Who paid for those innovative and now discredited procedures performed by neurosurgeon Dr. J. Paul Muizelaar at the UC Davis Medical Center? How much did they pay and where did the money go?
In 2010 and 2011, before university officials issued a cease-and-desist order, Muizelaar and his colleague Dr. Rudolph Schrot opened the skulls of three terminally ill brain cancer patients and deliberately introduced bacteria into their open wounds. The neurosurgeons theorized that the procedure would trigger an immune response and prolong patients' lives. All three died.
The procedures were described as experimental by critics. UC Davis Medical Center officials insist they were "innovative and nonstandard, not experimental."
All parties agree that they were done without the proper clearance from medical center authorities or patients. In response, the university last year barred both doctors from performing research involving human subjects. Federal regulators who investigated their activities issued a 92-page report last week that faulted the medical center for its failure to properly oversee them.
The deficiencies were so severe, investigators wrote, that the UC Davis hospital "lacks the capacity to render adequate care to patients." That sweeping conclusion, based on the questionable activity of just two physicians, seems overly broad. Nonetheless, the medical center's missteps were clearly serious.
Since The Bee's Marjie Lundstrom started reporting about Muizelaar in July, the doctor has relinquished his position as chairman of the medical school's neurosurgery department. Last week, just before the federal investigative report was made public and as four new malpractice suits were filed against him triggering an internal peer review of those cases Muizelaar took a leave of absence.
What has not been disclosed: Who profited from Muizelaar's actions?
Public records show he was paid $859,000 in 2011, making him one of the highest paid individuals in the University of California system. Still, exactly how much income he or the university derived from the "innovative" procedures that are no longer allowed remains secret.
In the wake of the critical report from federal regulators, a 2008 civil lawsuit filed against Muizelaar by a fellow neurosurgeon deserves fresh scrutiny. All allegations were eventually dropped, but Dr. John Chang accused Muizelaar, Chang's supervisor at the time, of retaliation after Chang accused the university of "aiding and abetting the unlawful practice of medicine for the sole purpose of generating revenue from reimbursements by third party insurance carriers and from federal and state health care programs."
Chang called Muizelaar a "prolific biller."
"As a member of the UC Davis Medical Center staff," the lawsuit stated, "Dr. Muizelaar generates millions of dollars in hospital charges and professional fee components for the UC Davis Health System."
To what extent if any did Muizelaar's ability to generate "millions of dollars" in revenue explain the university hospital's lax oversight that federal regulators are now investigating? Was the university remiss in reining in Muizelaar because of financial considerations?
The dean of the UC Davis Medical School, Claire Pomeroy, announced last month that she was resigning. Muizelaar has taken a leave of absence but the investigation into his activities and the university's role in it is not likely to end, nor should it.