Yet Another Sick Feeling for Medical School Dean

The gruesome mea culpa from UC Irvine had Dr. Thomas C. Cesario, dean of the College of Medicine, in a place all too familiar and hard.

Surrounded once again by reporters at a long conference table, he answered questions about yet another scandal at his medical school--this one about allegedly stolen cadaver parts.

“It is really demoralizing,” he said. Cesario used that word again and again in an hourlong interview.

No wonder. It was yet another embarrassing apology from a medical school whose administrators candidly admit they want to be seen as the equal of UCLA.

“It makes it extremely difficult for all of us, and it is very demoralizing to have to go through this type of problem every six months,” he said.

Cesario ticked them off--the problems, that is, including the infamous fertility scandal that broke as he took over the deanship in 1994.

“This is the fourth,” he said, with three in less than a year.

Five years ago, the College of Medicine was rocked when its world-renowned fertility clinic was shut down after it was revealed that doctors there were stealing eggs and embryos from patients, then giving them to other couples or to researchers without the knowledge of the donors.

Late last fall, a highly regarded professor--Dr. John Hiserodt--left the university while under investigation for engaging in unauthorized cancer experiments on people. The university also was forced to give refunds after it had improperly billed dying patients or Medicare more than $55,000 for experimental drug treatments.

Last month, university officials said they were investigating former faculty member Dr. Darryl See because they had no evidence that See had conducted research at UCI that he used as the basis for a medical journal article on nutritional supplements. See quit a year ago after the school found that he had violated research procedures by, for example, using patients’ blood samples without authorization and using inappropriate procedures on laboratory animals.

And on Friday, Cesario announced that the school had fired the director of the Willed Body Program and launched an investigation into possible improper sales of body parts from cadavers and failure to return cremated remains to relatives.

Cesario admitted the drumbeat of bad publicity has caused personal hurt and tarnished the institution.

“We are definitely concerned about the reputation of the school,” he said. “The school has been doing very well despite all of these problems.”

He listed accomplishments from improved faculty recruiting to “the best research year we have ever had in terms of grant funding.”

“The faculty have been working hard in trying to ensure that we get where we want to be, which is a first-rate medical school,” he said.

There was some consolation in the school uncovering the problem itself, but Cesario took only momentary solace from that.

“We really have been vigilant because we have been going above and beyond to ensure there are no problems,” he said. “So, I think we are turning up problems at a fairly rapid rate because we want to clean them up.”

Others said the school deserves credit for finding the problem and taking its lumps.

Insisting on compliance and developing a code of honesty are not easy, said Tony Mazzaschi, assistant vice president for biomedical research at the Assn. of American Medical Colleges in Washington.

“Human frailties are such that in a large organization, things are going to happen,” he said. “The question is, do you have systems in place to educate people, and if something does go awry, can you find it and correct it quickly?”

Universities that have “been once, twice or three times burned,” Mazzaschi said, usually create compliance programs to fix the problems.

As a result, he said, “You tend to see the culture of institution change: It becomes a way of life for an institution. Problems then start to diminish.”

Perhaps most difficult for every physician at UCI’s medical school is that the latest scandal again tears the bond between doctor and patient.

“It is all so demoralizing to us because we want to build up trust in the community,” Cesario said. “Our highest responsibility is to these patients and to these donors, and we recognize that. It really does make us feel very badly when we are uncomfortable in being able to fulfill our commitments. We try really hard to do that.”