Stealing Dreams: A Fertility Clinic Scandal

Stealing Dreams: A Fertility Clinic Scandal

by Mary Dodge, Gilbert Geis
     
 

When three whistle-blowers informed authorities and the media in 1995 that doctors at the prestigious and lucrative Center for Reproductive Health — a fertility clinic operated by the University of California, Irvine (UCI) — were taking eggs from some women and implanting them into others without donor consent, a scandal unfolded that ended careers,

Overview

When three whistle-blowers informed authorities and the media in 1995 that doctors at the prestigious and lucrative Center for Reproductive Health — a fertility clinic operated by the University of California, Irvine (UCI) — were taking eggs from some women and implanting them into others without donor consent, a scandal unfolded that ended careers, destroyed reputations, and forever altered the lives of many families. This first incident of egg and embryo theft, as well as claims of insurance fraud, research misconduct, and misappropriation of funds, grabbed headlines around the world and was featured on television programs from Primetime to The Oprah Winfrey Show. By the time the scandal had subsided several years later, two of the clinic's preeminent physicians had fled the country to avoid prosecution, one doctor was convicted on criminal charges in a highly controversial trial, and UCI had paid over twenty million dollars to settle laws suits filed by former patients.

The full story behind the much-publicized case is unveiled for the first time in this riveting book. The authors untangle an intricate web of repeated cover-ups, scapegoats, evasions, self-interest, nastiness, and injustice. They scrutinize how a complex interplay of circumstances set the stage for wrongdoing at the clinic, reveal how the dramatic events were played out on both the public and legal battlefields, and examine the personal histories, motivations, and actions of the major players-the physicians, the whistle-blowers, the claimants, the lawyers, the various investigatory committees, the overzealous media, and UCI administrators.

Stealing Dreams provides an absorbing, evenhandedlook at the evolution of the fertility clinic scandal and illuminates the complex ethical, medical, and legal issues surrounding the largely unregulated field of reproductive medicine.

Editorial Reviews

Library Journal
Dodge (public affairs, Univ. of Colorado, Denver) and Geis (criminology, law, & society, Univ. of California, Irvine) explore the much-publicized scandal that broke in 1995 at the Center for Reproductive Health, a fertility clinic run by the University of California, Irvine (UCI). The book begins with a chronology of events revealing the insurance fraud, use of nonapproved fertility drugs, unconsented transfer of eggs, and other wrongdoing at the clinic. The authors interviewed major players in the scandal and reviewed newspaper and journal articles, court case transcripts, and some UCI documents. The result is an absorbing work that further details a case that has been featured on television programs such as Primetime and The Oprah Winfrey Show and brings to light some of the ethical and legal issues of reproductive medicine. Recommended for large public libraries.-Sarah Jent, Univ. of Louisville, KY Copyright 2003 Reed Business Information.
Kirkus Reviews
Detailed but dry account of malfeasance and witch hunts at the UC/Irvine’s fertility clinic. The early-1990s controversy reflects the challenges of new technologies like in vitro fertilization, state coauthors Dodge (Public Affairs/Univ. of Colorado, Denver) and Geis (Law/UC Irvine; Crimes of the Century, 1998, etc.). "It is also," they write, "a story replete with evasions, nastiness, and injustice." The authors begin in 1995, when traumatized couples came forward to claim that eggs stored at the clinic had been implanted in other women without their permission. Dodge and Geis then backtrack to the clinic’s 1986 hiring of prominent reproductive physician Ricardo Asch, whose accounting and record-keeping were soon questioned by subordinates. Conflicts between doctors and staff led to audits amid an atmosphere of distrust; in 1994, three clinic employees filed formal complaints with multiple fraud-related allegations. By the time the National Institutes of Health intervened, the situation had developed into a PR disaster. The authors convincingly argue, as many in the medical community did at the time, that UCI deliberately directed the scandal toward Asch and two Latin American colleagues, who were publicly tarred as greedy and remote. Asch and José Balmaceda fled to their home countries; Sergio Stone stayed and was seemingly prosecuted for the allegations against all three. Devoting long chapters to each doctor’s case, Dodge and Geis explore the ambiguities, arguing that the physicians were pilloried for behavior that was hardly unique. Alienation of civilian managers and poor record-keeping were common practices in the medical subculture, the authors assert, abetted in this instance byUCI’s lack of oversight until damage control was necessary. Dodge and Geis take a broad view, summarizing the scandal’s every stage and providing legalistic references that fill in the details without generating much suspense. Their tart analysis of the thorny field of contemporary reproductive science, however, is eye-opening and informative. More for students of clinical management and reproductive issues than general readers.

