UCI Fertility Scandal Widens to UC San Diego : Biotechnology: Officials say that at least five patients at UCSD may have been victims of egg-swapping scheme.

UC San Diego officials announced Friday that Dr. Ricardo H. Asch may have victimized at least five patients in a human egg-swapping scheme at the university, broadening the scope of the UC fertility scandal to as many as 40 women at three Southern California medical centers.

The improper transfers from one patient to another at UC San Diego’s 2-year-old Assisted Reproductive Technologies program appear to have involved three egg donors and two recipients and may have resulted in at least one pregnancy, said Dr. Thomas Moore, acting chairman of UCSD’s Department of Reproductive Medicine.

“I can only speak as a physician about my profound concern and disappointment,” Moore said during a news conference in La Jolla to discuss the preliminary findings. “This is an unthinkable event.

“The concept that parts of our appropriated cells can be outside of ourselves and that these very special tissues are not maintained, husbanded and cared for in the most meticulous fashion . . . well, the very thought of that is unthinkable.”

In a hint that the scandal could expand still further, UCSD officials acknowledged they could not account for the disposition of 17 other patients’ eggs or embryos.

In addition, outside auditors found evidence of possible unapproved use of frozen embryos at UCSD that were obtained from patients at UC Irvine, according to a report released Friday.

“This is like a nightmare that doesn’t end,” said state Assemblywoman Jackie Speier (D-Burlingame), who chairs a consumer protection committee. If the charges prove true, “the ethics of this physician are of the lowest common denominator.”

Speier, who underwent fertility treatments years ago, said patients have been horribly betrayed. “You are dealing with people who are emotionally raw,” she said. “And to place an overlay like this on these people is just heartless.”

In all, UCSD has “concerns” about 22 of the 155 patients treated at the San Diego clinic, officials said. University officials have not been able to reach five of the patients, three of whom apparently were involved in unapproved transfers, Moore said. Two of the three are from Mexico and one from Panama.

One of the five patients already has filed a notice of intent to sue Asch and the university system, Moore said. That patient has alleged her eggs were used to impregnate a woman who now has a year-old boy living in Mexico.

The announcement “merely confirms what Dr. Asch told my client himself in April, 1995,” said the patient’s attorney, Larry Feldman. “On the other hand, it never ceases to amaze me how the university continues to hold press conferences rather than dealing directly with the patients and trying to ease their pain.”

Asch’s civil attorney Ken E. Steelman said Friday that the doctor “categorically denies” any wrongdoing. Asch never had custody or control of consent forms and other documents on which the university is basing its allegations and cannot be held responsible for what they say, Steelman said.

Ronald G. Brower, Asch’s criminal attorney, has previously suggested that any mishaps were caused by staff members at the clinics where Asch worked.

The San Diego clinic, which severed ties with Asch last month, has suspended operations since May and will remain closed until the crisis is resolved, officials said.

UC San Diego’s announcement follows a monthlong investigation by outside auditors hired after UCI accused Asch and his two partners of human egg misappropriation and other improprieties at UCI’s Center for Reproductive Health in Orange.

UCI has since accused the three doctors of improper transfers involving 35 women at the Orange clinic and a now-closed affiliate in Garden Grove.

UCSD’s accusations targeted only Asch, who helped to establish the Assisted Reproductive Technologies center in 1993 and made four visits a year to treat patients. Asch’s partners did not practice there and no other doctors at UCSD are implicated in the alleged wrongdoing, UCSD officials said.

“I am satisfied that Dr. Asch--a professor and world-renowned expert in this area--was ceded to in every instance regarding procedure, consent forms and so forth,” Moore said. The outside auditors, KPMG Peat Marwick, found evidence not only of improper transfers at UCSD but of possible unapproved use of frozen embryos from UCI as well. Five frozen embryos from the UCI clinic were given to the two recipients at UCSD, according to the auditors’ report released Friday.

UCI spokeswoman Fran Tardiff said she was not aware of the findings and declined to comment further.

But Leslie Franz, spokeswoman for the UCSD School of Medicine, said the school’s investigation produced “pretty clear evidence” that two recipients were implanted with frozen embryos from UCI.

