More scrutiny for UCLA's School of Medicine
In the wake of a whistleblower lawsuit, a new
study raises a red flag about universities'
financial ties to industry.

The $10-million, mid-trial settlement this week between
the UC system and the former head of orthopedic surgery
at UCLA has prompted a consumer group to seek an
independent investigation by California Atty. Gen.
Kamala Harris or Gov. Jerry Brown.
(Brian van der Brug, Los Angeles Times / April 25, 2014)

UC OKs paying surgeon $10 million in whistleblower-
retaliation case UC OKs paying surgeon $10 million in
whistleblower-retaliation case

By Chad Terhune
April 25, 2014

In the wake of a $10-million payout to a whistleblower,
UCLA's School of Medicine is drawing more scrutiny
over its financial ties to industry and the possibility
that they compromised patient care.

A new study in this month's Journal of the American
Medical Assn. raised a red flag generally about u
niversity officials such as
Eugene Washington,
the dean of UCLA's medical school who
also serves on the board of healthcare
giant Johnson & Johnson.

The world's biggest medical-products
maker paid Washington more than $260,000
in cash and stock last year as a company director.

"There are real risks here," said Walid Gellad,
assistant professor of medicine at the University
of Pittsburgh and co-author of the JAMA study.
"Are the policies in place enough to govern these
potential conflicts among the leadership of academic
medical centers?"

Meanwhile, the $10-million, mid-trial settlement this
week between the UC system and the former head
of orthopedic surgery at UCLA has prompted a
consumer group to seek an independent investigation
by California Atty. Gen. Kamala Harris or Gov. Jerry Brown.

In a 2012 lawsuit against UCLA and UC regents, Dr. Robert Pedowitz, 54, alleged that they
failed to act on his complaints about widespread conflicts of interest among the medical
school faculty and that they later retaliated against him for raising those concerns as a
whistleblower.

As department chairman, Pedowitz testified, he became concerned about colleagues who
had financial ties to medical-device makers or other companies that could unduly influence
their care of patients or research into new treatments.

University officials said they thoroughly investigated Pedowitz's claims and found no
wrongdoing and no evidence that patient care was jeopardized. UC regents said they agreed
to settle to avoid the time and expense of further litigation.

In a statement Friday, UCLA said Washington's work as a J&J director did not compromise
the "integrity of operations" at UCLA, and that his outside activities complied with university
policies.

"Dr. Washington has absolutely no oversight of purchasing decisions involving devices or
supplies," UCLA said. "Dr. Washington's board service provides significant benefits to both
UCLA and the wider field of medicine. As the only physician on the board, Dr. Washington
provides a frontline perspective on patient care and the needs of doctors."

Such ties between healthcare companies and physicians have drawn increasing attention
from government officials and patient advocates. Taking effect this fall is a provision of the
federal Affordable Care Act that requires public disclosure of financial relationships between
medical companies and doctors.

Consumer Watchdog, a Santa Monica advocacy group that asked for the state investigation,
said the troubling nature of Pedowitz's allegations and the large settlement amount warrant
further inquiry.

"It is apparent that UCLA's policies governing financial conflicts are either inadequate or
unenforced," Jamie Court, president of Consumer Watchdog, wrote in a letter sent to state
officials Thursday.

"Are the same failures happening at other hospitals in the UC system? Your independent
investigation is needed to ensure that patients are not harmed," he wrote.

Consumer Watchdog said the investigation also should determine whether oversight of UC's
relationships with medical companies should be taken away from university administrators
such as Washington and given instead to an independent monitor.

A spokesman for the attorney general said Harris is reviewing the consumer group's request.
He would not comment further.

Responding to the letter, UCLA said its "current policies and procedures represent best
practices that have continued to become stronger and more rigorous in recent years.... We
are always looking for ways to improve further."

In an interview last week, the chief compliance officer of the UCLA Health System said
Washington encouraged her to investigate Pedowitz's claims fully. Washington testified at
Pedowitz's trial, and his handling of the surgeon's allegations came up regularly.

The compliance officer, Marti Arvin, said industry relationships are unavoidable at
universities and that patients benefit from that collaboration.

"Having those relationships with industry is a component of allowing us to meet our mission
of leading-edge patient care, education and research," Arvin said.

Washington was reelected to J&J's board Thursday. The company said "we see absolutely
no financial conflict of interest with Dr. Washington serving on our board."

He wasn't alone among academic medical center officials who served on the boards of major
pharmaceutical companies in 2012, the year examined by researchers.

For instance, the dean of USC's School of Pharmacy, R. Pete Vanderveen, serves on the
board of Mylan Inc., a major drugmaker based in Canonsburg, Pa.

A spokeswoman for USC said the university has policies in place to manage potential
conflicts. But USC said that's "a moot point in this case because the School of Pharmacy has
no business relationship with Mylan."

