Obstetrician Faces Negligence Charges

An obstetrician accused almost a year ago of botching the deliveries of two infants--with disastrous consequences--continues to practice in Santa Ana unfettered by state licensing authorities, even as additional accusations and complaints accumulate against her.

Dr. Farhat Khan, accused by the Medical Board of California in March of negligence contributing to brain damage in one child and the death of another, now faces additional charges of performing unnecessary surgery leading to a 32-year-old woman’s hysterectomy and mishandling two delicate prenatal tests.

Through her attorney, Khan has denied the charges and vowed to fight them. Because all the cases are several years old, the medical board does not have the option of immediately shutting down her practice.

Khan’s case serves as a telling example of how long and arduous the quest to restrict or remove a doctor’s license can be. The volume and range of the charges--which would seem to lend urgency to the case--have slowed the process of investigation and prosecution, licensing officials say.

Four years ago, after Khan left a Santa Ana hospital for a hair appointment, a laboring patient’s liver ruptured and her baby suffered brain damage from lack of oxygen, according to an investigator with the medical board, which cited the case in its first formal licensing action against the physician in March. In another 1992 case, the board’s accusation contends, Khan failed to notice that a fetus was in distress and was suffocating.

The first child, Albert Sanchez, is blind, deaf and mentally disabled and probably will require institutionalization for the rest of his life, according to medical board documents. The second child died seven days after birth.

Khan has reached an undisclosed out of court settlement with the Sanchez family and faces lawsuits in some of the other cases.

The documents contend that the doctor allegedly removed the wrong ovary in a third patient and failed to repair a vaginal incision that went too deep in a fourth.

In two cases, the medical board charged, Khan tried to cover up her mistakes by falsifying documents.

But as the board dug into these complaints, and Khan continued to see patients, more concerns about her past cropped up.

In November, the board accused Khan of operating inappropriately on a 32-year-old woman’s ovaries in 1991, factors leading to her hysterectomy and sterility. This month, in another action, the board alleged that in two cases dating back as far as 1989, she prematurely performed amniocentesis procedures, in which fluid is extracted from the womb. The action endangered mother and child, the board alleged, and Khan lied to one patient about why the process had to be redone.

Officials say they have received--but have not yet taken action on--several more complaints.

In state licensing proceedings, the board has accused Khan of gross negligence, repeated negligent acts, incompetence and corruption. In one patient’s case, the state said, she lacked “even a shred of human caring,” telling the woman to “shut up” during the painful extraction of amniotic fluid, refusing to hand over her medical records and ignoring telephone calls for five days.

Still, licensing officials say, they cannot just step in and shut the doctor’s practice down--not in this case, and not in many others.

First, the accusations remain unproven. In fact, the doctor’s attorney has pledged to put up a vigorous fight for her license, calling the state’s charges a “vendetta” carried out by an “extremely overzealous” medical board investigator and a private attorney. A hearing on the charges is set to begin in April and could last into mid-June.

“She’s an excellent board-certified obstetrician, very well trained, highly regarded by her patients and her colleagues,” said Khan’s attorney, Henry Fenton. “I think she’s going to be completely vindicated in these cases.”

Fenton described the most recent cases filed by the medical board--involving the extraction of amniotic fluid--as “inconsequential” because, he said, they caused no patient harm. He said any complaints against the doctor that have not been filed must be considered groundless.

Under state law, the only way to immediately suspend a physician’s practice without a hearing is to prove that he or she presents an immediate danger to the public. In this case, although the charges are serious, officials acknowledge that they cannot meet that standard with the evidence at hand.

The main problem is that the allegations are dated, licensing officials say. All but one case goes back several years. Steve Rhoten, the senior medical board investigator handling the case, says the general rule is that cases must be no more than a year old to qualify for a temporary restraining or suspension order, although judges have some discretion in the matter.

The law is intended to protect patients from harm without unnecessarily snatching away the livelihoods of doctors, medical board and legal officials say.

“No one thinks of taking the right to practice away from [doctors] summarily,” said Paul Hogan, the presiding administrative law judge in Los Angeles, whose office will handle Khan’s disciplinary hearing. “You have to show a cogent reason for doing that.”

Such a measure is granted rarely--only 19 interim suspensions or temporary restraining orders were issued last year statewide. By contrast, the board filed 353 accusations against physicians.

In Khan’s case, the first complaint was brought to the attention of the board by a patient’s attorney in January 1994--slightly less than two years after the doctor allegedly botched the delivery that led to the Sanchez baby’s brain damage. The other cases were discovered after the board opened its investigation into that report.