The Cover-up is always worse than the crime itself

Unfortunately in this cover-up, people actually died. As a businessman and one of the last patients of Ricardo Asch at UCI, I was impressed with Dr. Asch abilities and compassion for the patients. I was always appalled at UCI’s gross mismanagement of the clinic. As a businessman a red flag went off in my head when the UC Regent’s paid $1 million in “whistleblower money” to the UCI managers of the fertility clinic. It was in my personal opinion; they were at the root of the problem. It turned out that I was not alone in my opinion. In an article in the LA Times (09/27/97), then Lt. Governor Gray Davis (who went on to be governor) had called a meeting of the UC Regent, expressed his concern about a cover up and potential wrong doing. He called the money paid to the so called whistle blower, “hush money”. “I am…outraged over the seeming unending hemorrhage of millions of dollars of public funds to the cleanup and compensate for misconduct by university officials”.

Articles slowly started appearing on the UC Regent’s complex methods of covering up and paying off to avoid being held responsible for the root causal problems systemic to the UC system.

Yes, The UC Regent’s had a virtual handbook an effective total assault….on the rights of both the plaintiffs and co-defendants, this was discover in the Denise DeSoto case. The UC Regents’ attorneys blocked some records for more than three years. (04/23/97 LAT)

I personally believe part of this assault, was all out war against Dr. Asch. UCI and The Regent’s attached him economically, shutting down his practice, eliminating his pay as professor and stopping his legal liability insurance.

For more than a decade, UCI officials have repeatedly ignored red flags, downplayed serious problems, misrepresented facts and punished or fired people who exposed wrongdoing, according to interviews with current and former employees, court records and UCI's own audits. …….. I don't think we're dealing with isolated problems and bad actors only," said new UCI Chancellor Michael V. Drake…

Whistle-blower complaints, state Senate committee hearings and internal investigations exposed UCI's efforts to limit the investigation and punish those who reported problems. It was a pattern that would be repeated.

Whistle-blowers said they were warned not to talk publicly and threatened with dismissal.

Whistle-blower complaints, state Senate committee hearings and internal investigations exposed UCI's efforts to limit the investigation and punish those who reported problems. It was a pattern that would be repeated.

Whistle-blowers said they were warned not to talk publicly and threatened with dismissal. (LA Times 02/14/06).

The following is a partial list of problems that emerged all because the UC Regents preferred to cover-up, pay off and not address the root causal issues.

The time is long overdue for our legal system to send the UC Regent a clear message and review Dr. Asch’s case, clear him of all charges. Our legal system should stop being a page in the UC Regent’s handbook on the assault on the rights of both the plaintiffs and co-defendants.

James J. Jones
A parent of twin daughters and former patient of Ricardo Asch
jjjpwr3@gmail.com

UC Regents Accused of Obstruction

Courts: Action means judge will determine damages in malpractice suit involving woman left in coma after surgery at UCI Medical Center.
April 23, 1997 | KIMBERLY SANCHEZ | TIMES STAFF WRITER

SANTA ANA — An Orange County Superior Court judge Tuesday accused the University of California Regents of grossly obstructing justice in a malpractice suit filed by the family of a 34-year-old woman left in coma after hand surgery at UCI Medical Center.

Judge C. Robert Jameson ruled in favor of Denise DeSoto after finding that the regents had withheld key evidence and hidden the existence of a crucial witness in an effort to stonewall attorneys for DeSoto.

DeSoto, the mother of two young boys, remains in a coma three years and four months after a blocked breathing tube caused her to go into cardiac arrest after surgery.

Cornelius Bahan, DeSoto's attorney, said the family will ask for $15 million to $20 million in damages. The judge will determine how much to award the family after hearing arguments from Bahan, he said.

"We are being absolutely stonewalled by the regents through their attorneys," Bahan said. "Their conduct has been just outrageous, and yet their ability to keep us from finding out what happened has been effective."

Regents attorney Mark Maizel called the sanction "too severe" and said the regents intend to appeal the ruling.

"We turned over all documents relative to her medical care and treatment and never hid or failed to disclose any witness," he said.

But Bahan argued, and Jameson agreed Tuesday, that the regents had willfully misled the plaintiff's attorneys from the beginning, including omitting from medical records the existence of a first-year anesthesiologist who was key in DeSoto's treatment.

Bahan, in court documents filed Tuesday, said what transpired in the suit "constitutes a virtual handbook on how to wage an effective total assault . . . on the rights of both the plaintiffs and co-defendants."

