Deaths Shadow UCLA Physician

Dr. Jonah Odim says he walked into a “hornet’s nest” four years ago, and the hornets keep following him wherever he goes: across the Canadian border and over state lines, from Georgia to California.

Despite his stellar credentials--his Yale education, his Harvard and University of Chicago training--the 43-year-old cardiac surgeon keeps getting stung by questions from 1994, that horrible year in Winnipeg, Canada, in which 12 of his tiny surgical patients died.

Though unpublicized in the United States, the case has raised an enormous outcry in Canada from parents, politicians and the press. The deaths, in fact, are the subject of the nation’s longest running inquest.

Now, UCLA Medical Center, where Odim quietly obtained a temporary appointment as a clinical instructor a year ago, is considering whether to extend his position for another year. And the doctor once wooed by some of the continent’s best medical institutions finds his career on the line.

This is not the professional odyssey he planned.

His career took a radical turn in Canada, when his surgery program was abruptly suspended and pressure from the media and grieving parents led to the inquest. It swerved off course again two years ago, while he was at Emory University in Georgia, when medical authorities there balked at extending his temporary license after learning of the probe.

He is trying again at UCLA. When he applied to be a trainee in transplantation, he said, he told the medical center upfront about the Canadian inquest, to avoid any repetition of the “circus affair” in Georgia. He also notified the Medical Board of California.

UCLA makes no apologies for hiring him. The chief of cardiothoracic surgery, Dr. Hillel Laks, cited Odim’s “good background and training.”

“We heard [the Canadian program] was a troubled program for some time. . . . We had an open mind as to causes of problems. He was hired in a supervised role. If we had been looking for a primary surgeon, we would obviously have to use different criteria.”

Nevertheless, Odim voluntarily stopped seeing patients at UCLA after a reporter made inquiries two weeks ago. Moreover, California medical authorities said last week that they are “looking into his history in other jurisdictions.”

Meanwhile, the Canadian inquest, begun in March 1996, and scheduled through September, continues to probe the wreckage of the Winnipeg program.

Its purpose is not to point fingers at Odim or anyone else, but to discover why the children died and whether the cardiac surgery program at Winnipeg’s Variety Children’s Heart Centre may have been fatally flawed, perhaps well before Odim’s arrival.

A Residue of Bitterness

Still, some people in Winnipeg blame Odim. Seven of the 12 youngsters’ bereaved parents are suing him for malpractice. Several testified that they never were told by Odim or the hospital that this was the doctor’s first stint as a chief surgeon.

“I was led to believe he was one of the best,” testified Danica Terziski, 37, whose son, Daniel, died after a high-risk procedure.

Some parents said they would have pushed to have their children transferred to a more established program, had they only known of Odim’s inexperience.

“It took an inquest for me to get my answers,” said Benedict Capili, father of 2-year-old Marietess, who died after one of her major vessels was narrowed by a suture.

“It was unethical. Him as a doctor, he should have known what he could do and couldn’t do. . . . What he wanted to prove was, ‘Hey, I can do this stuff.’ ”

According to inquest documents and testimony, some nurses Odim worked with believed that he fumbled, that he was rough, sloppy, hurried and difficult to communicate with. Nurses said tubes fell out and vessels tore; patients bled excessively and took longer to recover.

In an interview, Odim termed these allegations “salacious” and unsubstantiated by medical records.

Cardiac nurse Carol Youngson said she and other nurses complained to their superiors but were not heeded. Later, they named themselves the “Broken Hearts Club.”

“As time went on . . . I could no longer . . . take these children out of their parents’ arms and go into the operating room with them,” Youngson testified. “I just couldn’t. . . . I had lost confidence in the surgeon.”

Less than three months into Odim’s tenure, anesthesiologists temporarily refused to work with him on high-risk cases. The program was suspended in December 1994, after the head intensive care unit neonatologist refused to refer any more patients to Odim’s team.

Dr. Molly Seisha testified that after two relatively low-risk procedures had gone badly, she wondered, “Was this going to occur again? Were other babies potentially going to die?”

Some inquest witnesses recalled chaotic scenes inside and outside the operating room.

Dr. B.J. Hancock described how she and Odim tried to remove 8-month-old Jessica Ulimaumi from a portable bypass machine in the ICU.

The problem, Hancock noted, was that certain key equipment was not on hand. Jessica began bleeding massively as the bypass line was removed.

Hancock then noticed that a second line connected to the heart had mistakenly not been clamped, potentially leading to more blood loss.

Lacking a vascular clamp, Odim tried to control the bleeding from where the bypass line had been removed by putting his fingers over the hole in the vessel, Hancock said. By the time a clamp arrived, Jessica had bled to death.

