Objections to Cornea Policy Date Back to 1992

Contrary to public assertions by the Los Angeles County coroner’s top administrator, internal complaints had been voiced for years about the ethics of harvesting corneas without permission or knowledge of the next of kin.

Several of those complaints, dating back to 1992, were made directly to the administrator, coroner Director Anthony Hernandez.

Hernandez recently assured the County Board of Supervisors that concerns over the removal of corneas by the Doheny Eye & Tissue Transplant Bank had not surfaced until eight months ago.

“That is totally inaccurate,” said coroner employee Pam Eaker, one of those who had been raising questions for several years.

Reached Friday, Hernandez refused to elaborate on the matter.

The rumblings of internal discontent went unheeded until a Times story this month prompted the coroner’s office to revise its policy and require employees to seek family consent before removing corneas.

For years, the coroner’s office had authorized the removal of thousands of corneas by Doheny under an obscure state law sanctioning the procedure as long as no known objections from the deceased’s family existed. In recent months, Doheny was paying the coroner’s office $215 per set of corneas and reselling them to transplant institutions for a markup of up to 1,400%.

According to interviews and documents recently obtained by The Times, coroner employees had for years repeatedly warned Hernandez and his top managers about their ethical and legal qualms over the extensive harvesting of corneas, the dome-like tissue covering the eye’s colored iris.

Some of the complaints were made in writing, while others were made directly to Hernandez during meetings of the department’s division chiefs.

“This has been going on for a long time--a long, long time,” said Lt. Fred Corral, who supervises a shift of coroner field investigators.

Corral said he aired his complaints several times to Hernandez, dating back as far as 1992, even before Hernandez was promoted to his current post.

Corral said that he also talked to chief of investigations Craig Harvey and the department’s former director, Iona Lewis--who retired from the county in 1993 and took a job with Doheny’s management firm, Tissue Banks International.

“I brought it up as a result of other investigators asking why we’re not” notifying families in advance of cornea harvesting, Corral said.

Former coroner’s office field supervisor Peter Linder said he also complained to Harvey and Hernandez “four or five years ago.”

“We brought it up several times until it was obvious that nothing was going to be done,” said Linder, who retired last year for medical reasons. “They handled it like a minor irritant. We thought it was major.”

On Sept. 22, 1993, three investigators wrote a memo to Harvey detailing their misgivings about removing corneas without notifying families.

“We as investigators are concerned about the current practices of the eye bank operating in our office and seemingly under our protection,” wrote investigators Dan Aikin, Pam Eaker and Cheryl Goodman.

“It may not be the eye bank’s place to determine if there is an objection but it would seem to be the ethical thing for us to do,” they wrote.

Aikin, who has recently been promoted to lieutenant in the coroner’s office, declined to comment.

But Eaker and Goodman said the memo was the first of several unsuccessful attempts to change department policy.

More than a year later, Eaker wrote a second memo addressed to Hernandez regarding “continuing problems with the eye bank.”

The veteran investigator recounted a case in which a Doheny technician removed corneas before she had the chance to call in with an objection from the next of kin.

“[The Doheny technician] advised it was too late, that they had already harvested the corneas,” Eaker wrote in the Oct. 2, 1994 memo. “At this time I made my displeasure known, to which [his] reply was that the family would never know.”

That memo, Eaker said, earned her a meeting with Coroner Lakshmanan Sathyavagiswaran and Hernandez, who was then overseeing the office’s administrative side.

At that meeting, she said, Hernandez instructed her: “We don’t want you asking the families for permission. We don’t want to get involved in that aspect.”

These memos, along with the accounts of coroner insiders, contrast sharply with Hernandez’s statements before the county supervisors Nov. 4, following publication of The Times story. At that time, under questioning from his elected bosses, Hernandez repeatedly insisted that there had been no long-standing concerns in the office about the application of the state cornea statute.

He said that until internal questions were raised eight months ago, “there’s been no issues whatsoever with respect to this law.”

In a follow-up memo to the board Monday, Hernandez reiterated that position, saying staff dissent was first discovered in early 1997. “Up until then,” he wrote, “there was no written policy to address this matter since it had not been raised as an issue.”

On Friday, Hernandez said only: “I think this issue is pretty much over with, and really we don’t have any more comments. . . . That’s it.”