Loss of Fertility Clinic ‘Halo’ Worried Official : Investigation: UCI Medical Center’s Mary Piccione feared that misconduct allegations would dim the luster brought to the university by center director Roberto Asch, ex-administrator says.
More than two years ago, UCI Medical Center Executive Director Mary Piccione was worried that misconduct allegations at UCI’s renowned fertility clinic might disturb the “halo effect” that clinic director Ricardo H. Asch brought to the university, according to a letter from a senior administrator to auditors.
The October, 1994, letter by former administrator Stephany Ander contends that Piccione and her deputy, Herb Spiwak, were informed of a host of clinical problems at the fertility center long before a formal investigation was launched in September, 1994.
Ander also told UCI auditors in June, 1994, that Spiwak had known of possible human egg misuse at the clinic for nearly 1 1/2 years, according to auditors’ notes released Wednesday. The auditors concluded that Spiwak had “done nothing about it.”
A former clinic nurse testified before a state Senate committee last week that he had brought evidence of improper egg transfers to the attention of university auditors as early as 1992. But Ander’s statements expand on that testimony, alleging that she had presented concerns about medical and financial wrongdoing directly to Piccione and Spiwak before leaving the university in February, 1993.
An attorney for Piccione and Spiwak said Wednesday that his clients had no knowledge of any allegations other than of financial wrongdoing at the clinic until March, 1994.
Piccione and Spiwak consistently followed up on reports of wrongdoing and promptly passed them on to the appropriate investigators, attorney Gary Overstreet said.
In her letter, Ander said she had “multiple meetings” with medical center staff members during her two-year tenure about a range of troubles at the clinic. The meetings included Spiwak and, on one occasion, Piccione herself, Ander wrote.
In her October letter, Ander said the meetings addressed staff allegations that jewelry and eggs were exchanged for medical treatment, that medical records were being modified, that physicians were not present in the operating rooms even though their names were on the operative reports, and that patients were treated without being registered. Also discussed at the meetings were allegations of theft and cash management problems at the fertility clinic and an investigation by an insurance company of possible forgery by an employee, Ander wrote.
At one meeting, Ander wrote, Piccione stated that she “was very concerned about this issue as ‘[Dr.] Ricardo [Asch] brings a halo effect to the university.’ ” The executive director told Ander that she and Spiwak would follow up on the concerns with legal counsel and the UCI chancellor, among others, Ander wrote.
In the June, 1994, interview, Ander told auditors that she discussed “all the issues,” including egg misuse, with Spiwak, and he said he would “take care of it.”
“To my knowledge,” Ander wrote in her letter, “there was NO action taken.”
Ander, who oversaw ambulatory care, went on to say that the private practice by members of UCI’s medical faculty was in general “a very complicated and challenging situation.” She said Spiwak and an assistant made it difficult “to move issues forward in a responsible, professional manner.”
Spiwak, she said, often referred to the faculty as a “piece of [expletive].”
“Mary seemed to delegate operational responsibility to them and because of her demanding schedule (or other reasons unknown to me) did not intervene in what I considered to be blatant obstruction of progress,” Ander wrote.
Ander’s replacement at UCI was Debra Krahel, a whistle-blower in the UCI scandal who ultimately was paid $495,000 in a confidential settlement with the university.
In Senate testimony last week, Krahel accused Piccione of ordering her to keep her “loose lips” closed about the clinic’s troubles and of retaliating against her for coming forward with complaints. A management audit by two University of San Diego law professors, which was released last week, substantiated that Krahel was a victim of retaliation.
Piccione and Spiwak missed Wednesday’s deadline, set by the university, to formally respond to the scathing audit, their lawyer said.
Both administrators have denied that they retaliated against any of the three whistle-blowers in the scandal. Piccione and Spiwak were instructed to provide a written response to the audit by 5 p.m. Wednesday but were unable to comply because they did not have enough time and were not allowed to interview witnesses, Overstreet said.
In a brief letter to Overstreet on Monday, university Deputy General Counsel John Lundberg suggested that top UC administrators are moving quickly to decide the pair’s fate. Lundberg declined Overstreet’s request for more time and made it clear that Piccione and Spiwak could be fired “at will,” without a formal hearing.
“Unfortunately,” Lundberg wrote, “we do not have the luxury of time.”
Lundberg emphasized that “since the findings of the report were serious, it was felt fair to provide Mary and Herb with an opportunity to respond.”
Overstreet said he was retained by Piccione and Spiwak on June 2 and had only 19 days--interrupted by the state Senate hearing June 14--to prepare a response.
At least six outside agencies are investigating the UCI fertility clinic, run by Asch and his colleagues, Drs. Jose P. Balmaceda and Sergio C. Stone. UCI has sued the three, alleging that eggs were transferred from one patient to another without permission, that cash payments were not reported to the university and that the doctors engaged in research misconduct.
Agents from the FBI’s Santa Ana office have joined the inquiries and are trying to determine whether the physicians may have committed insurance fraud or mail fraud in falsely billing for procedures, a source close to the investigation confirmed Wednesday.
The physicians have denied knowingly engaging in any wrongdoing.
Times staff writer Tracy Weber contributed to this report.