The study found that 41 board members at large drug companies held leadership posts at
academic medical centers. Their average compensation for serving as a company director
was $312,564.

"These leaders are wearing two very important hats at the same time," said Gellad, the
study's co-author. "There are a lot of benefits from academic medical centers having
interactions with industry, but we can't ignore the risks."

chad.terhune@latimes.com
UC OKs paying surgeon $10 million in
whistleblower-retaliation case
The settlement ends a case brought
by the ex-head of UCLA's orthopedic
surgery department, who says the
medical school allowed doctors to
take industry payments that may
have compromised patient care.
By Chad Terhune
Los Angeles Times
April 22, 2014

University of California regents agreed to pay $10 million to the former chairman of UCLA's
orthopedic surgery department, who had alleged that the well-known medical school allowed
doctors to take industry payments that may have compromised patient care.

The settlement reached Tuesday in Los Angeles County Superior Court came just
before closing arguments were due to begin in a whistleblower-retaliation case
brought by Dr. Robert Pedowitz, 54, a surgeon who was recruited to UCLA in 2009
to run the orthopedic surgery department.

In 2012, the surgeon sued UCLA, the UC regents, fellow surgeons and senior university
officials, alleging they failed to act on his complaints about widespread conflicts of interest
and later retaliated against him for speaking up.

UCLA denied Pedowitz's allegations, and officials said they found no wrongdoing by faculty
and no evidence that patient care was jeopardized. But the UC system paid him anyway,
saying it wanted to avoid the "substantial expense and inconvenience" of further litigation.

As department chairman, Pedowitz testified, he became concerned about colleagues who
had financial ties to medical-device makers or other companies that could unduly influence
their care of patients or taint important medical research.

He also alleged that UCLA looked the other way because the university stood to benefit
financially from the success of medical products or drugs developed by its doctors.

One of the orthopedic surgeons that Pedowitz complained about testified at trial about
receiving $250,000 in consulting fees in 2008 from device maker Medtronic. In memos to
university officials, Pedowitz raised concerns about the financial dealings of other doctors
as well.

Inside the courtroom Tuesday, Pedowitz sat in the front row with his wife and daughter as
the judge told jurors that a settlement had been reached. He said he felt vindicated by the
outcome.

"These are serious issues that patients should be worried about," Pedowitz said in an
interview. "These problems exist in the broader medical system and they are not restricted
to UCLA."

The seven-week trial in downtown Los Angeles offered a rare glimpse into those potential
conflicts at a time when there is growing government scrutiny of industry payments to
doctors.

Starting this fall, the federal Physician Payments Sunshine Act, part of President Obama's
healthcare law, requires public disclosure of financial relationships between healthcare
companies and physicians.

Many doctors and universities defend long-standing industry arrangements as essential for
carrying out cutting-edge research and top-flight medical education.

In a statement Tuesday, the UC regents said they "resolved this lawsuit to end a prolonged
conflict and permit UCLA Health Sciences to refocus on its primary missions of teaching,
research, patient care and community engagement."

The statement added that "multiple investigations by university officials and independent
investigators concluded that conduct by faculty members was lawful. Patient care was not
compromised."

This latest settlement eclipses a $4.5-million payout the UC regents made last year to
resolve a racial discrimination lawsuit filed by another UCLA surgeon.

Pedowitz, as part of his settlement, left the UCLA faculty, effective Tuesday. He had agreed
to step down as department chairman in 2010 after initially voicing his concerns to top
UCLA officials. He filed a whistleblower retaliation complaint in March 2011.

Experts in medical ethics say the UCLA case shows much more
needs to be done within academia and by government regulators
to address potential conflicts of interest in medicine.

Susan Chimonas, associate director of research at Columbia University's Center on
Medicine as a Profession, said some medical schools are still reluctant to take on specialists
who bring in considerable money from patients, medical research and patents on
breakthrough products.

"Institutions can be dependent on the money these big-earning specialties like orthopedic
surgery bring in," Chimonas said. "They are the cash cows and they can set their terms.
This is not the first time I've heard of medical schools having policies that are not well
enforced."

In an interview last week, the chief compliance officer at the
UCLA Health System flatly rejected the notion that the university
didn't enforce its policies or look fully into Pedowitz's allegations.
She also said industry ties are unavoidable at a big medical school and rules are in place to
prevent conflicts.

"We have processes in place to identify those relationships in a transparent fashion and
ensure they don't have any inappropriate influence on the actions of the university," said
Marti Arvin, chief compliance officer. "In order to meet our mission, it is important we have
both the brilliant minds we have at UCLA and collaboration with industry."

Arvin said the university "thoroughly and objectively investigated those allegations of
noncompliance raised by Dr. Pedowitz. We were able to determine the vast majority were
unsubstantiated."

