyelids, according to documents. Rutgard or a member of his staff would tell patients to close their eyes and take a little peek--creating a drooping eyelid effect.

At times, patients were sedated before their pictures were taken or their eyelids were taped into position to appear as though the eyelids obscured the individual’s sight, according to documents.

“Old people do not always know what they are agreeing to,” said Janie Cordray, spokeswoman for the Medical Board of California. “It’s a ripe field for abuse. . . . You have to understand how vulnerable the elderly are--if their eyesight degenerates to the point where they cannot pass a driving test, they lose their license and their freedom.”

Jim Andrews, now 71, had suffered several strokes when he first saw Rutgard June 14, 1988, his wife told The Times on Thursday. Andrews had undergone extensive eye tests at the VA Hospital in La Jolla and UCSD Medical Center in Hillcrest, before seeing Rutgard.

His wife, Josephine (Dodie) Andrews, said they were surprised when Rutgard told them that Jim Andrews had cataracts in both eyes.

With surgery, Rutgard promised that Jim Andrews, who has Medicare and is very ill, would be able to see five times better, Dodie Andrews said. Initially, Jim and Dodie Andrews were angry that all the experts Jim Andrews had seen failed to detect cataracts.

But after the first cataract operation on one eye, Andrews’ vision was no better--in fact, it was worse, said Dodie Andrews, who, along with her husband owns Simmonds Real Estate in La Jolla.

Disappointed by the results of surgery, Jim Andrews saw two other eye doctors--each told him he didn’t have cataracts, Dodie Andrews said. Jim Andrews never had the second cataract operation on his other eye.

“My husband, with his strokes, has been through hell, we were so tickled to think that someone would be able to help him,” she said. “But what happened is just criminal. I’m so furious. It’s just devastating. I hope they hang Rutgard.”