Here's a post from a former UCLA anesthesiologist. Somewhat hidden in the post is another example of the same pattern I've noted before at the University of California: billing for things that were not actually done. In particular, there's this passage:

"the O.R. cut–off time for elective dental surgery at UCLA was 4 p.m.

Translated, that meant the patient had to be out of the room and in the recovery room by that time.

That was so everyone could go home by 5 p.m.

...

So part of my job was to inform them at 3 p.m. that they needed to finish up so I could wake the patient up and get her/him to recovery by 4 p.m.

Frequently this would result in abandonment of some crucial part of the procedure or a shortcut to get done in time."

(bolding and ellipse mine).

Just another data point.

Thoughts from Maryland about alleged fraud at the University of California, Davis.

JUST FOR FUN:

Roman Polanski has been in the news a lot lately. People have been wondering -- why now? What was the big change that led to extradition attemps now?

I think the big change that led to Polanki's extradition had nothing to do with Polanski. The Polanski extradition is a message to someone
My guess as to the intended recipient of that message? Marco Morales.

Update: OK, perhaps some of you don't know who Marco Morales is. Marco Morales was a Chicago contractor convicted of bribery in the Chicago Silver Shovel case. After conviction, Mr. Morales was to be transferred from custody in Illinois to federal custody in Michigan. The method of prisoner transfer apparently involved giving Mr. Morales a car in Illinois and telling him to drive himself from custody in Illinois to prison in Michigan.

Mr. Morales never showed up in Michigan. He next surfaced living freely in his home country of Mexico. While Mr. Morales was living in his new home in Mexico, Mr. Morale's young son was awarded 60 million dollars in consulting and contracting fees.

Also, Mr. Morales has been documented to state that he'd been threatened at gunpoint should he talk about the circumstances surrounding his bribery of Chicago officials.

It sounds to me like Mr. Morales knows something that people in Chicago don't want known. Further, it appears he's made a deal to keep his mouth shut, and that he's living up to his end of the deal. Were Mr. Morales to simply die / be killed, it's reasonable to believe that others who might have made similar deals would loose faith in their own deals. Therefore, it is in the best interests of whoever made a deal with Mr. Morales to ensure that Mr. Morales is visibly healthy and happy.

At the same time, whatever Chicago dealmaker apparently made this deal with Mr. Morales certainly has rivals. Every dealmaker in Chicago has rivals. It would be in the best interests of those rivals for Mr. Morales to talk. That way, the original dealmaker might be marginalized, and the rivals could seize the dealmaker's clout. Again, the rivals have no interest in the death of Mr. Morales. If he's dead, he can't talk about whatever it is he's being quiet about.

With Chicago having been considered for the Olympics, and with all the attendant spending, the rivalry among Chicago political factions was likely particularly intense. I think that one of the rivals came up with a plan to encourage Mr. Morales to talk at the direction of that rival. Since Mr. Morales is out of the USA and is apparently under the protection of whoever he made his deal with, the encouragement would have to be somewhat subtle. Such a plan might involve demonstrating to Mr. Morales the rival's ability to reach across international borders and arrange extradition / imprisonment for another fugitive who thought he was safe.

Roman Polanski was that other fugitive. While Chicago was preparing to gather vast sums of money through the Olympics, Mr. Polanski became an example of how US law enforcement can reach out to touch people abroad. As I wrote above, I think Mr. Polanski's fate was meant to encourage Mr. Morales to cooperate with someone.

As for who that "someone" might be -- what (possibly former) Chicago politician might have access to the levers of international power so as to reopen a thirty year old case, and might have an interest in scaring off rivals for the gigantic boodle that was to be part of the Chicago Olympics -- I leave that speculation to you.

This month seems to have had a surprisingly high number of stories in the news about child abuse. There's a few patterns there.



