A Commentary on the Case of Ricardo Asch
In 1995, a scandal erupted at the Center for Reproductive Health at the University of
California, Irvine's Medical Center (UCIMC).
The accusations of mail fraud, tax evasion, and unconsented use of human ova were serious in nature,
though more than 10 years later few people actually know or understand what occurred at the clinic,
despite claims to the contrary. Patients, lawyers, state senators, and university administrators
quickly and publicly placed the blame for what went wrong on Doctors Ricardo Asch, Jose Balmaceda, and Sergio Stone
in order to self-aggrandize or deflect responsibility.
The rush to judgment precluded any opportunity for the physicians to adequately
engage in preparing or presenting information in their own defense. With
the certainty of imprisonment looming and the low probability of receiving
a fair trial, Asch and Balmaceda made the logical choice to leave the United
States in the best interest of their personal and profession lives before
the federal indictments were released. That federal prosecutors have chosen
to pursue extradition at this late date may represent pure folly and more
than likely is tinged with vindictiveness. In the case of Dr. Asch, the
effort to return him to the United States to stand trial is particularly
The Influence of Media Coverage
The odds that Asch would receive a fair trial are diminished by previous
and current media coverage that has tainted public opinion. The newspaper
and television coverage of the alleged fertility scandal was widespread,
though in-depth and unbiased perspectives were antithetical to the cause
that further spurred the anger dredged up in the court of public sentiment.
The Orange County Register, for example, saw the story as a means to a Pulitzer
Prize and published more than 230 articles on the subject in 1995 alone
(Dodge and Geis, 2003). Patients, who garnered a great deal of sympathy,
appeared on national syndicated shows; including, for example, Tom Brokaw,
Oprah Winfrey, Maria Shriver, Maury Povich, and Phil Donahue. Narrative
from the Oprah Winfrey clearly demonstrates the media created hysteria:
Her September 5, 1995 program began with a barrage of overblown rhetoric: ‘It
is an extraordinary tale, all the makings of a terrifying science-fiction
thriller.’ ‘Is it a high-tech baby kidnapping too bizarre and
horrifying to be real?’ she asked. Later in the program the story
became ‘unimaginable’ and the show’s presentation, notably
sketchy, was [incorrectly] heralded as ‘the first in-depth’ coverage
(Dodge & Geis, p. 15).
The case also became fodder for a third-rate television drama on Lifetime
that veered far from any factual data, despite the network's purchase of so-called "insider" stories.
The hyperbole surrounding the events at the University of California's Medical Center was designed
to arouse readers and promote circulation and television ratings-not discover the truth.
The University's Culpability
Over the past ten years, the UCIMC in Orange County, California has been
plagued with scandals, administrative battles, and bad press. Amid plans
to open a new $371 million hospital, calls for accountability among programs
and hospital personnel arose as a series of clinical catastrophes occurred;
partially attributable to a climate that put fiscal concerns over patient
care and promoted pervasive institutional deviance. In 1997, the Food and
Drug Administration discovered that a lab at UCI’s Chao Cancer Clinic
illegally charged patients and Medicare for experimental drugs and asked
for donations from patients who wanted to participate in clinical trials.
In 1998, Doctor Darryl See was forced to resign after allegations arose
that he improperly used patients’ blood samples and failed to follow
appropriate protocol in the treatment of laboratory animals. In 1999, the
director of the UCI’s Willed Body Program who handled donated cadavers
was fired for allegedly marketing body parts to other research institutes.
In 2004, Dr. Hoda Anton-Culver, a cancer researcher at the university, was
accused of mishandling $2.3 million in state and federal funding.
In 2005, the liver transplant program was halted after the withdrawal
of Medicare funding. An article in the Los Angeles Times reported
that 32 peopled died waiting for liver transplants, partly because doctors
had refused available organs—the program lacked a full-time transplant
surgeon. In 2006, questions also arose about the low number of kidney and
bone marrow transplants that appeared to threaten patient care.
Additionally, two primary physicians in cardiology were rebuked for not
having state licenses and appropriate board certifications. Allegations
of ethical lapses emerged in the department of anesthesiology along with
accusations of nepotism in hiring. Recently, Dr. Ralph Cygan, chief executive
of the hospital and medical school dean, Dr. Thomas C. Cesario resigned
their positions (events and timeline presented in Ornstein & Berthelsen,
Clearly, UCI failed to provide proper oversight to “ensure good
medical practice” in clinics under its purview and staffed by university
employees. When push came to shove rather than accept responsibility for
the series of unfortunate events, university administrators and lawyers
found individual scapegoats. The misdeeds of many, however, were overlooked
and only the physicians involved with the Center for Reproductive Health
were targeted for individual prosecution.
The federal indictment charged Asch with mail fraud that included issues
connected to insurance billing, egg transfers, and the distribution of an
unapproved drug into interstate commerce. Ironically, the accusations of
insurance fraud were peripheral to the case and represented a widespread
problem at the hospital. In fact, the billing practices handled by university
staff and administrators, not physicians, appeared to be standard operating
procedures. In the late 1990s, the University of California system paid
$22.5 million to Medicare after a federal investigation of billing errors
at all five teaching hospitals.
The report noted that a major issue was “whether medical faculty
inappropriately billed the government for care actually provided
by residents or doctors in training, person who are not eligible to bill
regarding the use of a non-FDA-approved drug were, by all accounts,
insignificant. The only hard evidence that could substantiate the
transfer of eggs without consent is DNA evidence that confirms the genetic
parents in suspected case—an unlikely legal scenario.
A California Court of Appeal, for example, rejected any attempt by a former
patient to obtain blood and DNA samples. The judge dismissed the
case after reviewing a donor/recipient list and declaration by a former
clinic biologist which he deemed to be hearsay. A case ruling that wisely
was based on the best interest of the children (Ofgang, 2002; Prato-Morrison
After his relocation, Dr. Asch began practicing in Mexico City until
he was detained by customs in Argentina. In the ten years during
his exile from the United States he has treated, quite successfully, scores
of patients who placed their trust in the physician, despite the accusations
and insinuations that continued to haunt his reputation. Internationally,
reputation flourished and he has continued to lecture worldwide
as a leader in the field of reproductive medicine.
His positive contributions have continued, despite the UCI ordeal, and
without apparent complaints by patients and peers. The need to bring Asch
to trial in the United States on mail fraud charges undermines the credibility
of federal prosecutors and represents an enormous waste of financial resources.
The contextual background of the case, abundant hearsay, and lack of documentation
regarding “who did what” at the Center for Reproductive Health
will certainly hinder justice and diminish the possibility that Ricardo
Asch will be treated fairly in the United States.
Dodge, M. & Geis, G. (2003). Stealing Dreams: A Fertility Clinic
Northeastern University Press.
Ofgang, K. (30 October, 2002). C.A. Rejects Bid by Couple Caught Up in UCI
Scandal to Determine Relationship with Children.” Metropolitan News.
Ornstein, C. & Berthelsen, C. (17 February, 2006). “UCI Medical
Center Tried ‘Too Much’ - The Scandal-Plagued Orange Hospital had
Inadequate Resources to Match its Ambkitions, a Panel of Outside Investigators
MARY DODGE, Ph.D.
Graduate School of Public Affairs
University of Colorado at Denver & Health Sciences Center
GILBERT GEIS, Ph.D.
University of California, Irvine