Board Alleges Two Births Were Botched : Inquiry: Obstetrician could lose her license. She is also accused of incompetence or negligence in two other cases, and that she tried to alter documents to protect herself.

State licensing authorities have accused a Santa Ana obstetrician of botching the deliveries of two infants, one who was born brain-damaged after nearly suffocating and another who died seven days after birth.

Dr. Farhat Khan, 48, of Santa Ana failed to respond promptly to signs that the infants were in serious trouble, according to a formal accusation released this week by the Medical Board of California. The doctor also is accused of incompetence or negligence in two other cases: removing the wrong ovary in one patient and failing to repair a incision that went too deep in another.

The doctor tried to cover up her mistakes by altering documents in the case of the brain-damaged child and in the ovarian case, the documents state. Senior medical board investigator Steve Rhoten said Wednesday that these matters have been referred to the Orange County district attorney’s office for possible criminal prosecution.

Khan, who has the right to fight the board’s accusation at an administrative hearing, declined to comment Wednesday, an office employee said. The charges could lead to revocation of her medical license.

“I view this as being worse than usual cases,” said Sherry Ledakis, the deputy state attorney general who filed the action for the medical board. “It warrants that she be strictly followed if not have her license completely revoked.”

Before the delivery of the brain-damaged baby in April, 1992, a nurse said, Khan left Santa Ana Hospital Medical Center for more than an hour to get her hair done, according to Rhoten and an attorney for the patient’s family. Later, the mother’s liver ruptured and the baby was born with such severe neurological damage that he probably will have to live in an institution for the rest of his life, medical board documents state.

Albert Sanchez, now 3, is blind, deaf, mentally disabled and living in a home providing round-the-clock nursing in Riverside, said the Sanchez family’s attorney, Melanie Blum, who reported the case to the state medical board and filed a civil malpractice case against the doctor. Khan agreed last August to pay $897,500 to settle that case, according to documents filed in Orange County Superior Court.

The medical board alleges that Khan neglected to properly treat the mother, who eventually suffered complete liver and kidney failure, and failed to recognize the signs of distress in the fetus before he began to suffocate.

Instead, the doctor left the hospital for a time, then returned to deliver the child by Cesarean section. The baby, who was limp, had to be resuscitated, and it took 15 minutes to obtain a heart rate, according to the documents filed by the medical board.

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Khan apparently did not notice that the mother’s liver had ruptured, despite large quantities of blood in her abdomen, according to the documents. It was not until the mother was transferred to UCI Medical Center in Orange the next day that doctors learned of her burst liver. She was “critically ill,” according to documents, and required a lengthy course of hemodialysis to recover.

The child, meanwhile, developed multiple organ failure and seizures, leaving him impaired, probably for life, the documents state.

The medical board accuses Khan of altering documents in the case that falsely represent the level of prenatal care the mother received. Blum said the doctor dictated medical notes on the case--three months after the birth--that falsely suggested the mother had missed appointments and received little prenatal care. In fact, Blum said, the mother kept regular appointments with the doctor and has receipts for each visit.

In another case, medical board documents state, Khan mishandled a September, 1992, birth by failing to respond promptly when tests repeatedly indicated that the fetus was in distress. It took half an hour for Khan to arrive at the mother’s bedside at Western Medical Center-Santa Ana after she received word of the fetus’ poor condition, documents show.

According to the documents, the child, Brandon Patrick Bradley, suffered severe oxygen deprivation and had to be resuscitated after birth. After spending seven days on life-support machines, he died, documents state.

A civil malpractice suit filed by the Bradley family contends that Khan caused the child’s death by failing to do a timely Cesarean section. That suit recently was settled out of court and the terms are confidential, said the family’s attorney, Peter A. Seidenberg.

In a 1989 case, the medical board accuses Khan of accidentally removing a woman’s healthy left ovary instead of her right one, which had recurrent cysts. The woman only learned of the mistake after her family doctor did an ultrasound, documents state. She is now infertile.

Meanwhile, according to medical board documents, Khan altered the patient’s medical records in an attempt to cover up her error.

In another instance in 1990, the medical board contends that Khan accidentally cut too deep when performing an incision in the vaginal area to ease a delivery. The cut lacerated the woman’s anus and sphincter, but the doctor apparently didn’t notice the injury or repair it, according to documents filed by the board.

The woman didn’t notice either, until several days later when she developed complications, documents state. The injury was then repaired surgically by another physician.

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State licensing officials say they became aware of problems with Khan’s care through lawsuits and complaints from individuals involved, not from hospitals where Khan had admitting privileges. In particular, officials said, they were surprised not to have received a report in the Sanchez case from Santa Ana Hospital Medical Center.

Hospitals are required to make reports to the medical board when their medical staffs administer any significant internal discipline against a doctor--such as revocations or restrictions on staff privileges, for example. Sanchez family attorney Blum said she complained to the hospital directly about Khan.

“I would expect (the hospital to make a report to the medical board) in this case and was surprised that there wasn’t,” said Ledakis, the deputy attorney general.

Hospital business development director Lisa Wilson said Wednesday that she cannot address the case specifically because doctor discipline is decided in a confidential peer review process.

In general, she said, “I understand there are a lot of reasons why (reports) would or would not be filed. I don’t know (in this case). I’m not privy to that information.”