September 2009 marks the ten year anniversary of Janet Reno's appointment of John C. Danforth as a special prosecutor into possible federal misconduct in Waco Texas. The events surrounding that possible misconduct had been justified by Attorney General Reno with a (never substantiated) claim of child abuse in Waco. That possible misconduct led to actual harm to multiple children, as well as adults. Federal operations turned multiple children into this:

That picture illustrates, in my opinion, the ultimate in child abuse. The actions that led to the creation of that picture, including an armed raid on a peaceful home, use of incendiary devices against people hiding in a wooden structure, and more, were incontrovertibly committed by agents of the Federal Government.

Danforth's investigation essentially exonerated the federal government of any wrongdoing in the events that led to the generation of the picture like the one above (and many more such pictures besides). September 2009 also marks the 9th anniversary of the dismissal of a wrongful death suit brought by the survivors of the Waco massacre.

So: unproven allegations of child abuse were enough to launch a raid that resulted in the death and mutilation of "victims" and "perpetrators" of this child abuse. Actual child abuse -- the actual killing and burning of actual children -- was not sufficient to cause federal agents any serious embarrassment (the commander of federal operations at Waco, General Wesley Clark, would run for the Democratic Party Nomination for President after Waco) let alone criminal charges. The survivors of the events in Waco couldn't even get civil compensation for the killing and mutilation of their relatives and friends.

Just starting to get traction in the newspapers in September 2009 (the story actually broke August 28, 2009, very close to September) was the story of Jaycee Lee Dugard, kept as a sex slave for 18 years by Phillip Garrido and his wife, Nancy Garrido. From what I can tell of the story, Nancy Garrido was the breadwinner of the household, working for the government - funded Contra Costa ARC until 1998. So far, most of the coverage that I've seen focuses on Phillip Garrido, almost to the exclusion of his wife, Nancy. Historically, criminal women or criminal couples have not been exempted from coverage or opprobrium due to their gender -- think Bonnie and Clyde, or Ma Barker -- but Nancy Garrido has been referred to as a "victim" of Phillip Garrido, rather than a co-perpetrator, in some (not all) accounts in the press. Why the differential coverage?

On to September's next child abuse story. In September 2009, James O'Keefe and Hannah Giles uncovered multiple instances in which a federally funded agency, ACORN, enthusiastically offered support for the sex slavery of multiple underage girls in various cities around the country. That would certainly have been child abuse in my opinion. At this time, the only lawsuit that has been brought in this matter is the one against James O'Keefe and Hannah Giles for their role in uncovering these actions on the part of ACORN. Again, agents ("agents" used in this case in the sense of "a representative who acts on behalf of other persons or organizations") of the federal government appear to have been enthusiastic supporters of child abuse. The judicial system of the State of Maryland is, as I write this, engaged in proceedings against those who would uncover use of federal funds to support underage sex slavery.

The next child abuse story: In September of 2009, Roman Polanski was arrested by the Swiss after fleeing punishment for alleged child rape (Polanski had plea bargained down a rape charge, and had been convicted of unlawful sexual intercourse with a minor. He fled the country after serving less than half of an approximately 90 day sentence). As I write this, large segments of the US artistic and political classes are calling for the freeing of Polanski. It remains to be seen what the California and Federal governments -- after years of inaction -- do in this case.

Based on the path I've noted before in this blog, there might as well be a University of California element to this line of inquiry. In fact, I know of two University of California elements that could reasonably be dubbed "child abuse cases in the news in September."

Here's one, from the September LA TIMES: UCI settles a dozen fertility suits. Doctors at the school's Center for Reproductive Health were found to have stolen eggs or embryos for years and given them to other women. Two doctors involved fled the country to avoid prosecution. As described elsewhere on this blog, University of California personnel sold embryonic children for research, where they were presumably boiled for DNA extraction, sliced by microtomes for microscopy, and all the other elements of biological research. Boiling and slicing of embryonic children who were stolen from their parents could, in my opinion, reasonably be described as child abuse. Further, some of the survivors of that University of California clinic would now be young adults. The University has, thus far successfully, managed to keep both the public and the parents of these now young adults from learning their identity, or even their fate. In fact, the very existence of these children was a secret for approximately two decades, leaked to the press, and to their parents, only during the 2006 increased press attention due to the UC Irvine / UC San Diego sham liver transplant program.