DeSoto was on her way home from work as a legal secretary on Dec. 6, 1993, when she rolled her car. She was taken to UCI Medical Center in Orange, where surgeons amputated two fingers and reattached two others.

A week later, she lost circulation in the reattached fingers and went into surgery a second time to correct the problem.

After 30 minutes in the recovery room, DeSoto turned blue from a lack of oxygen, Bahan said. When doctors removed her breathing tube, they found mucus clogging it, blocking her air passage and causing her to go into cardiac arrest, he said.

"She has been in a coma ever since that moment," Bahan said. "It has been our struggle and our effort during all this time to find out who was there, when were they there, what kind of problems did she have, and what did they do?"

In court documents, Bahan claims that the defense hid evidence and witnesses, including the anesthesiologist who was the first physician to come to DeSoto's aid and who, Bahan said, helped destroy the breathing tube.

Bahan said it took more than three years, and numerous trips to court, for the regents' attorneys to admit the existence of the anesthesiologist, who had just five months' experience as a resident. After a private investigator hired by Bahan found the doctor, according to court papers, the regents' attorney advised the doctor to evade the subpoena.

Maizel, the regents' attorney, denied hiding witnesses and said Bahan had spoken with the majority of people involved with DeSoto's care.

"In fact, Mr. Bahan took the deposition of the witness that was allegedly hidden," Maizel said. "We provided Mr. Bahan with the last known address of the individual to assist him in locating the individual."

Bahan said Jameson's attempts to sanction the University of California for misconduct failed. Two months ago, the judge fined UC $5,000 for misconduct in the case. Last summer, a discovery referee appointed by the court found that there was willful obstruction of justice by the regents' attorneys.

"A $5,000 sanction in a $15-million lawsuit isn't anything," Bahan said. "It grew worse, so that was the last straw."

Bahan said DeSoto remains on intermittent ventilation at Meridian Neuro Care in Santa Ana, where she was moved after two months at UCI. She is somewhat aware but unable to talk, move her limbs or communicate with her husband and sons, Bahan said.

DeSoto has been threatened with eviction from Meridian if $568,000 in medical bills, which UC agreed to pay, is not made soon, Bahan said.

Maizel said he was not aware that any such payment agreement existed.

Maizel's firm, Baker, Silberberg & Keener in Irvine, also is defending four UCI doctors involved in the case. The trial is scheduled for Sept. 8. Both sides say they plan to go forward with those cases.

Tuesday's action means the case against the university will not go to trial. Bahan now simply must make his case for damages, which the judge ultimately will determine

However, Kevin E. Monson, defense attorney for one of the plastic surgeons, said Jameson's default judgment might dissuade the family from additionally suing the individual doctors.

"I think that it will put pressure on the plaintiff to solely look to UC regents, rather than individual doctors," Monson said. "Why would he fight it out when he has a default against the deep pockets?"

Tuesday's ruling could lead to another enormous payout by the University of California for problems at UCI Medical Center, which has been embroiled in lawsuits regarding its now-defunct fertility clinic. UC has paid out millions in settlements to whistle-blowers and alleged victims of egg stealing at the clinic

UC Agrees to Pay Huge Settlement in Malpractice Suit

Medicine: Multimillion-dollar award resolves case of woman in coma since surgery 4 1/2 years ago in Irvine. Judge previously ruled university had 'stonewalled.'
June 21, 1998|GREG HERNANDEZ | TIMES STAFF WRITER

The University of California has agreed to a $20.2-million settlement with the family of a Garden Grove woman who has been comatose since hand surgery 4 1/2 years ago at UC Irvine Medical Center, the family's attorneys said Saturday.

Most of the money, believed to be the largest medical malpractice award against the hospital, will pay for the future medical care of 39-year-old Denise DeSoto, who has not regained consciousness since her breathing tube was blocked during an operation.

For the Record Los Angeles Times Sunday June 28, 1998 Home Edition Part A Page 3 Metro Desk 2 inches; 46 words Type of Material: Correction Hospital settlement--A story in last Sunday's Times erroneously reported the settlement amount in a case involving UC Irvine Medical Center and the DeSoto family of Garden Grove. The figure the UC regents agreed to pay is $4.25 million. The anticipated value of the settlement over Denise DeSoto's lifetime is $18.3 million.

