Nadya Suleman's doctor is defended by colleague at medical board hearing

The Beverly Hills fertility doctor who assisted Nadya Suleman in conceiving octuplets in 2008 mostly followed "standard" procedure from the time he started treating her a decade earlier, according to a doctor who testified on his behalf Wednesday at a state medical board hearing.

Dr. Michael Kamrava's medical license could be revoked if it is determined that he was grossly negligent in his treatment of Suleman and two other female patients: a 48-year-old who suffered complications after she became pregnant with quadruplets and a 42-year-old diagnosed with advanced ovarian cancer after receiving fertility treatments.

Dr. Jeffery Steinberg, an Encino-based fertility specialist, testified Wednesday at a hearing held before Administrative Law Judge Daniel Juarez in downtown Los Angeles, the most recent in a series of hearings related to Kamrava's medical practices. 

Steinberg said he spoke with Kamrava and reviewed his records. He said he found the records justified Kamrava's aggressive treatment of Suleman because she had fertility problems and Kamrava had a low success rate at getting patients pregnant. Those aggressive treatments included implanting Suleman with six embryos in 2006, when she became pregnant with twins.

In January 2008, Kamrava implanted Suleman with eight embryos, a decision Steinberg said was unusual. Suleman did not become pregnant at the time, and Steinberg said there is no generally accepted standard for the number of embryos that should be implanted.

"He was trying very hard to help this woman get pregnant. I can't fault his judgment," Steinberg said. "I can question maybe how aggressive he can be, but again, I wasn't in the room with the patient."

In all, Kamrava helped Suleman conceive six children before the octuplets. He has testified that he recommended implanting four embryos in July 2008, or using embryos Suleman had already frozen, but she disagreed and he acquiesced to implanting 12 embryos.

Steinberg has not yet testified about Kamrava's decision to implant the dozen embryos.

But Steinberg, who has been practicing for 35 years and treats 200 to 480 patients annually, said many of his patients want to become pregnant with multiple babies in order to have large families.

"In our eyes, those embryos belong to the patients and they have to make decisions about them," Steinberg said.

Kamrava has said he counseled Suleman about reducing the number of fetuses and attempted to follow up with her after she became pregnant, but was unable to reach her.

"Fetal reduction remains as our safety net with in vitro fertilization," Steinberg said. "We counsel them in advance about options and alternatives and ways to manage, and that’s essentially what went on here.”

Three other doctors testified at hearings in the case last month.

Dr. Parviz Daniels, a general surgeon at Cedars-Sinai Medical Center, testified that he worked with Kamrava for years and "never heard anything negative" about him. Dr. Suraj Achar, associate professor of clinical medicine at the UC San Diego School of Medicine, conducted a daylong visit to the fertility doctor's office on short notice and described Kamrava as "remorseful."

But Dr. Victor Y. Fujimoto, director of UC San Francisco's in vitro fertilization program, testified for the state that Kamrava repeatedly failed to screen Suleman for mental health issues or limit the number of embryos she had implanted or frozen.

The state may present additional witnesses, followed by closing arguments, which are expected to start Thursday. Suleman and the other two patients are not expected to testify.

After Thursday's hearing, Judge Juarez is expected to submit his opinion to the state medical board, which will make the final decision about whether Kamrava can continue practicing medicine in California.

-- Molly Hennessy-Fiske

Photo: Dr. Michael Kamrava at a hearing before the state medical board last month in Los Angeles. Credit: Mark Boster / Los Angeles Times

Comments

[TheBigPicture]

Years after the fact...The State Medical Board...what a joke...

Nothing will happen to this guy...

[rene]

Easy don't take away his license ...have this clown pay to raise these kids from his salary

[Poucette]

When will there be an investigation on how Suleman paid for all these procedures? She was unemployed and on welfare when she had the many IVF treatments, which are very expensive. Were she and Kamrava involved in an egg-selling scheme?

[Peanut Santiago]

This "friend" of Doc Kamrava is a controversial doc himself, with his "designer babies."
*****One question: How does Doc Frank-n-Steinberg explain TWELVE embryos being implanted? No matter what the patient wanted or demanded! Jeez!

[Astonished]

One of the first things this "doctor" should have ensured is that she had the finances to raise these children. In this economy, "because I wanted them" shouldn't be a factor!

[Astonished]

"Steinberg said he spoke with Kamrava and reviewed his records. He said he found the records justified Kamrava's aggressive treatment of Suleman because she had fertility problems and Kamrava had a low success rate at getting patients pregnant. Those aggressive treatments included implanting Suleman with six embryos in 2006, when she became pregnant with twins." Oh yeah, those are really moral reasons! NOT!

[Jenna]

I hear both of these doctors saying that they have to do what the patient wants.
That's all well and good, but the big concern here is what is best for the babies, and we all know that high order multiple babies have "issues", to put it lightly. In my opinion what he and Nadya did is reckless endangerment of eight innocent babies. Eight counts of reckless endangerment. Guilty. Who cares what the mentally ill patient wanted?

[NoCalBarb]

Steinberg supports Kamrava's actions because "she (NS)had fertility problems"? Isn't that the usual reason people go to fertility doctors? Oh brother, puuuleeze! She already had 6 children with no means of support. That's still considered a fertility problem??? Maybe Kamrava needed to review the situation and change course. Is Steinberg as big of a quack or just has a god complex?

[NoCalBarb]

Steinberg said (under oath I presume) there is "no generally accepted standard for the number of embryos that should be implanted". Did he say that with a straight face? So all the other doctors in America are just misinformed and being old meanies? (including the group that booted Kamrava already) Maybe Steinberg should be watched more carefully if he is such a loose canon himself.

[taffey]

Kamrava's success rate is "MINUS", and the Steinberg's adverts suggest specification of sex from embryos and IVF - they both sound like a couple of SNAKE OIL salesmen from previous centuries selling nothing more than promises, but counting on each other for good PR for anticipated appointments. They are BOTH bogus, greedy, money and fame hungry a$$es IMO! They BOTH flip the "bird" at the guidelines and laugh and think all is okay - but it really isn't. Kamrava is BAD, and Steinberg is worse...NOBODY should ever go to them because IMO, they'll get fleeced and heart-broken with the results!!

[Joe Doe]

"Steinberg said there is no generally accepted standard for the number of embryos that should be implanted."

He said WHAT?? Hello! The whole reason Kamrava is on the chopping block is because he exceeded the standard for the number of embryos transferred! Steinburg is a member of ASRM . Has he not bothered to read the guidelines?

http://www.asrm.org/uploadedFiles/ASRM_Content/News_and_Publications/Practice_Guidelines/Guidelines_and_Minimum_Standards/Guidelines_on_number_of_embryos(1).pdf