This continued separation of children from their parents is, in my opinion, also possible child abuse. In my opinion, the University has been remarkably fastidious about keeping information about their children from the parents of these stolen young adults. The secrecy that the University continues to maintain regarding these children is particularly remarkable, in my opinion, given that many of the embryonic children from the same program were known to have been sold for medical research, that the University of California is known to have performed lethal research, with poor "consent" procedures, on other apparently unwitting young subjects and that the University has been cavalier about other medical information .

The ususal reasons for keeping the identity and fate of these children (now young adults) from their parents, and vice versa, don't seem to apply here. Whatever troublesome conflicts in parenting styles between the biological parents and the "adoptive parents" really should not be much of a problem for children who are now in their 20s. The biological parents did not sign away their parental rights to these children; they didn't even know of their children's existence until 2006.

I also keep in mind the fact that the University of California had at least one known extraordinary business arrangement with the Yakuza, namely running an expedited liver transplant program for Yakuza at UCLA. Of all the transplant operations in the world, the Yakuza apparently were most quickly able to arrange their transplants at UCLA when the time came that those transplants were needed. This suggests, in my opinion, that there may have been previous connections between Yakuza and the University of California. This may relate to the stolen children through this fact: Yakuza are alleged to use child pornography as a base of their income.

Finally, note that the University of California was home to at least two separate groups, at UCLA and at the University of California Irvine, which illegally sold human bodies to outside purchasers.

Given all of this, I shudder to think of the possible reasons that the University of California might be so motivated to have kept the very existence, and now the fate and identity, of these young adults under wraps. There have been no criminal proceedings in this case.

Lest one be tempted to depend on the courts to ensure oversight over the University of California in the context of child abuse, I present this story from the Orange County Register: Prominent doctor gets 30 days in jail for molestation. The prominent doctor in question was Dr. William Moore Thompson III, University of California surgeon for 40 years. Dr. Thompson allegedly molested at least one child under the age of 14 "on 15 to 20 occasions between May 24, 2003 and May 23, 2004," and allegedly violated another child at some point at least ten years ago. Dr. Thompson "pleaded guilty to two felony counts of lewd and lascivious conduct with a child under 14 years old, and one count of dissuading a witness from testimony." Dr. Thompson got 30 days in jail, as well as house arrest to precede the jail time.

The remarkable thing in Dr. Thompson's case, in my opinion, is not that he allegedly molested two children on multiple occasions. It is that a California court, apparently in recognition of Dr. Thompson's life's work (which, as above, apparently mainly consisted of 40 years as a University of California surgeon) gave him such a light sentence. According to the linked article, "Sentencing guidelines call for a three- to eight-year sentence in state prison for the crime" to which Dr. Thompson pleaded guilty. Clearly, something about Dr. Thompson caused the court to impose a sentence far outside the guidelines. My best guess is that something about Dr. Thompson is his long term status as a government agent, i.e. a University of California surgeon.

So, as the name of the blog says, I'm trying to make sense out of this. One thing that jumps to mind is that there appears to be an unholy (I haven't used the word "unholy" before on this blog, but somehow no other word appears correct) use of allegations of child abuse by government agents when it suits their purposes, and downplaying of actual abuse when government agents, or those in the political class, are the perpetrators. I'm still trying to figure out the nuances, but, based on stories from this month alone, at first glance, it looks bad. Really bad.

(this post slightly edited after initial posting)

Here's a story about ... well, about the same sort of life threatening events, and coverup of same that have become a staple of this blog. The linked story hits most of the main points, so I commend you there.

Update: Actually, on further read, the linked story does not address one of the elements of what appears to be the UC pattern in such cases. That element is aggressive management of public opinion, which may consist of slander regarding a concerned party.