The settlement was triggered by a ruling last fall by Orange County Superior Court Judge C. Robert Jameson. He ordered the UC regents to pay the family nearly $19 million after finding that the university had withheld key evidence and concealed the existence of a crucial witness in a mal practice case brought by DeSoto's husband, Jose "Pepe" DeSoto, 39.

Jameson said the university had "stonewalled from the get-go" and tried to prevent the court from learning how Denise DeSoto suffered brain damage through "intentional, despicable, unprofessional" conduct.

As a result, the judge took the extraordinary step of barring the university from presenting a defense against the lawsuit.

UC Irvine officials have acknowledged that there were delays in handing over evidence in the case but said they were not meant to stymie the court. The hospital appealed the judge's decision, but then entered settlement discussions in March.

UC Irvine attorneys could not be reached for comment. However, hospital spokeswoman Kim Pine confirmed the settlement had been reached, but said it calls for a lower figure, $18.3 million. "UCI really regrets this unfortunate event which had such a sad outcome," Pine said.

The settlement, finalized on Friday, also will pay past medical bills and leave about $500,000 to Pepe DeSoto and another $500,000 in trust for the couple's two sons.

DeSoto was on her way home from work on Dec. 6, 1993, when she had an accident in her minivan. She was taken to UC Irvine Medical Center, where surgeons amputated two of her fingers and reattached two others.

A week later, she lost circulation in the reattached fingers and underwent surgery a second time to correct the problem.

After 30 minutes in the recovery room, DeSoto turned blue and suffered cardiac arrest and brain damage from lack of oxygen, said Cornelius P. Bahan, the family's lawyer. When doctors removed her breathing tube, they found it was clogged with mucus, preventing the passage of air.

Bahan asserted in court that the university concealed the existence of some witnesses with firsthand knowledge, including the anesthesiologist who was the first physician to come to DeSoto's aid.

Bahan said it took more than three years and numerous trips to court for the regents' attorneys to admit the existence of the anesthesiologist, who had just five months' experience as a resident.

The lawyer said the family's nightmare was exacerbated when the hospital billed his client for more than $200,000 in medical bills not covered by insurance.

"They continued to press for collection and completely wiped out the family's credit," Bahan said.

Said Pepe DeSoto: "I remember one time I got a bill and they were threatening me. I told them it was under litigation, and they said, 'We really don't care. You owe us the bill.' "

The attorney said UC Irvine also refused to pay the mounting bills at a long-term care facility in Santa Ana, where Denise was moved

O.C. settles Medicare overbilling charges.
It will pay the federal government $7 million for false reimbursement claims in the 1990s blamed on an administrative error.
By David Haldane Los Angeles Times Staff Writer

December 21, 2007

Orange County paid the federal government $7 million Thursday to settle allegations that its Health Care Agency overbilled Medicare by at least that amount in the 1990s.

"This was a mistake," Board of Supervisors Chairman Chris Norby said of the false reimbursement claims. "The mistake was rectified a long time ago, and we felt that we wanted to put it to bed."

UCI's Woes Imperil 'New Era'
Problems at the hospital conflict with plans to put it on a par with renowned institutions. Some say the stories are overblown.
By Roy Rivenburg and Kimi Yoshino Times Staff Writers

March 5, 2006

Since November, UCI has been battered by revelations about serious problems in its liver, kidney and bone-marrow transplant programs, questions about cardiologists' credentials, turmoil in the anesthesiology department and alleged nepotism in hiring.

Last month, a panel of experts concluded that UCI's ambitions overshot its ability to care for its patients successfully.

Dr. Laura Mosqueda, director of geriatrics…..

"It's embarrassing to be affiliated with UCI," the professor said. "Morale is not particularly high."

Fertility Lawyer Loses Appeal
State court denies bid by woman who embezzled from victims in the '90s UC Irvine scandal.
By Kimi Yoshino Times Staff Writer

March 3, 2006

A prominent Orange County attorney convicted of embezzling more than $150,000 from patients whose embryos were stolen by UC Irvine fertility doctors has lost her appeal.

Probation Urged for UCI Kidney Transplant Unit
By Charles Ornstein Times Staff Writer

February 18, 2006

The federal contractor that oversees organ transplants nationally has proposed putting UCI Medical Center's kidney transplant program on probation, after a scandal that forced the closure of the hospital's liver transplant unit in November.

…..UCI has come under scrutiny since it closed its liver transplant program after federal regulators withdrew certification and funding. The Times reported that more than 30 patients on the program's waiting list died in 2004 and 2005, even as the hospital turned down organs that might have saved some of them.

