Letter Details Alleged Wrongs at Fertility Clinic

In the letter that prompted UC Irvine to launch a full-scale inquiry into its Center for Reproductive Health, three whistle-blowers paint a graphic picture of what they call “wrong, likely illegal and highly improper” procedures, according to documents obtained by The Times on Tuesday.

Most of the accusations involve Dr. Ricardo H. Asch, head of the internationally renowned program, whom the letter describes as having consistently disregarded “the dignity and rights of patients,” occasionally “to pursue his own entertainment.”

The whistle-blowers’ letter, signed by San Diego attorney Daniel John Yakoubian, who at one time represented all three, alleges among other things that:

* Asch often kept patients waiting or anesthetized for hours while he finished watching sporting events on television. At other times, the letter says, Asch simply delayed or canceled scheduled treatments to leave and pursue his own interests.

* A CRH staff member “was requested, on the spot and without any screening, to donate sperm to fertilize a CRH patient’s eggs.”

* Asch and his partners operated an unlicensed sperm bank, submitted false insurance claims and failed to report cash payments to the university.

While corroborating most of the whistle-blowers’ charges, a three-member clinical panel appointed by UC Irvine noted in an independent audit that it could not substantiate allegations of an unlicensed sperm bank or of a staff member donating sperm.

UC Irvine has sued Asch and two of his colleagues--Drs. Jose P. Balmaceda and Sergio Stone--all of whom have denied misconduct allegations and say they intend to vigorously contest them in court.

Asch’s criminal defense attorney, Ronald G. Brower, said Tuesday night that he had not seen the whistle-blower letter, but reiterated that his client had never knowingly misused his patients’ embryos.

Various investigations into the fertility clinic have broadened in recent days to encompass the state Senate and Assembly, which held a hearing on the matter on Tuesday, as well as law enforcement and federal agencies that could suspend more than $14 million in university research funds.

University officials said Tuesday that until they received the letter, dated Sept. 10, 1994, they lacked enough information to investigate allegations that eggs were misappropriated from one woman to another without the consent of either.

“It definitely was the first solid, concrete, detailed report on the egg allegations,” said Fran Tardiff, spokeswoman for UC Irvine. “It laid out the allegations. There were more specifics about what they were talking about.”

The three whistle-blowers--all former UCI Medical Center employees--each reached financial settlements with the university between April 26 and May 22. As part of the agreements, the women agreed to return medical records and other documents taken from UC Irvine.

Debra Krahel, a former senior administrator, received a lump sum of $495,002. Marilyn Killane, former manager of the center, received $325,436, to be paid over the next eight years. And Carol Chatham, a former ambulatory systems manager, received $98,930.

All of the women will forfeit a portion of the money if they discuss the agreements or their whistle-blower complaints, unless they are subpoenaed to testify--which state Sen. Tom Hayden (D-Santa Monica) says he intends to arrange in connection with a June 14 hearing in Sacramento.

University administrators have declined to name the whistle-blowers, but Hayden identified the three, along with seven other witnesses whom he intends to subpoena, in a letter made public Monday.

UCI Executive Vice Chancellor Sidney Golub has denied that the settlements were meant to “hush up anything” and said they were intended to protect patient confidentiality.

But in a written statement, UCI officials said the settlements “were reached to settle any liability the university had for claims of retaliation and to avoid litigation over [CRH] matters the university [is] investigating.”

Attorney Yakoubian states in the letter that, because of their efforts to expose “the pervasive and serious nature” of “gross misconduct and malfeasance” by Asch and his colleagues, the whistle-blowers were subjected “to a common scheme of retaliation.”

Later, Yakoubian writes: “It appears that full investigation and action on this issue may have been suppressed . . . in order to protect Asch.”

Yakoubian could not be reached for comment Tuesday on the letter, portions of which were obtained by The Times.

The letter also accuses Asch and his colleagues of “failure to report cash payments and make required payments” to the UCI College of Medicine, of filing “false insurance claims,” of misappropriating UCI Medical Center property and of “economically wasteful and legally questionable” practices.

Under the heading “Gross Misconduct and Malfeasance,” the letter says that Asch and his colleagues “deliberately caused staff to exploit their control over the financial operations of CRH in order to financially benefit the physicians.”

Staff members who resisted, the letter says, “were verbally abused, retaliated against and displaced.”

In an independent audit dated March 17, the three-member clinical panel appointed by UCI said the allegations contained in Yakoubian’s letter “merited a full investigation, including personal interviews of the relevant whistle-blowers.”

The panel found that Asch had dispensed a fertility drug, HMG Massone, which has not been approved by the U.S. Food and Drug Administration and which he imported, on his own, from Argentina, and that “credible evidence” pointed to the doctors having implanted human eggs into patients without obtaining the consent of either donor or recipient.

“We find this allegation to be the most serious and troubling of all of the allegations because of the profound ethical and moral questions involved in transfer of donor ocytes and embryos,” the panel wrote.

The panel--which consisted of Dr. Stanley Korenman of the UCLA School of Medicine, Dr. Mary C. Martin of UC San Francisco and Dr. Maureen Bocian of UCI--corroborated the whistle-blowers’ accusation that Asch kept patients anesthetized while tending to other activities.

The panel quoted Dr. Steven Barker, chairman of the department of anesthesiology at UCI, as saying Asch would often instruct him to anesthetize a patient but would then leave the area “and his whereabouts were unknown.”

This led to a policy of Barker not anesthetizing a patient unless “Asch was in the operating room, in his greens and ready to begin the procedure,” according to the panel’s findings.

Asch, the panel noted, has denied this and many other allegations.

But in conclusion, the three physicians wrote that Asch and his colleagues “were significantly deficient in a number of critical areas,” including most prominently the screening, documenting and treatment of both the donors and recipients of human eggs.

* LEGISLATORS CRITICIZE UCI: Lack of fertility clinic oversight called “astounding.” A19