Such apparent aggressive management of public opinion may have occurred in the case described below, in the form of Chancellor Reed's comments about the family of Sheri Sangji.

From my own contacts, I believe that such aggressive management of public opinion may be occurring at UCSF, in this case. I've heard that UCSF administrative personnel have been claiming that Dr. Kessler is not fit to be Dean because he "does not work well with others." Given that Dr. Kessler is apparently alleging significant financial improprieties at UCSF, "not working well" with the people there would, in my opinion, be expected.

addendum: for example, comments on this story by "surfs_up." In a story about the U. of California being audited after Dr. Kessler's allegations, we learn that the U. of California has already twice audited itself and found no financial improprieties, but that a subsequent audit by KPMG "stated it was not able to replicate the methodology used by the internal analysts for their reviews." There was apparently enough uncertainty about these audits that PWC has since been retained to perform another audit. Someone with what appears to be an insider opinion regarding Dr. Kessler rebuts that "[Kessler] is a master at crying foul and his wife's a big shot lawyer on the east coast who, lets just say does not have a stellar reputation."

And now, in the pump failure case, the comments to the Orange County Register story about the case contain evidence that the same aggressive management of public opinion is occurring. See comment 8, the one that begins "This is all about a disgruntled employee trying to avoid termination for misbehaving and now making up stories." Given the facts of the case as known, including the facts that the pumps in question had been recalled by the FDA, that apparently UCI kept its pumps despite the recall, that UCI had pump failures during testing that were so severe that just under 1/3 of the pumps had to be removed from service, and more, I think that the content of comment 8 is suspicious at best.

I think I've just documented another element of the pattern.

Press release from the California Department of Public Health:

SACRAMENTO – The California Department of Public Health (CDPH) announced today that 13 California hospitals have been assessed administrative penalties of $25,000 per violation after a determination that the facilities’ noncompliance with licensing requirements has caused, or was likely to cause, serious injury or death to patients.

There were 355 hospitals (nonfederal, short term, general, and specialty hospitals whose services and facilities were open to the public) in California in 2007, the latest year for which I have an accurate count. There are 5 main University of California medical centers. Of the 14 episodes of noncompliance with licensing requirements that "caused or [were] likely to cause serious injury or death to patients," four of those episodes were at University of California main medical centers. A fifth episode was at the Harbor-UCLA medical center, which, while not one of the main UC medical centers, is run by UCLA.

This means that the five main UC medical centers, in addition to Harbor-UCLA, were over 32 times more likely than all other California hospitals to generate an episode of "noncompliance with licensing requirements that caused or was likely to cause serious injury or death to patients." Something to keep in mind if you are hospitalized. Well, something to keep in mind if you want to live, anyway.

As a visual aid to the disproportion involved, here's one asterisk: *

compared to 32 asterisks: * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

If the one asterisk represents a chance that a California, but non UC, hospital generated an episode of "noncompliance with licensing requirements that caused or was likely to cause serious injury or death to patients," then the 32 asterisks represent the chance, based on the data above, that a UC hospital generated such an episode.

Further, of the institutions listed in the press release, the one with the largest history of penalties for such episodes of noncompliance was Harbor-UCLA (four such penalties so far). According to the press release, UC Irvine was the only institution to merit two such penalties in this reporting period. Wow.

addendum: well, if you die at UCLA, at least there's historical precedent for your still being involved in the process of commerce. A businessman accused of selling body parts from corpses donated to UCLA medical school in a scandal that tarnished the reputation of the university's willed body program was found guilty today in Los Angeles Superior Court of conspiring to commit grand theft, embezzlement and tax evasion.