Product Details

ISBN-13:
9781555535858
Publisher:
Northeastern University Press
Publication date:
08/28/2003
Pages:
256
Product dimensions:
5.50(w) x 9.00(h) x 1.10(d)

Read an Excerpt

Stealing Dreams

A FERTILITY CLINIC SCANDAL
By Mary Dodge and Gilbert Geis

NORTHEASTERN UNIVERSITY PRESS

Copyright © 2003 Mary Dodge and Gilbert Geis
All right reserved.

ISBN: 1555535852


Chapter One


Three women employed at the medical center operated by the University of California, Irvine, after first seeking whistle-blower protection, informed authorities and the media that wrongdoing was afoot at the Center for Reproductive Health. The center was run by world-renowned fertility specialists. The most serious allegation was that the doctors were taking eggs from some patients and implanting them into others without the consent of the "donors." There also were claims of insurance fraud, research misconduct, and misappropriation of funds by the physicians.

Media coverage sought to pinpoint the villains and flesh out the story. An editor of the Orange County Register, the local newspaper, immediately (and accurately) saw the charges as an avenue to a Pulitzer Prize. University officials moved into action, creating a smoke screen to avoid charges of personal responsibility or inadequate oversight. The university's first move was to pay off the whistle-blowers with almost a million dollars as part of a settlement agreement that stipulated that they remain silent.

By the time the scandal had wound down several years later, the scene was strewn with destroyed reputations and careers, much of it the product of a process of scapegoating. Two of the doctors fled the country; the one who remained was convicted on criminal charges in a trial that at best can be called controversial. The fertility clinic story throws light on in vitro fertilization and other recently developed medical procedures for making babies. It also is a story replete with evasions, nastiness, and injustice.

John and Deborah Lynn Challender were the first to go public and in time they became the most outspoken of the slightly more than one hundred couples who believed that they had been duped and despoiled in the worst fertility clinic scandal in the annals of reproductive medicine. The Challenders were interviewed by Tom Brokaw, Oprah Winfrey, Maria Shriver, Maury Povich, Phil Donahue, Gordon Elliott, and others. Their story was translated into a third-rate television drama on Lifetime featuring Linda Lavin as a whistle-blower employed in the fertility clinic and Marilu Henner as Debbie Challender. Numerous popular magazines, including Redbook, Vogue, and People, provided sympathetic accounts of the Challenders' experience.

The Challenders had been patients at a medical facility run by the University of California, Irvine (UCI). The university chancellor, Laurel Lynn Wilkening, was a forty-eight-year-old planetary science scholar and rather new to the job, though she had been second in command at the University of Arizona and the University of Washington. Later she would say of the fertility clinic situation, "I have never encountered such depraved behavior on the part of faculty members in my entire life." The manner in which she dealt with the scandal may well have cost the chancellor her job; she resigned shortly before the mandatory five-year review of her stewardship, announcing somewhat gratuitously that she never again would serve as the head of a university.

Patients' reactions to the accusations of egg theft would be as searing as the chancellor's allegation that the doctors' behavior was "depraved." One patient labeled what had been done to her as "rape on a genetic level." In an odd contrast, while the fertility scandal was preoccupying the media, two UCI faculty members-one a physicist, the second a chemist-were awarded Nobel Prizes. The assistant executive vice chancellor attempted, with a notable absence of success, to smother the fertility clinic problems with the Nobel Prize blanket: "The fertility scandal," William Parker proclaimed, "was three jokers screwing around here for three years. The Nobel prizes was scholars working here for three decades."

The Challenders, the initial complainants, lived in a small house in Corona, California, an upper-middle-class city of about 55,000 residents, with the Temecula Mountains rising beyond their backyard. She is bubbly and gregarious, welcoming. He is more reserved-choosing his words carefully, appearing to be wary-but nonetheless polite. He gives the impression of a man not to be taken lightly, a man who speaks little, but when he does speak expects to be listened to and treated with respect.