UCI Medical Center Tried 'Too Much'
The scandal-plagued Orange hospital had inadequate resources to match its ambitions, a panel of outside investigators conclude
By Charles Ornstein and Christian Berthelsen Times Staff Writers

February 17, 2006

…Though the 24-page document was unsparing in its general criticism, it offered strikingly few specific recommendations. It called for every program to be fully reviewed and for leaders to be held accountable, but it did not name the problem departments or suggest discipline for any officials.

…Furthermore, the report did not address why major problems repeatedly have occurred at UCI Medical Center, across disciplines and departments, over the last decade.

In 1999, UCI fired the director of its donated-cadaver program, amid suspicion that he had improperly sold spines to an Arizona research program.

…He said whistle-blowers should never be targeted for intimidation and punishment, as some faculty say has occurred at UCI. …The Times reported that more than 30 patients died on its waiting list in 2004 and 2005, even as the hospital turned down scores of organs that might have saved some of them. Lawrence S. Eisenberg, the lead lawyer in 50 lawsuits involving the liver program Trail of trouble

Notable controversies in the last decade at UCI Medical Center: 1995: In May, UC Irvine accuses Ricardo H. Asch, Jose P. Balmaceda and Sergio C. Stone, a team of fertility doctors at its Center for Reproductive Health, of stealing patients' eggs or embryos, implanting them into other patients and conducting human-subject research without permission.

1997: After the Food and Drug Administration launches an inquiry, UCI finds that a research lab at its Chao Cancer Clinic in 1995 and 1996 violated university and federal regulations by charging patients and Medicare for experimental drugs without authorization and soliciting donations from patients trying to get into clinical trials.

1998: Dr. Darryl See resigns after UCI says he violated procedures by using patients' blood samples for research without their authorization and using inappropriate procedures on laboratory animals.

1999-2000: The university finds that Christopher Brown, director of the medical school's Willed Body Program, has sold parts of cadavers, misappropriated money, conducted unauthorized autopsies, improperly solicited cash donations for the program and overcharged travel costs.

2004: UCI officials say a cancer researcher, Dr. Hoda Anton-Culver, misspent as much as $2.3 million in state and federal funds on unauthorized software instead of cancer research.

Nov. 10, 2005: UCI shuts down its liver transplant program after federal Medicare funding is withdrawn and the Los Angeles Times reports that 32 people died awaiting livers in 2004 and 2005, even as doctors turned down organs that were successfully transplanted elsewhere.

2006: Reports surface of underperforming kidney and bone marrow transplant programs. In addition, UCI's cardiology chief and associate chief draw criticism from staff and regulators for not holding state licenses or U.S. board certifications, the anesthesiology department faces possible sanctions, and possible ethical lapses are reported, including suspected violations of nepotism rules in hiring. The Times also reports that a young Orange County physician was accepted into a newly created residency position the same month his father pledged $250,000 to the radiology department.

UC Irvine Hospital's Diagnosis: Denial

The institution gets scathing reviews from embittered former employees. Chancellor concedes its myriad troubles aren't isolated.

By Kimi Yoshino
Times Staff Writer

February 17, 2006

There seems to be one constant in UC Irvine's medical programs: scandal.

For more than a decade, UCI officials have repeatedly ignored red flags, downplayed serious problems, misrepresented facts and punished or fired people who exposed wrongdoing, according to interviews with current and former employees, court records and UCI's own audits. And time and again, UCI's woes end up in headlines and in court.

.. I don't think we're dealing with isolated problems and bad actors only," said new UCI Chancellor Michael V. Drake…

….32 patients died awaiting liver transplants because no full-time surgeon was on staff and viable organs were turned down.

…Chancellors and administrators who came before him may have thought problems could be fixed solely by firing bad employees. Not Drake. His approach, he said, is to "take a big step back and then to look broadly" at the university as a whole. What he will find, critics say, is a university that has failed to repair its damaged core.

…Problems in UCI's medical programs were first exposed in 1995 when it was reported that doctors at the Center for Reproductive Health…..

…..included misplaced cadavers, the sale of cadaver body parts without consent

….research violations at the Chao Cancer Clinic

…..32 patients had died awaiting livers in 2004 and 2005, as doctors turned down organs that were successfully transplanted elsewhere

……Problems also surfaced in the kidney and bone marrow transplant programs.