Update 03/19/11 regarding the "willed body" scandal:" http://www.latimes.com/news/local/la-me-banks-20110319,0,6741888.column

Update 05/20/10: No University of California hospitals were on the California Department of Public Health most recent list of "hospitals [that] have been assessed administrative penalties after a determination that the facilities’ noncompliance with licensing requirements has caused, or was likely to cause, serious injury or death to patients." Good news. On the other hand, on (just about) the same day, the Federal Centers for Medicare and Medicaid Services announced two cases of "immediate jeopardy" at U. California, Irvine.

An interesting (though old) series about institutional punishment of whistleblower physicians.

I so want to retire this blog. I am tired of seeing the same patterns show up at the University of California (UCLA in this case). Elements of those patterns include:

1. "a culture of noncompliance with the law," (in this case, noncompliance with work safety rulings and OSHA findings)
2. refusal to address risks (in this case, apparently not warning their employee of the risk of her work, and not training her to ameliorate the risks)
3. billing for services not performed (government grant awards to run research labs generally include a section to fund proper training, which training was apparently not done)
4. and possible coverup (claiming safety training had occurred when there was no documentation of such training, when the putative trainee denied receiving such training, and when evidence strongly suggests that no one in the lab had received adequate training)

I am particularly disappointed when these patterns seem to directly cause the death of a 23 year old talented young lady. Ms. Sheri Sangji is only the latest victim of these patterns.

The lack of attention to safety at UCLA does not surprise me in the least. It's apparently routine for lab workers at both UCLA and UC Irvine (the two labs where I've had the most contact) to work without safety equipment in place.

When I was a resident at UCLA, the lack of attention to basic safety protocols for most people was evident. This lack of attention did not extend, of course, to higher ranking personnel. For example, I remember doing anesthesia cases on people who were having extremely bloody surgery done with power tools. Blood spattered well away from the surgical field, and it seemed to be in the air as well. While I was protected only by hospital-issued scrubs, gown, and paper facemask, the attendings either stayed only very briefly in the room (anesthesia attendings), or wore full "moon suits" with battery-powered respirators (surgical attendings). In fact, on the topic of differential safety precautions and infectious disease, I believe it is relevant to point out that one study showed that approximately 20% of low-level health care workers (nurses and residents) seroconverted for tuberculosis every year worked at the Harbor-UCLA ER, while almost none of the attendings did. Not that I'd want more attendings to seroconvert; it's just that seroconversion was obviously preventable for the attendings, and not for others. I think that's a relevant point to make in the context of Ms. Sangji's apparently preventable death.

I don't think that there's any significant American institution, other than the University of California, which could have caused a similar toll of death, ruined lives, large scale fraud, waste and abuse, as documented in this blog and elsewhere over the years, and not experienced at least a major reorganization or perhaps even faded from existence. And yet, the University of California keeps on keeping on.

Update from the LA Times: allegations of possible illegal lab procedures before the fire, and possible evidence tampering after the fire, as well as allegations of a "shoddy investigation." Who would have thought that a story about a 23 year old burning to death could possibly get sadder?

Another update from the LA Times: Cal/OSHA chief to oversee criminal investigation of fatal lab fire. That story contains this statement about Kevin Reed, UCLA Vice Chancellor for Legal Affairs "Reed also accused the family of sending Cal/OSHA a letter 'ghost-written by plaintiffs lawyers' in an 'effort to get some big judgment at the end of the rainbow here.'
Naveen Sangji, a Harvard medical student, told The Times that she wrote the letter."

So, just when I thought this story had reached the limits of reasonably believable tragedy, it just keeps on getting worse. Accusing the bereaved family of ghost writing in order to get a big judgment? I can imagine how that statement would play to a reasonable jury, if the case ever gets to trial. Besides, if those sort of accusations are what Chancellor Reed's states in public, then what is the likely tone of the conversations in the administrative suites overall? Based on Chancellor Reed's public statements, is it likely that safety concerns are paramount in those internal conversations in the UCLA administrative suites?

