UCI’s Spate of Scandals Alarms Some Observers : Education: Experts suggest an encompassing review of policies and procedures at the university’s medical school.

UC Irvine’s medical school, shaken in the past four years by four scandals that all raised questions about a lack of supervision and oversight, should conduct a top-down review of its research practices and procedures to determine whether there’s a broader systemic problem, some ethicists and outside medical experts suggested Thursday.

One ethics director said UCI needs to bring in an independent panel to investigate whether broader oversight flaws exist.

“This may just be bad luck or whatever, but there’s enough to indicate there may be something more going on,” said Stephen Wear, director of the center for clinical ethics at New York’s University of Buffalo. “There’s a lot of smoke there.”

In the latest problem, which erupted last week, officials announced that a UCI worker at the medical school’s Willed Body Program may have sold the body parts of cadavers. As a result, the university promised to install a new record-keeping system and create strict oversight of the handling of the donated human remains.

Poor oversight also played a role in the other UCI cases: in 1995, when doctors stole the eggs and embryos of scores of women and gave them to other patients; in 1997, when cancer researchers improperly charged patients for experimental treatments; and again last year, when a professor used patients’ blood samples for research without seeking permission.

Each time, UCI fired or sanctioned administrators or professors who were responsible for the research that went awry or those in charge of overseeing the work. The executive director of the UCI Medical Center and her chief deputy, for example, were dismissed in 1995 after being accused of trying to cover up the fertility scandal.

“The problems have been probably blamed on individual ‘bad apples,’ as it were, instead of being recognized as something reflecting a systematic problem,” said Alexander M. Capron, professor of law and medicine at USC and co-director of the Pacific Center for Health Policy and Ethics. “Until they do a root cause analysis and get down to the origins, they are likely to repeat themselves in one way or another.”

UCI officials say they adopted stricter oversight to prevent similar problems, including closer supervision of research projects and additional workshops for department heads and professors on federal and university research regulations and ethical guidelines.

Bill Parker, an associate executive vice chancellor at UCI, said he is encouraged that the university discovered the problems in the Willed Body Program and is taking steps to correct them.

“That’s an indication that we’re making improvement, but the problem still occurred,” he said, “which suggests we have even more progress to make.”

Parker said that department chairmen and chairwomen, trained as academics and not as administrators, need additional help and training to keep a closer watch on their areas. He said they need to learn how to manage effectively, receive more staff support and better internal information.

“We have had very active discussions in the last few weeks looking for ways to improve support to the department chairs,” he said.

Audit Cited Oversight Problem

Parker offered no explanation for the rash of scandals at the medical school, saying only that “the accomplishments far outweigh the small number of problems discussed publicly.”

A 1996 audit of five medical school departments unrelated to any of the public scandals stressed that oversight was a major problem at UCI’s medical school.

The audit, by KMPG Peat Marwick, found that the university’s medical college was able to attract these physicians and grow into a premiere research institution because it gave researchers a cushion of independence. However, that growth and autonomy came at the expense of “sound management controls and internal control procedures in some areas,” including loose billing procedures, the audit stated.

When the audit was released, UCI officials said many of the suggested reforms were already in the works, including the installation of a centralized billing system to ensure that doctors bill correctly.

One former top UCI official said the university’s research atmosphere has always been influenced by Orange County’s entrepreneurial view of the world, creating an environment that some unscrupulous researchers may abuse.

“It does create a sort of tolerance for entrepreneurial innovation, which some individuals . . . may take to a bad level,” said Sidney Golub, a former UCI vice chancellor who left this year to become the director of the Federation of American Societies for Experimental Biology in Bethesda, Md.

Still, Golub believes the fertility clinic scandal and the recent research troubles at UCI were aberrations and not symptoms of any underlying deficiencies in university leadership. Golub said the research culture at UCI was very similar to the culture at UCLA, where he worked before teaching at Irvine.

“Large research institutions have people who play at the edge and who get in trouble,” Golub said. “Once you’ve had one problem you tend to be under a lot of scrutiny, so smaller problems that come up over the course of things seem larger.”

Dr. Robert Levine, chairman of the human investigation committee at Yale University School of Medicine, also said he doesn’t see connections among UCI’s problems.

“Any large collection of people are going to have some deviant behavior,” he said. “I don’t see any unifying theme that makes me think there is something systemically wrong at the university.”

However, Jerry Porras, a professor at the Stanford University Graduate School of Business, said UCI’s ambitions of reaching the top tier of universities must not override all else. Top leaders in any organization must show how important they view basic values and that people who adhere to them should be rewarded, he said.

“I don’t think people in organizations are fundamentally bad people,” he said. “Often they are driven to do things they think are reasonable because of the way the organization is put together and signals the organization gives on what to do to be successful.”

Other experts, including Barbara Koenig, executive director of Stanford’s Center for Biomedical Ethics, offered a variety of reasons for UCI’s continuing set of troubles, from lack of supervision to cutbacks that have forced academic medical institutions around the country to cut corners.

“I think every single academic center is vulnerable to these things because of the pressures I’m talking about,” Koenig said, pointing to recent scandals involving Duke University, UCLA and the Veterans Affairs Hospital in Los Angeles.

Times staff writers Kate Folmar and Peter M. Warren contributed to this report.