Debbie Challender was born to Al and Betty Hager on the first of October in 1958 in Hawthorne, California, a Los Angeles suburb. Her father was an engineer at North American Rockwell. Her mother stayed at home and raised Debbie and her brother, born nine years earlier. Debbie attended Valley Christian, a nearby parochial school, and remains deeply devout. After high school, she qualified as a registered nurse at Cerritos College. She then went to work for Kaiser Permanente and, moving among different Kaiser sites, has been with the organization ever since, primarily as a pediatric nurse. Today she is a case manager in Kaiser's occupational medicine division at the Fontana, California, treatment center.

John is a native of Springfield, Ohio. His father was in charge of the motor pool at the Patterson Air Force Base in nearby Dayton; his mother worked as a cosmetologist. John moved to California in 1974, prodded by two weather-related incidents that occurred in close succession: first, his brother in California told him during a telephone conversation about taking a dip that day in the swimming pool; then John walked outside into the Ohio frost and found that someone unable to navigate on the ice and snow had crashed into his car.

The Challenders had met when John was managing and Debbie working at a Burger King outlet. She was only sixteen years old-he is ten years older-and it would be another four years before they were married, on June 23, 1979, in Orange, California. They set up house in Mira Loma and later moved to Riverside. There were some hard times: in 1987, John suffered a heart attack and lost the trucking company he owned. Seven years later the Challenders filed for bankruptcy, gave up the Riverside home, and moved to Corona. "I liked it there," says Debbie about Corona, almost invariably upbeat; John grants only that Corona was "a convenient place to live."

The couple first told their story about their experiences at the UCI fertility clinic during a June 6, 1995, press conference attended by nearly two hundred media representatives. The Challenders had taken their complaint to Theodore S. Wentworth, a Newport Beach attorney with thirty-two years' experience. Wentworth told them that the only way they would get the university's attention was to initiate a legal action, to mount "a monetary assault." That action could take any of three forms: the Challenders could file suit as John and Mary Doe; they could file suit under their own names; or they could elect the second option and take steps to see to it that the media paid attention to their case. "The media was a tool that we could use or we could be carried with the tide," John remembers being told by the attorney. John believes that the media representatives understood perfectly well that the situation provided a good match between the reporters' goals-to arouse public interest and sell newspapers-and those of the Challenders-to secure justice and compensation for what had been done to them.

Wentworth sent the Challenders to Anne Ready in Santa Monica, who runs Ready for Media, "the west coast's most experienced media strategy and training firm," so that she could prepare them to deal with print, radio, and television reporters. The aim of Ready's agency, she says, is "to level the playing field by teaching [those who come for help] the media rules and how to play the game." A key theme is that persons being interviewed should provide answers that direct the interviewers to themes that are of concern to the client, though not necessarily issues being raised by the questioner. Mock interview sessions often are arranged for people scheduled to appear on talk shows. Ready is vague about fees. Clients usually are seen for about three to four hours and the charge, she says, can range from "hundreds to thousands of dollars."

The Challenders were concerned, John remembers, that they would "muddle the message" and that people would say, "Look at that clown; he's scared to death." "Neither one of us wanted them to focus on the messenger," says John, "but on our message." In the three-hour session, Ready emphasized that "if you have a key point, keep it in your mind and be sure to repeat it again and again." She warned them to say things in short bursts: to create sound bites for the media. The Challenders were instructed "not to let the media lead you in a direction you don't want to go."

Wentworth later would be criticized for prepping his clients and trying to make them more media savvy. His defense, in a letter published in the Los Angeles Times, focuses on his view of his clients' inexperience and the need to prepare them for what lay ahead.

It was obvious when I filed suit, the media would put a huge number of cameras and reporters in the face of the uninitiated family coming forward to seek justice. It seemed a compassionate move on the part of caring counsel to assist a vulnerable client with the media. They might well have camped out in their front yard with searchlights trained on their home if they did not come forward.

"These were not acting lessons," Wentworth maintained. The Challenders needed to put their thoughts into short sentences and they needed to be able to talk on camera while listening to questions, sometimes through an earphone for satellite transmission. Wentworth thought he deserved praise, not condemnation: "Why criticize a thoughtful, considerate lawyer for adding some grace to the disgrace of a media frenzy, and the often callous questions posed to clients in a delicate but public matter?" A defense attorney insisted that Wentworth's tactic would have backfired if his clients had had to face a cross-examination, though it would never come to that. A sharp lawyer would tell the jury that the former patients "can't be that upset if they need to go to media school to learn how to act."