Update 03/13/10: The bounds of tragedy may have been breached, and UCLA may be well into criminal territory here. Serious lab accident at UCLA in 2007 was not reported. Not only was there a serious burn BEFORE Ms. Sangji was burned to death, but the previous serious burn was not reported to Cal/OSHA, and there are documented episodes of continued unsafe practices BEFORE and AFTER Ms. Sangji burned to death.

The failure to report the previous serious burn to Cal/OSHA suggests collusion by two different groups within UCLA. Firstly, UCLA, as the employer, is obligated by law to report serious workplace injuries to Cal/OSHA. Secondly, the doctors who attended to the burned patient would have been required by law to document that this case was a "reportable" (i.e. required to be reported to Cal/OSHA) case. A workplace burn that required hospitalization -- or, indeed, that required anything other than non-prescription treatment and a single follow up visit -- would have been required to be designated by the attending physician as something that would be required to be reported to Cal/OSHA.

The fact that the reporting was not done, even after an injury serious enough to require hospitalization ... well, it appears that the "culture of noncompliance with the law" is alive and well at the University of California.


Update 12/28/11: looks like criminal charges may actually be filed. UCLA calls these charges for events which led to Sangji's burning to death, "outrageous."

Update 7/28/12:

UC regents strike plea deal in UCLA chemistry lab death

Update on UC Irvine alum Dr. George Steven Kooshian: Doctor admits skimping on AIDS patients' meds. Dr. Kooshian allegedly sold saline, or dramatically diluted meds, to AIDS and hepatitis patients. This is a case in which payment was sought and received for goods and services not actually rendered.

That pattern has come up a lot in the news recounted on this blog.

Sentencing is apparently in May 2009.

UC admits misleading public about buyout-taker

Apparent fraud ... by the person responsible for "whistle-blower complaints and public records requests" at her campus, no less. The comments are interesting, in my opinion.

Incongruous headline of the day: do you think the headline to this story really gives the most accurate short version of the story?

And to give you a taste of the linked story, here's an excerpt:

"In a psychiatric seclusion unit, a patient complained to inspectors that she had urinated on sheets in her room because she couldn't communicate her need for a bathroom. The patient's medical record said she refused offers to go to the bathroom, which were made every two hours. Inspectors tested the audiovisual equipment that monitored patients in seclusion and found the video worked but the sound did not. When loose wires were found disconnected from the intercom, staff was unaware how long the equipment had been nonoperational, the report says"

Besides the obvious, you may wish to note the Orwelian overtones of referring to a room in which one is locked, alone, for an extended period of time, in which room one cannot be heard, but only watched at the convenience of those outside, as a "seclusion unit." The only thing that differentiates a psychiatric seclusion unit from the solitary confinement type of torture is careful and caring oversight of the inmates. UCI personell didn't even provide enough oversight to save the patient above from having to urinate on her sheets. In other words, it appears that UCI did not provide careful and caring oversight. Therefore ... well, the conclusion is obvious.

It's good, in my opinion, that Medicare is looking into these things. Once again, the University of California has been accepting payment for services (adequate monitoring of solitary patients in this case), and then apparently not providing the service. It's a pattern.

However, the question almost asks itself: where is law enforcement? In this particular case, the failure to provide the services which differentiate between "psychiatric seclusion unit" and "solitary confinement" suggest that abuse of a dependent person (the psychiatric patient in this case) may have occurred. What would it take to make UC administrators and staff actually perform the monitoring that they are paid to do? Would it take a death? In December 2005, a psychiatric patient with a known suicidal history was was monitored so ineffectively as an inpatient at UC Irvine that he managed to kill himself. So, it appears that death due to inadequate monitoring is not enough to justify adequate monitoring going forward, nor even to preclude disconnection of basic monitoring equipment. There may be a pattern here beyond financial irregularities, and that possible pattern should be investigated beyond the financial aspects.

The University of California "culture of noncompliance with the law" strikes again. From the SF Chronicle:

Activist group sues UC [the University of California], claiming illegal search.

(the search was of non-UC newspaper offices, no less)