UCI Clinic Also Being Investigated by Auditor : Health care: State office, which in 1994 shut down a UC San Francisco paramedic program, had been alerted six weeks ago to the fertility center.

The California state auditor has been investigating a renowned UC Irvine fertility clinic and the three doctors who operate it since receiving a call from a whistle-blower more than six weeks ago, university officials confirmed Tuesday.

State Auditor Kurt Sjoberg said Tuesday that by law he could neither confirm nor deny an investigation by his office.

But Sjoberg said his office has wide powers to launch investigations into “fraud, deceit, improper personnel practices and gross inefficiencies” and “any improper conduct by a government agency or employee.” He said his office would not embark on such an inquiry unless the allegations were corroborated in some way.

Sjoberg’s office, which is conducting its investigation independent of the university, joins inquiries by a growing number of state and federal agencies into UCI’s multimillion-dollar Center for Reproductive Health.

The clinic’s founder, Dr. Ricardo H. Asch, resigned from UCI on Friday amid allegations that he took eggs from patients without their consent for research purposes and, in at least one case, used the eggs of one woman without her knowledge to impregnate another woman.

Asch, 47, has denied violating his patients’ wishes and says the university must share the blame for any administrative mistakes made at the Orange clinic. Asch’s partners, Drs. Jose P. Balmaceda and Sergio Stone, who have been put on leave by the university, also have denied any wrongdoing.

Although Sjoberg would not comment on the UCI investigation, he said his office has aggressively pursued abuses in California’s public university system. Recent inquiries by the state auditor resulted in the closing of a paramedic training center at UC San Francisco in 1994 after auditors accused the agency’s administrator of “gross mismanagement” and conflict of interest. University officials there also were severely criticized for not providing oversight even after they were warned of problems.

In a 1987 case, a UCLA professor was forced to repay the university $500,000 after an audit accused him of using state resources in his private tissue-typing business. Sjoberg said his staff pursued the UCLA investigation because the university’s own audit was inadequate.

John Lundberg, an attorney for the UC Regents, said Tuesday that his office has been in contact with Sjoberg and is cooperating with the ongoing investigation at UCI.

The fertility clinic will close its doors at UCI Medical Center in Orange on June 2, amid a number of other investigations into the clinic and the activities of its doctors that have been launched this week. The university’s administration currently has five internal investigations into various aspects of the clinic.

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A team assembled by the Orange County district attorney and led by the UCI police and the California Medical Board began an investigation of the clinic Monday.

Today, Assemblyman Mickey Conroy (R-Orange), a member of the Assembly Higher Education Committee, will ask that committee to “look into what happened at UCI and decide if there was any wrongdoing on the part of the university,” said Chris Manson, Conroy’s administrative assistant.

The state Senate Select Committee on Higher Education launched an investigation of the center Friday at the request of its chairman, Sen. Tom Hayden (D-Santa Monica), said Stephanie Rubin, a consultant to the committee.

“We are gathering materials and information,” Rubin said. “Once we have a better idea of what is happening, we will know where to go.”

Dixon Arnett, executive director of the state medical board, said his office was contacted by the UCI officials last week with allegations about misconduct at the fertility clinic--coincidentally, he noted, at the same time the allegations were detailed in news accounts.

“Potentially what is at stake here is much more than a temporary suspension from a faculty,” Arnett said. “If there was negligence, either repeated or gross, we would go after their licenses.”

Arnett said that if the allegations prove true, the trust of the clinics’ patients “was dramatically, graphically violated.”

He said complaints about laboratory mix-ups of eggs and sperm at fertility clinics are “very rare” and he could not fathom why a doctor might purposely transfer eggs from one patient to another without proper authorization.

“This is conduct that does not fit with the reputation of the individuals, who are not only clean in terms of their records, but very respected,” Arnett said.

If the patient’s allegation of fraud proves true, Arnett said, it is likely that other women may also have been defrauded. “From where I sit it is clear that it [would have] had to be done on purpose over a sustained period of time,” he said.

If “an honest-to-God mistake was made” by the doctors, the board probably would enforce a penalty short of removing their licenses, Arnett said. “But if willfulness is involved, purposeful defrauding, their licenses are in jeopardy and possibly criminal charges would be levied.”

Arnett predicted the joint investigation by the district attorney and medical board will be “complicated, not easy.”

“The difficulty is trying to understand who did what to whom, when and where, and what was labeled what and why,” he said. “You almost have to re-create events.”

He said that although blood tests may help determine what mother a baby is genetically related to, and thus whose eggs were used to conceive a child, such evidence alone is not conclusive. Arnett said investigators also would need corroborating evidence, such as accurate medical reports or reliable witnesses to any wrongdoing.

The allegations against Asch also have led the UC San Diego School of Medicine to re-evaluate all aspects of its reproductive program. Asch has been affiliated with Assisted Reproductive Technologies, or ART, at the La Jolla medical school since 1993, spokeswoman Leslie Franz said.

He worked at UCSD as “a non-salaried clinical professor,” and because of allegations stemming from his work at UCI, his UCSD contract--which expires June 30--is not being renewed, Franz said.

“Our initial review has reassured us that the research studies under question [at UC Irvine] did not involve any San Diego patients,” Franz said.

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Between 150 and 200 women have been involved as patients in the UCSD program, Franz said, most treated by a therapeutic team.

“Dr. Asch worked with the team on most of the patients,” Franz said. “To say that any one patient would be the patient of any one physician just wouldn’t be accurate. As opposed to Irvine’s, ours is very much a team approach. It’s just different at Irvine. . . . It’s a completely different construct from the way our program has evolved. It’s a different kind of situation, a different kind of relationship.”

Asked if the team approach would lend itself more easily to oversight, thus helping to prevent abuses by an individual doctor from taking place, Franz said, “we’re reviewing the entire program, and I wouldn’t want to make any assumptions.”