At the press conference, Wentworth announced that he had filed lawsuits on the Challenders' behalf against the university, the fertility clinic, and the three doctors who were partners in its operation: Ricardo H. Asch, José P. Balmaceda, and Sergio C. Stone. The suits alleged that the doctors had misappropriated the Challenders' eggs, embryos, or both and altered or destroyed evidence. The university, it was claimed, had failed to supervise the clinic properly and then had spent almost a million dollars to silence whistle-blowers who reported irregularities.

The Challenders said that they had learned of their problem in May 1995, when two newspaper reporters from the Orange County Register-a man and a woman-came to their house bringing photocopies of the Challenders' medical records. The records showed that eggs taken (harvested is the term used in the world of reproductive medicine) from Deborah had, without her permission, been implanted in other women. "We were devastated when we learned of this terrible thing," Deborah Challender said. Her lawyer, attuned to the world of short takes, dubbed the doctors' behavior "embryo piracy." He noted that three months earlier university investigators had uncovered five other confirmed or possible instances in which the clinic doctors had used human eggs without the consent of their owners. He believed that there were another half dozen or so cases, an estimate that would prove to be well off target, nowhere close to the more than one hundred that were settled, with about a third involving egg and embryo misappropriations.

The Challenders told the media that the color copy of the records they were shown by the reporters had their signatures in black ink with an "X" in blue ink written in the box indicating their consent to a donation of the eggs. They stoutly denied that they had-or ever would have-selected the donation option. Besides, the form was dated September 9, 1991, and Deborah did not have her own embryos implanted until two months later. She said that it was unthinkable that she would give away eggs or embryos before becoming pregnant herself.

The seemingly straightforward lament of the Challenders would not go unchallenged, though their obvious anguish about the apparent misuse of Debbie's eggs seems altogether genuine. Armchair investigators pointed out that the evidence of unconsented usage was hardly foolproof. Debbie had signed the form and now was claiming that the other-colored checkmark had been made subsequently by someone else. But why had she herself at the time she signed the document not checked the box that disallowed use of her eggs? Besides, it is not unreasonable that different pens came into use during the same interchange. Skeptics noted that the Challenders would have two children if the procedure was a success, that John Challender had undergone a serious health setback, and that Debbie might not under those circumstances want to conceive and raise a third child.

For his part, Asch, the doctor involved in the case, initially accepted the Challenders' position at face value and interpreted it in terms of a conspiracy theory: "I believe Mrs. Challender. I'm sure she's right. I'm sure she didn't mark the 'X' there, and I'm sure someone in the university, someone in the center who was trying to hurt me, trying to set me up, did that."

Several years later, Asch told a different story about the Challender mix-up and was adamant that their medical chart indicated their consent to donate. Asch portrays the couple's relationship as one in which John was uncaring and Debbie was cowering. "She didn't have the guts to recognize to him that she did consent to donation," he said. Asch claims that John rarely accompanied his wife to the clinic: "Her husband never came, never came, never was with his wife. I think the day of the procedure he didn't come to leave a specimen. I think she brought it with her. The guy never, never, ever showed up." Asch's impression of the Challenders contrasts sharply with the judgment of virtually all commentators on the case, who see them as true victims of unethical medical tactics. According to Asch, "The man never gave a shit about his wife. Those people are crazy. Those people are really crazy. They had twenty embryos frozen, something like that. They never asked for them." Asch, himself Jewish, also felt personally insulted when the Challenders showed concern that the eggs allegedly went to a Jewish couple: "These people, when they learned that the recipient of the egg was Jewish, they became crazy."

Continues...


Excerpted from Stealing Dreams by Mary Dodge and Gilbert Geis Copyright © 2003 by Mary Dodge and Gilbert Geis
Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Meet the Author

Mary Dodge is Assistant Professor in the Graduate School of Public Affairs at the University of Colorado, Denver. She is the coeditor (with Gilbert Geis) of Lessons in Criminology. Gilbert Geis is Professor Emeritus in the Department of Criminology, Law and Society, at the University of California, Irvine. He has written twenty-five books, including Crimes of the Century: From Leopold and Loeb to O.J. Simpson, also published by Northeastern University Press.

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