Tougher Disciplining of Doctors Sought : Medicine: Sen. Presley revives plan to overhaul state system. Case of Valencia doctor convicted of murdering nine babies is impetus behind proposal. : paginch,4.085i-4l,3

SACRAMENTO —  Flanked by a judge, prosecutor and juror who helped convict a Valencia obstetrician of murdering nine babies, a state senator renewed his fight Wednesday to toughen the state’s doctor disciplinary system that its critics charge contributed to the infant deaths.

Sen. Robert Presley (D-Riverside) said the case of Dr. Milos Klvana, a physician who was allowed to retain his license to practice even as he sat in jail accused of murder, spurred him to revive a legislative proposal to overhaul the system overseen by the California Medical Board.

Presley said that while his proposal is a slightly watered-down version of a bill he withdrew last month, he is considering strengthening it by adding provisions that would strip the doctor-dominated board of its power to investigate complaints. Instead, Presley said the investigatory authority would be vested in the Department of Justice headed by the state attorney general.

Presley’s latest proposal would also place new requirements on courts, coroners and hospitals to report doctors suspected of malpractice, empower administrative law judges to temporarily suspend physician licenses in egregious cases and streamline the disciplinary system.

Deputy Dist. Atty. Brian Kelberg of Los Angeles County said the Klvana case pinpointed the weaknesses in the system at the investigative level where an apparent lack of medical expertise and investigative prowess had allowed doctors like Klvana to escape discipline. He said many of the later baby deaths would have been prevented if the board had taken early action against Klvana.

“We need to make sure that investigations are done properly . . . (and) not to allow the worst kind of practitioner, a Dr. Klvana, to continue practicing and to continue killing babies and placing mothers at risk as well because of a structure which is simply not capable of protecting the public,” he said.

Taken by surprise by the introduction of the new legislation, Medical Board Executive Director Ken Wagstaff said he would not quarrel with the proposal to transfer the investigative function to the attorney general if it can be shown to be more efficient.

But, he said, it would be unfair and inaccurate to conclude only on the basis of the Klvana case that the medical board is ineffective and its investigative staff inept.

“Everyone has a case that goes bad on them as the (Los Angeles County) district attorney well knows,” he said. “They had a problem with the McMartin case but nobody is suggesting the district attorney’s office in Los Angeles should cease doing sex abuse prosecutions.” Ray Buckey and his mother, Peggy McMartin Buckey, were acquitted of child molestation charges in January after the longest and costliest criminal trial in history. The case was prosecuted by the Los Angeles County district attorney’s office

Wagstaff said the medical board takes “full blame for the early twists and turns in the case” when complaints that Klvana’s incompetence was causing the deaths of newborn babies were not adequately investigated. He said those responsible have since left the agency. In later years, he said the medical board put its investigation on hold so as not to interfere with the district attorney’s criminal investigation.

He said he has since corrected many of the problems in the disciplinary system which allowed Klvana to continue practicing in the face of a mounting number of complaints.

Wagstaff acknowledged that cases take too long to complete and that the board continues to have a backlog of investigations. He said the board is saddled with a cumbersome system of procedures and it lacks adequate staff to erase the backlog because low pay makes it difficult to attract the qualified and experienced investigators it needs.

“There is a legitimate concern that the whole process of going after dangerous doctors takes too damn long,” he said. “We agree with that.”

Klvana, who received his medical training in his native Czechoslovakia shortly before the 1968 Soviet occupation prompted him to flee to the United States, was convicted of second-degree murder last December after a 10-month trial in Los Angeles Superior Court.

Eight of the deaths involved newborn babies. The ninth involved a fetus. Prosecutors contended that in each case there were childbirth complications that Klvana lacked the medical skill to handle.

Prosecutors argued that Klvana tried to hide his bungling of high-risk deliveries by keeping his patients away from hospitals where his mistakes might be uncovered. In many of the cases, they said, referral to a hospital might have saved the baby’s life.

Outraged by the behavior of a doctor whom she described as putting his financial needs ahead of his patients’ well-being, Los Angeles Superior Court Judge Judith Chirlin sentenced Klvana to 53 years to life in state prison.

On Wednesday Chirlin, Kelberg and Jury Foreman Jaime Pulido stood beside Presley as he announced his new legislation to demonstrate their determination to play a role in reforming the system.

“Sending a doctor to prison without changing the system is not the solution,” said Pulido.

There was ample evidence throughout the trial, Chirlin said, that Klvana repeatedly hoodwinked medical board investigators and consultants when, with a minimum of checking, they could have found out that he was forging documents and doctoring medical charts.