As a part of normal review, a committee of the College of Physicians and Surgeons of Manitoba, the provincial licensing body, concluded that four of the 12 deaths, including Marietess’ and Jessica’s, could possibly have been prevented.

But college registrar Kenneth Brown said the report doesn’t single out “any particular individual.”

“We have absolutely no reason to support any kind of negative image” of Odim, he said.

Odim’s supporters say he has been unfairly branded by overzealous media and that he was performing complex procedures on very sick children, a portion of whom would have died whatever he did.

“All of the good stuff is being ignored,” said Odim’s attorney, Todd Campbell. “You don’t hear or read about the kids who survived.”

Odim agreed to discuss his Winnipeg experience in an interview last week, just as a UCLA medical staff committee considers whether to extend his temporary appointment beyond June 30.

He says he doesn’t want a repeat of his Georgia experience. He was less than two months into a five-month surgical appointment at Emory University when a Canadian reporter called the university and the state Medical Board to discuss the inquest, he said.

The upshot was that he had to leave Emory. He says the Georgia board put off a hearing to extend his temporary medical license, so he couldn’t practice in Georgia.

“He looked real good on paper,” recalled Andrew Watry, former executive director of the Georgia board. But Watry said the Canadian inquest was “at the very least disturbing” and that the board decided to “let his license expire.”

Odim says he declined the board’s invitation to be considered two months later.

Now he sees a reason to tell his side of the story.

He is cautious, speaking in measured tones. He declines to go into the details of the inquest, where he testified for six weeks. He prefers, instead, to stick to the general issues of the program.

He has been made a target, he says, by “people in different corners.” He cites the comments of a colleague who said “in all his years he had never witnessed a physician or a criminal undergo the pillage that I have [undergone].”

From Odim’s perspective, the Winnipeg job that had so intrigued him--that he chose over several other offers--was nothing like what he had expected.

For starters, he said, two of the hospital officials who recruited him from his prestigious fellowship at Boston Children’s Hospital left the institution. Then he discovered that the program was underfunded and had been for years, squeezed by Canadian health care politics. His predecessors had similar complaints.

Odim handed a reporter an inch-thick binder of news articles and documents, carefully indexed, some of which suggest that the Variety Centre had a long history of woes predating his arrival. Others raised the fundamental issue of whether the sparsely populated province should even operate a pediatric program of this kind; some said the numbers were too small to keep surgical skills sharp.

An internal report ordered by the Canadian hospital after suspension of the program--prepared by cardiac surgery experts from Toronto after a two-day visit--gives fodder to both Odim and his detractors.

There is “evidence to at least question the technical competence of the present cardiovascular surgeon,” the reviewers wrote. But Odim may have been judged unfairly by some colleagues and “the program has been poorly supported by the institution from the outset,” they said.

Though small numbers made statistical analysis impossible, the reviewers did say the mortality rates for infants during the 10 months Odim was there were “unacceptable.” Ten of 34 infants died and 2 of 44 children over a year old.

Odim did his own analysis of the program’s record over time, and found that his predecessors, in some years, fared about the same or worse.

Finding New Respect

Four years later, at UCLA, the circumstances are different. He is an instructor and trainee, not a chief. He is doing what he has done so many years of his medical career--learning from top performers in the field. His supervisors are complimentary.

“We have had nothing but good reports,” UCLA’s Laks said. “He is very compassionate, he has worked extremely hard, his judgment has been good, his knowledge is excellent.”

That is the kind of doctor Odim says he has long wanted to be. It’s the kind he believes his father was. Odim’s father, who was Nigerian, insisted that his family be evacuated to the United States during the Nigerian civil war in the 1960s, but he stayed behind four years to attend to Biafra’s civilian victims.

“I saw how important he was and valuable in his community, as an advisor, a caretaker,” Odim said. “I wanted to be like that. I wanted to enjoy the type of career he had, where you take care of people, not only their somatic problems, but also spiritual.”

Though he has no family of his own--besides a Great Dane--one of the more satisfying aspects of his career he says has been his relationships with the families he treats.

This view collides with the anger and sense of betrayal that some parents in Manitoba express. Some, during his testimony at the inquest, wore black and red clothing to symbolize their losses, red for blood and black for death. Others broke down on the stand.

“I’m not saying he can’t be a good surgeon,” said Laurie Maguire, 26, whose son Jesse’s death was determined by the Manitoba college to be “related to surgical technique.”

“However, he needs to realize these are human babies he is working on. . . . He has to be aware that people are devastated by what he does. . . . It would hurt me if another baby died because of him.”