Even More Trouble in the OC: the UCI Bone Marrow Transplant Program

We have previously contrasted claims by the University of California (UC) that lavish salaries and benefits were needed to attract the best possible administrators with stories of mismanagement of the University of California - Irvine (UCI) medical center's liver transplant program.

New reports in the Organge County Register and Los Angeles Times suggest that yet another transplant program at the University of California - Irvine (UCI) is severely troubled.

The program performed fewer than the minimum number of transplants per year required by California state standards for 10 of the last 11 years. A state reviewer wrote in 2002, "given these persistently inadequate numbers, the correction action steps outlined in your letter to address your low numbers are vague and frankly, insufficient to ensure any confidence that you can effectively turn UCI's adult [bone marrow transplant] program around in a one-year time frame." UCI first claimed that people at the highest level, including the Dean of the Medical School, Thomas C Cesario, and hospital Chief Executive Officer (CEO) Dr Ralph Cygan were addressing the problems. Then, UCI withdrew from the Medi-Cal program. (Cygan is now on paid administrative leave after problems in the liver transplant program surfaced, as per this previous post.)

The bone marrow transplant program has suffered from a lack of leadership. Dr Winston Ho, its full time director, quit in 2002. Dr Henry Fung served only from 2003 to 2005. The current interim director, Dr Leonard Sender, is also full-time director of the cancer center at Children's Hospital of Orange County, and the amount of time he serves at UCI is unclear.

The staff of the program have turned over rapidly. No one from the original 1995 team is left. At least one staff member (out of eight) has left every year.

Nonetheless, the medical center has vigorously promoted the program. The Register noted that the UCI web-page advertised its "top-notch team at a state-of-the-art cancer center to provide the care needed by patients and family during this complex procedure." Also, "UCI's cancer center is renowned for its bone marrow transplant program." Furthermore, the web-page claimed that the transplant program is eligible to get donations from the National Marrow Donor Program registry. However, UCI is actually not part of that program.

The Times noted that "a spokeswoman for the medical center said last month in an interview that the marrow transplant program was fully functional. Asked if there were any problems with it, the spokeswoman, Susan Mancia, said, 'No, not that we're aware of. We have a really robust and viable program.' Mancia acknowledged Wednesday that here answer was misleading but said that was what doctors and university officials - whose names she couldn't remember - told her."

The evidence of mismanagement at UCI continues to mount, now coupled with suggestions of misleading marketing practices.

One member of the UC Board of Regents justified the pay and perks given to top managers as necessary to get the best people in the market. Instead, perhaps they got the people in the market most interested in lavish pay and perks, rather than the academic and clinical mission.