Whistle-blower complaints, state Senate committee hearings and internal investigations exposed UCI's efforts to limit the investigation and punish those who reported problems. It was a pattern that would be repeated.

Whistle-blowers said they were warned not to talk publicly and threatened with dismissal.

…UCI's attorneys repeatedly tried to limit investigations and public release of information, former employees said.

Andrew Yeilding, at the time UCI's chief auditor, was widely quoted as saying that Diane Geocaris, legal counsel to the chancellor, told him he should not press doctors hard for information. Other administrators told three internal auditors not to set foot on hospital grounds — or even exit the freeway near the Orange facility — or they would face termination, according to depositions and interviews.

In several cases, public comments by administrators were misleading and, occasionally, false. Geocaris, who remains the chancellor's legal counsel, urged the spokeswoman for the hospital, who later quit in frustration, to delay release of records as long as legally possible, according to reports in the Orange County Register.

Lab technician Gene Ioli filed his whistle-blower complaint about research violations at the Chao Cancer Center lab in December 1996, ….They later released a memo written by Ioli's former boss describing him as a "difficult" employee whose complaints were constant and a nuisance.

…after the fertility scandal. The work environment evolved from "free, open and supportive" to "completely hostile and negative," Chatwin said in a deposition as part of later litigation over UCI's Willed Body Program.

University officials "didn't want anything on paper," Chatwin said……staff urged the audit department to stamp sensitive documents "attorney-client privilege.

….Hebeish was later fired and Chatwin was encouraged to quit, despite what they said were many positive employee reviews. Both allege in court documents that UCI failed to fully investigate later scandals and that administrators and UCI attorney Geocaris reduced their responsibilities and limited their access to employees.

…In December 1996, Chatwin launched an audit of UCI Medical Center's Organ and Tissue Bank, checking into allegations of conflicts of interest……. that auditors would "do as little as possible," to ensure that UCI was at low risk of exposure.

…..UCI quietly closed the Organ and Tissue Bank in June 1997 without conducting a full-scale fraud investigation.

…Likewise, Hebeish said he was not allowed to fully investigate the Willed Body Program in 1999.

…A cancer researcher, Dr. Hoda Anton-Culver, misspent as much as $2.3 million in state and federal funds on unauthorized software instead of cancer research in 2004.

…A transplant surgeon, Dr. Anthony Savo, and transplant coordinators also complained. Administrators transferred Savo out of the transplant program and he later left UCI.

…Meanwhile, high-ranking officials, including then-hospital chief executive Cygan, misled health regulators into believing the problems were resolved, according to a UC investigation.

….More than a dozen anesthesiologists, for example, have complained that their department is putting money before academics. And several cardiologists have reported clinical and ethical lapses to internal committees.

… He said university officials are using the "moral minimum" to guide their decisions, doing only what the law compels. "It's a very shallow application of ethical standards," Fields said. "The law merely states what you have to do. Ethics are what you should do."

FULL DISCLOSURE

Prescription for UCI

From the Los Angeles Times

January 14, 2006

THE SCANDALS AT UC IRVINE Medical Center and its medical school have been more than painful evidence of a troubled organization. They point to an underlying culture of concealment, arrogance and occasionally outright lying that shouldn't be tolerated at any hospital, but especially not one owned and operated by the state of California

Two More Suits Filed Against UCI Hospital

Number of patient cases in court in the liver scandal rises to 18; 13 allege wrongful death.

By Christian Berthelsen
Times Staff Writer

December 31, 2005

.. The suits have been prompted by revelations that more than 30 patients on the UC Irvine hospital's waiting list died while waiting for liver transplants, as the hospital rejected scores of organs, at times because no surgeon was present to perform the operation. UC Irvine shut down the program Nov. 10 after the federal government withdrew funding.

The Times Editorial, January 14, 2006 “FULL DISCLOSURE, Prescription for UCI” does not go far enough. It was the attorneys for the UC Regent’s that were found to of obstructed justice in the 1997 case of “Denise DeSoto” which settled for $18.5 million. In the Times reporting of this case (9/27/1997), then Lt. Gov Gray Davis expressed his outrage and went on to call the $1 million in “whistle blower money” to the managers of the fertility clinic, “hush money”. This legal maneuver effectively blocked the investigation of UCI responsibility. Now with 32 people dead, $22 million in “PR” payments to fertility patients, it time to make changes at the top.

