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Witness testifies 'octomom' Nadya Suleman's fertility doctor improved treatment, recordkeeping

October 20, 2010 | 11:03 am

The Beverly Hills fertility doctor who helped Nadya Suleman conceive octuplets and six previous children Kamrava has since made efforts to improve his treatment and recordkeeping, a medical expert testified Wednesday.

Dr. Michael Kamrava could have his medical license revoked if it is determined he was grossly negligent in his treatment of Suleman, 35, and two other female patients.

One was a 48-year-old who suffered complications after she became pregnant with quadruplets and the other a 42-year-old diagnosed with advanced ovarian cancer after receiving fertility treatments.

Kamrava is expected to testify late Wednesday morning at a hearing before Administrative Law Judge Daniel Juarez. Suleman and the other two patients are not expected to testify, lawyers said.

Dr. Suraj Achar, associate professor of clinical medicine at UC San Diego School of Medicine, testified Wednesday as a character witness for Kamrava.

He noted that after a daylong visit to the fertility doctor’s office to review patient records (including Suleman’s), speak with staff and Kamrava, he found Kamrava to be “remorseful” and “contrite.”

Achar said that when he spoke with Kamrava, the doctor "discussed his strategies for trying to reduce the chance of multiple gestation with his patients in the future.”

Achar said that after Kamrava was accused of negligence in Suleman’s case, records showed he changed his patient consent forms to make clear he adheres to national guidelines limiting the number of embryos a doctor can implant.

Deputy Atty. Gen. Judith Alvarado asked whether Kamrava ever acknowledged that what he did to Suleman was wrong.

“In retrospect, he said it was wrong, that he felt bad about it and about the outcome,” Achar said.

Achar said the fertility specialist had also enrolled in the UC San Diego School of Medicine Physician Assessment and Clinical Education Program recordkeeping course.

The doctor said he did not review records of the other two patients included in the complaint, and he did not get consent from the patients whose records he randomly reviewed.

Alvarado attempted to have Achar disqualified as an expert, noting he practices family medicine, specializes in sports medicine and has never testified in a case involving in-vitro fertilization.

Juarez denied her request.

Kamrava's attorney, Henry Fenton, has said he had difficulty finding experts to testify on his client's behalf because of the publicity Suleman’s case received.

The sole witness for the state, Dr. Victor Y. Fujimoto, director of UC San Francisco's In Vitro Fertilization Program, testified Monday and Tuesday that Kamrava repeatedly failed to screen Suleman for mental health issues or to limit the number of embryos she had implanted or frozen.

He said Suleman's medical records show Kamrava used 16 of Suleman's eggs to create 14 embryos and implanted a dozen of them on July 19, 2008.

The babies were born nine weeks premature and remain the world's longest-living group of octuplets.

Fujimoto called the fertility treatments an "extreme departure" from the accepted standard of care established by the American Society for Reproductive Medicine.

National guidelines would have required Kamrava to implant no more than two embryos, ideally one, given Suleman's age and previous pregnancies.

Fujimoto also faulted Kamrava for implanting the 48-year-old patient who conceived quadruplets with seven embryos when he should have used no more than two, and for not doing a better job of screening the third patient for cancer, proceeding instead with fertility treatments.

Kamrava, who declined to comment Wednesday, has remained largely silent since the birth of Suleman's octuplets but defended his actions in a "Nightline" interview last year.

He said Suleman's case "was done the right way … under the circumstances."

-- Molly Hennessy-Fiske at the Junipero Serra state office building downtown

Photo: Dr. Michael Kamrava. Credit: Mark Boster / Los Angeles Times.