Namihas Blames Typo for Wrong Diagnosis of Cancer : Trial: Ex-Tustin gynecologist concedes mistake in letter to woman. He’s accused of mail fraud in billing patients for unnecessary and expensive surgery.

Under heated cross-examination Wednesday, ex-Tustin gynecologist Ivan C. Namihas blamed a typo in a letter that incorrectly informed a patient that she had cervical cancer, and he denied telling a 19-year-old woman she had AIDS without first testing her.

“You can’t force a patient into treatment, can you?” asked Assistant U.S. Atty. Jonathan Shapiro. “But you can sure scare them into coming back, can’t you?”

“I don’t think so,” replied Namihas, raising his voice sharply for the first time in more than three hours of testimony. “I wouldn’t have any way to make a judgment about the impact of my words” on a patient, he said.

Namihas, the object of the largest medical-abuse investigation in state history, is charged in U.S. District Court with 10 counts of mail fraud. Prosecutors allege the 62-year-old doctor fraudulently used the mail to bill six patients for unnecessary, expensive and often painful surgery.

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During his second day of testimony, Namihas insisted that he never exaggerated his patients’ conditions to get them to return to his office for more treatments and more payments.

In a letter to a patient in December, 1990, Namihas wrote to the woman that the results of a biopsy showed she had a condition that “is the same as cancer of the cervix.”

Namihas conceded that that statement was incorrect and was missing the words “in situ,” which would have signaled, at least to experts, that in fact the woman did not have cancer, but rather a condition that might lead to cancer. Namihas demanded in the letter $388 in payment for his services.

Namihas said he had typed the letter, and had accidentally left out the distinguishing words.

“I did make a mistake,” Namihas said.

“Did you ever try to deceive anyone by writing that letter?” asked his attorney, Paul Meyer.

“No,” Namihas replied.

Under further questioning, Namihas said he recalled a 19-year-old woman weeping in his examining room during a pelvic exam in early 1991 but said she burst into tears because he merely suggested she have an AIDS test.

The patient, Stacy Crumpler, and Namihas’ nurse at the time, Lisa Fischer-Perez, have testified that Namihas abruptly told the young woman she had AIDS without having tested for the disease.

“Did you ever consider anything you said may have made her cry?” Shapiro asked.

“No, I did not,” Namihas said firmly.

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Namihas later recommended laser surgery for both women and performed surgery on several other patients, including a man whose condition he diagnosed as viral warts.

During the trial, which began last week, several doctors have testified that Namihas either misdiagnosed his patients or misused laser surgery in treating them. But another doctor who testified on behalf of Namihas on Wednesday said that he believed Namihas gave appropriate medical care to his patients, including the use of laser surgery.

“I’ve seen more disasters with under-treating (using laser surgery) where a patient might die five years later, than with over-treating,” said Dr. Arthur Barnes, a gynecologist with a private practice in Los Angeles.

The state Medical Board revoked Namihas’ license in May, 1992, after the board received more than 160 abuse complaints by the doctor’s former patients.

Prosecutors said they declined to file sexual-abuse charges because of statute-of-limitations problems with many of the cases and because they concluded there was a lack of evidence to corroborate the patients’ complaints.

Namihas faces 50 years in prison and a $250,000 fine if convicted on all counts. The trial continues today with Namihas back on the stand.