Prescription for UCI

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.

UCI’s bone-marrow transplant division failed to meet standards set by the state’s Medi-Cal reimbursement program. It also couldn’t qualify for accreditation by a key agency or for participation in the national registry of donors, largely because it performed too few procedures.

Hospital administrators who run specialized programs such as transplant centers are sometimes caught in a Catch-22. When a new center opens, it is hard to attract patients, who tend to feel more comfortable with long-established centers. That means it’s difficult to perform enough procedures to meet the standards required by accrediting agencies. And not having accreditation means the center is likely to lose Medi-Cal funding -- which further cuts the number of patients. Of course, when this happens, it’s probably a sign that the new program was prompted more by a desire for prestige than by demand.

But there is no excusing the fabrication by hospital administrators at UCI. When they were asked by a reporter about the bone-marrow program last month, they said there were no problems, that it was downright “robust.” UCI too often shows more concern about looking good than in doing the right thing.

Its liver transplant program, which was forced to shut down in November, had even bigger problems than the bone-marrow center. Not only did it fail to meet accrediting standards, it had a lower-thanacceptable survival rate. For a long time, it lacked a full-time transplant surgeon and turned down numerous livers offered to its patients, sometimes because there was no surgeon to perform the operation. Yet hospital administrators misled state and federal regulators, saying they had hired a full-time surgeon even though he was available only part time. The hospital recruited new patients, never telling them about its shortcomings, even as it continued to reject livers offered to existing patients.

After its long string of scandals -- the theft of eggs and embryos from fertility patients, the illegal sale of cadaver parts, the improper billing of patients for experimental treatments -- it’s clear that UCI needs a firmer hand over its medical center. At a minimum, the University of California regents should appoint an overseer, answerable to the board rather than the university, to keep the hospital and medical school under continual audit. It will be a long time before UCI Medical Center can regain the trust of the public that has to pay its legal bills.