As we all know the cover-up is worse than the crime itself. The Regents were willing to pay off anyone in the fertility case, just to protect UCI reputation. They failed miserably. They paid over $500K to a couple that claimed they signed a blank consent form and now there is a couple that claims they to were pumped full of fertility drugs before having a reversal to having her tubes tied. It does not take a world class fertility doctor to understand this story may be a little short on facts.

If our goal is to have a world class university, with a world class teaching hospital, then the UC regents need to held accountable. Their legal counsel, including the decade plus role of Byron Beam needs reviewed.

James Jones
Costa Mesa

IT Never ends….
More problems discovered at UCI Medical Cente

Results of a surprise federal inspection could put the hospital's Medicare funding at risk.

By Molly Hennessy-Fiske

January 22, 2010

Federal investigators found scores of problems at UC Irvine Medical Center during a fall inspection that again put the troubled hospital's Medicare funding at risk, according to report released Thursday.

In an 85-page report on their surprise October inspection, regulators said they observed poor oversight and mistakes by UCI doctors, nurses and pharmacists, leading to inadequate care that in some cases harmed patients.

Among the findings:

* An 82-year-old man was mistakenly given a narcotic patch by a medical resident, without approval of doctors or pharmacists. The patch led to an overdose that required emergency intervention and may have contributed to his death a week later.

* A patient in the neuropsychiatric unit fell twice in three days and despite yelling "Help me, doctor, help me," suffered a head injury and had to be taken to intensive care.

* An on-call resident did not respond to repeated emergency pages from nurses in the neurological intensive care unit, where a patient with an irregular heartbeat languished for more than an hour.

* Pharmacists failed to monitor and store drugs correctly, allowing nurses to carry narcotics in their pockets and inject patients without proper oversight.

The report comes a year after investigators from the Centers for Medicare and Medicaid Services documented repeated examples of poor oversight at the hospital and threatened to cut Medicare funding.

In July, Medicare officials issued a finding of immediate jeopardy after investigators discovered that five UCI patients had received overdoses because nurses using pain medication pumps were not properly trained. UCI officials immediately began training nurses to use the pumps, the finding was lifted within 24 hours and the hospital submitted a plan of correction.

UCI nurses said Thursday that many of the latest problems stem from understaffing and other cost-cutting, even as the facility turned a $54.2-million profit last year and the chief executive earned an $83,250 bonus.

"This is a problem of money. To provide extra training, extra staffing, is money," said Beth Kean, California Nursing Assn. director for UC nurses, including 1,000 at UCI.

Terry A. Belmont, who took over as the hospital's chief executive last year, disputed that the facility was understaffed.

Belmont, who summarized inspectors’ findings in an e-mail to his staff, said hospital officials corrected some of the problems within a month of the inspection. They are working to remedy the rest with random audits and otherimprovements, he said.

Earlier this week, hospital officials submitted their latest plan of correction to federal regulators. Once it is approved, federal officials will return for another surprise inspection, according to Jack Cheevers, a spokesman for the Centers for Medicare and Medicaid Services western region.

Belmont said he has worked to create a culture of cooperation and accountability among physicians and staff since becoming interim chief executive in March. He was hired permanently last month.

"This organization has been in transition," Belmont said. "Our big issue now is how do we prevent human error from occurring, how do we catch it before it creates problems for our patients."

For instance, after the narcotic patch overdose, the hospital trained pharmacists to complete new forms verifying how the drugs are dispensed and mandated daily audits to prevent errors.

"Everybody's fallible. We just have to make sure we have the right processes in place" to catch errors, said Dr. Eugene Spiritus, UCI Medical Center's chief medical officer.

Spiritus also defended the compensation for hospital managers, saying they need to stay competitive in order to attract and keep talented managers, especially given the cost of living in California.

Still, Belmont said, hospital officials are considering whether managers' future bonuses should depend on passing inspections, "so that people feel more accountable for doing the right thing."

Hospital leaders have struggled to overcome a series of high-profile scandals during the last 15 years.

In 2005, the hospital closed its liver transplant program after The Times reported 32 people died awaiting livers in 2004 and 2005, even as doctors turned down organs later successfully transplanted elsewhere. In 1999 and 2000, the university's Willed Body Program drew criticism after its director performed unauthorized autopsies and sold body parts. In 1995, a team of fertility doctors at the school's Center for Reproductive Health was accused of stealing patients' eggs and embryos and implanting them in other patients without permission.

molly.hennessy-fiske@latimes.com