Auditors Clear UCI Plastic Surgery Unit

After a five-month investigation, auditors for the UC Irvine College of Medicine concluded Friday that allegations brought by a whistle-blower against the school’s division of plastic surgery were essentially without merit and revealed conditions that were “not fundamentally detrimental” to anyone at the school.

The investigation, initiated at the request of UCI’s general counsel, stemmed from allegations raised by Dr. J.A. Makena Marangu, a resident in the plastic surgery division from 1993 to 1995, who, according to the auditor’s report, “alleged retaliation in response to her effort to establish a global fee structure” for cosmetic surgery performed by residents.

Dr. David W. Furnas, chief of the plastic surgery division, contended that Marangu had “inappropriately and unethically charged, collected and kept fees from certain patients she saw for post-operative visits” at the UCI Medical Center, according to a 28-page report released Friday.

Neither Furnas nor Marangu could be reached for comment Friday.

Marangu had leveled a series of charges, each eliciting a detailed response from Patrick V. Reed, the university’s auditor:

* Marangu had questioned the practice of Furnas and his colleagues to refer plastic surgery patients to Plastic Surgery Associates of Orange County, a private medical practice based in Orange, of which Furnas is co-owner. But the audit revealed that such a practice was the outgrowth of a legal agreement between UCI and the company drawn up as far back as 1984.

“Referral of plastic surgery patients to Plastic Surgery Associates of Orange County was an approved practice in support of the plastic surgery residency program and was not fundamentally detrimental to either the patients or to UCI Medical Center,” Reed wrote.

* Reed concluded that the referral practice “does not constitute a conflict of interest” but conceded that the “arrangement should be better documented and its approval more widely known.”

* Marangu also alleged that the use of UCI facilities for occasional pre- and postoperative visits did not comply with university policy “and resulted in certain charges not being billed,” the report said. However, Reed concluded that the “extent and volume of this activity does not indicate a large dollar impact.”

* In response to one of Marangu’s charges, the audit concluded that the use and accountability of funds set aside in the UCI Residents’ Teaching Fund--designed to benefit the residents’ program--could be improved.

James Herron, associate dean of administration at the UCI College of Medicine, said Friday that, in the wake of the charges, efforts were being made to streamline “certain policies and procedures that probably needed to be improved.”

Having alleged that due process wasn’t followed in connection with her complaints, Marangu is scheduled to appear before university officials at a hearing on campus on Jan. 22, Herron said.

In terms of the allegation leveled against Marangu, the audit said, “A resident collected fees from five patients for post-operative visits which, while ultimately deposited with the university, appear to have been personally initiated for private gain.”

Marangu collected post-operative visit fees from five patients totaling $469, the report said, noting that such fees were repaid. “There is no evidence to support the assertion by Dr. Marangu,” the report said, “that she was instructed to collect such fees.”

The division is a plastic and reconstructive surgery program in which three plastic surgery residents are trained under a two-year program. Cosmetic surgery is generally done at the private facility where, the report noted, it can be done at less cost to consumers.