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A hospital may have declined organs

California patients said to have died seeking transplants

IRVINE, Calif. -- When Elodie Irvine was diagnosed with a deadly kidney and liver disease, doctors at the University of California, Irvine, Medical Center told her she would have a new liver within six months, and perhaps even in a week.

But as months became years, Irvine watched, terrified and helpless, as 10 friends from her hospital-sponsored support group died without getting the transplants they needed.

After four years, Irvine's kidney specialist became suspicious and advised her to transfer to another hospital, where she got the kidney and liver transplants within two months.

Others were not as lucky. More than 30 people died waiting for liver transplants from the University of California, Irvine, Medical Center, while the understaffed hospital turned down organs, the Los Angeles Times reported yesterday.

The Times reported that the hospital had received 122 liver offers between August 2004 and July 2005, but had transplanted only 12.

''They let me sit and sit at home in bed for four years. I thought I was going to die," said Irvine, choking back tears. ''To be honest, most of my friends are dead. I watched them die one by one. They kept on telling us, 'It's soon, it's soon.' "

Federal officials said yesterday, after seeing the Times story, that they would immediately stop paying for liver transplants for Medicare recipients on UCI's waiting list. The move, by the US Centers for Medicare and Medicaid Services, means that many of the more than 100 patients still in the program will have to be transferred elsewhere.

Officials at the medical center told the Times the problems were due to staff shortages. The medical center in the city of Orange declined to answer questions.

By the time Irvine received her transplant, her liver had swelled to four times its size, and cysts on her diseased organs had started to burst. She broke her back in six places while lifting a casserole out the oven; she attributed the accident to four years of bedrest that had weakened her spine.

Irvine, a single mother of a 9-year-old son, sued UCI and found out that the hospital had turned down 95 organs -- 38 livers and 57 kidneys -- that could have been appropriate for her.

''I tried to find parents for my son. I made him tapes so he could remember me. It was a very tough time," said Irvine, who is now 51. ''He would be, like, 2 years old and I'm vomiting in the toilet and he'd rub my back and say, 'Mama, it'll be OK.' "

She settled with UCI this year for an undisclosed amount; her lawsuit prompted the federal review that revealed larger problems with the program.

The hospital said that the medical center has not had a full-time liver transplant surgeon since July 2004, although federal standards require that a surgeon be constantly available, the Times reported.

Dr. David Imagawa, who oversees UCI's liver transplant program, said a full-time transplant surgeon will join the hospital in early 2006.

''We agree that there were some problems, and we're moving forward to change them," Imagawa, who founded UCI's liver transplant program in 1994 and who left in 2002 before returning last summer, was quoted as saying in the Times.

Imagawa acknowledged that the hospital had made mistakes in Irvine's transplant case.

However, he also said that the organs that had been offered for her were ''not suitable for someone without a life-threatening emergency."

According to the federal review, UCI performed only eight transplants a year between 2002 and 2004 -- fewer than the federal requirement of 12 annually.

Just under 69 percent of the liver transplant patients survived for at least a year; this is below the 77 percent survival rate required for federal certification, the report said.

Despite the problems, the hospital maintained its accreditation from the United Network for Organ Sharing.

UCI Medical Center has faced two other major scandals in recent years.

In the mid-1990s, doctors stole patients' eggs and implanted them in infertile women who in some instances gave birth. The university paid almost $20 million to settle claims. In 1999, the facility fired the director of its donated cadaver program amid suspicions that he had sold spines to an Arizona research program.

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