“Beyond that, we have no records where the frozen embryos came from, just that they came from UCI,” Franz said, noting that she was unaware of whether UCSD had informed UCI of its discovery.

Moore called UCSD officials “lucky” in having “about 90% of all the records we need.” However, for patients who traveled between Orange County and San Diego, “We do not have complete records,” he said.

Moore and other officials stressed that the UCSD findings were preliminary and were the first results of a three-phase study of the fertility program that will look at possible financial and research misconduct as well.

He said that certain medical consent forms are missing from UCSD’s records and that until all patients are interviewed, the university cannot fully determine the extent of the problem.

“The purpose of our investigation is to fully identify every instance of intended or inadvertent procedures or documentary irregularities and to insure that it never happens again at UCSD,” he said.

The San Diego university has made repeated attempts to obtain such records from Asch and his attorneys, but to no avail, Moore said.

“Without question, for the largest proportion of these patients, the lack of records--which we’ve requested from Dr. Asch personally--has inhibited our ability to draw specific conclusions,” he said.

Noting that UCI sued in attempts to gather records from Asch, Moore said that UCSD may follow a similar path but has yet to make a decision.

In a case very similar to one alleged to have occurred at UCI, auditors said seven eggs were taken from one woman in August, 1994, and transferred to another after being inseminated with the sperm of the second patient’s husband. A general consent form indicated that the patient had checked the box marked for donation but the mark “appeared different from other marks on the form,” according to the auditors’ report.

The auditors said “we cannot conclude that the consent was appropriately obtained.”

Officials inside and outside the UC system Friday expressed profound dismay at the widening fertility crisis.

“Obviously, we are very concerned about the patients, the families and the circumstances,” said Cornelius Hopper, UC’s vice president for health affairs, who has organized a UC task force to study reproductive technology oversight in response to the crisis. “We are very unhappy about this happening to the university.”

“It’s a confirmation that this outrage is not isolated to the UC Irvine Medical Center,” said state Sen. Tom Hayden (D-Santa Monica), chairman of a Senate committee looking into the fertility scandal. “Wherever Dr. Ricardo Asch has gone he’s been promoted as a savior. . . . There’s been an apparent breakdown of oversight and that has resulted in an egregious moral breakdown.”

Lt. Gov. Gray Davis, who also is a UC regent, said more controversy is the last thing the UC system needs now. But a full airing of what went on at the fertility clinics at UCI and UCSD could ultimately prove healthy, he said.

“This is a great university, but it is doing itself no favor by stringing out the bad news,” Davis said. “The best thing you can do with bad news is to come clean, put it behind you and move on.”

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Egg Swapping Scandal

Fertility clinics at two University of California medical centers and an affiliated hospital have become embroiled in controversy that rocked the world of reproductive technology and likely will change the way such centers are run nationwide. These three Southern California clinics are involved:

UC Irvine Center for Reproductive Health

* In May, UCI accused Drs. Ricardo H. Asch, Jose P. Balmaceda and Sergio C. Stone of taking human eggs and embryos without consent from patients and implanting them in others; performing unauthorized research on patients; underreporting income to the university; insurance fraud, and blocking UC investigations. Asch also is accused of prescribing a drug from Argentina not approved by the U.S. government.

* Doctors deny knowingly engaging in any wrongdoing.

* UCI contends perhaps 20-25 women involved in improper egg transfers.

* UCI says as many as seven pregnancies may have resulted from improper transfers at clinic and former affiliate at AMI/Garden Grove. Both now closed.

AMI/Garden Grove Medical Center fertility clinic

* Asch and Balmaceda are accused of about 10 egg transfers without consent between 1988 and 1990 at UCI-affiliated clinic.

* Clinic closed in 1990, when Asch and Balmaceda moved to their new headquarters at UCI and joined Stone.

UC San Diego Assisted Reproductive Technologies program

* Asch accused of unapproved egg transfers, causing maybe one pregnancy.

* Asch had help establishing clinic and visited it four times per year since 1993.

* UCSD did not renew Asch’s faculty appointment, which expired June 30. Clinic’s operations suspended pending internal investigations.

Source: UCI, UCSD; Researched by JULIE MARQUIS / Los Angeles Times