She said two doctors fell short of university expectations in their handling of outside income,
but there was no violation of law or university policy in either instance.

Arvin cited the case of Dr. Nick Shamie, the orthopedic surgeon who testified at trial about
receiving $250,000 from Medtronic for consulting work. She said department policy at the
time didn't require Shamie to send that outside income through UCLA's faculty
compensation plan.

At trial, Pedowitz said he was deeply troubled by the large amount of money Shamie was
paid. He testified that he was particularly concerned that Shamie was trying to enroll
patients in a research study involving Medtronic at the time.

"I saw this as an obvious problem," Pedowitz testified.

In court, Shamie said he abided by university policy and didn't pursue the study further
because finding patients was too difficult. He couldn't be reached for additional comment.

The other physician cited by Arvin for a potential shortcoming was Dr. David McAllister, vice
chairman of clinical operations for the orthopedic surgery department.

He didn't report payments from the Musculoskeletal Transplant Foundation, a nonprofit
tissue bank that does business with UCLA, because he didn't think disclosure was required
in that instance because it didn't involve a for-profit entity, Arvin said.

McAllister also declined to comment, referring a call to UCLA.

Shortly before Pedowitz joined UCLA in 2009, the university was already facing criticism
from Congress over the
failure of a top spine surgeon to report nearly
$460,000 in payments he received from Medtronic and other
medical companies while researching their products' use in
patients, government records show.

Dr. Jeffrey Wang, who left for USC Spine Center last fall, stepped
down as head of UCLA's spine program in 2009 after U.S. Sen.
Charles Grassley (R-Iowa) publicized his lapse in disclosure as
part of a larger investigation into medical conflicts of interest.

Several patients are now suing Wang and UCLA in state court for
negligence, fraud and malpractice in connection with surgeries
involving Medtronic's controversial Infuse bone graft.
UCLA said it
doesn't comment on pending litigation. Wang couldn't be reached for comment.

Shortly after raising his concerns, Pedowitz said, he was pressured to step down as
department chairman in 2010. Pedowitz said he was further retaliated against by being
denied patient referrals and prevented from participating in grants and other activities.

Before UCLA, Pedowitz worked at UC San Diego and as chairman of orthopedics and sports
medicine at the University of South Florida.

Mark Quigley, an attorney representing Pedowitz, said the case could have been avoided if
the UC system enforced the policies it already has in place.

"What good are all the policies if they protect the wrongdoers and
fail to protect the actual whistleblower?" Quigley said. "The
university wanted to cover it all up."
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UCSF
"What good are all the
policies if they protect
the wrongdoers and
fail to protect the
actual whistleblower?"
Quigley said. "The
university wanted to
cover it all up."
Dr. Robert Pedowitz
This case is just a small part of a larger problem at UCLA

"Shortly before Pedowitz joined UCLA in 2009,
the university was already facing criticism from Congress
over the
failure of a top spine surgeon to report nearly $460,000
in payments he received from Medtronic and other medical
companies while researching their products' use in patients,
government records show.

"Dr. Jeffrey Wang, who left for USC Spine Center last fall, stepped down as head of
UCLA's spine program in 2009 after U.S. Sen. Charles Grassley (R-Iowa) publicized
his lapse in disclosure as part of a larger investigation into medical conflicts of interest.

"Several patients are now suing Wang and UCLA in state court for negligence, fraud
and malpractice in connection with surgeries involving Medtronic's controversial Infuse
bone graft."

"...'What good are all the policies if they protect the wrongdoers and fail to protect the
actual whistleblower?' Quigley said. 'The university wanted to cover it all up.'"
A. Eugene Washington,
MD, MSc
Dean, David Geffen
School of Medicine
Vice Chancellor, UCLA Health
Sciences


[Maura Larkins' comment: Mr.
Washington's
involvement is
particularly dangerous
since he is in charge of
inculcating a culture of
greed and disregard for
many patients at one of
the country's premier
medical schools.]
Dr. A. Eugene
Washington to lead
UCLA Health Sciences
Mona Gable
January 21, 2010

Dr. A. Eugene Washington, an
internationally renowned
clinical investigator and health
policy scholar whose wide-
ranging research has been
instrumental in shaping
national health policy and
practice guidelines, will join
UCLA Feb. 1 as vice
chancellor of UCLA Health
Sciences and dean of the
David Geffen School of
Medicine.

Washington said he was
thrilled when he learned he’d
gotten the job. “The reaction
was elation, exclamation
point,” he said in a phone
interview. “I am honored that I
am being trusted by the UCLA
leadership and the selection
committee to lead this great
institution at this critical time.”

Known for his charismatic
leadership style, Washington
comes to UCLA after a long
and distinguished career at
the University of California San
Francisco (UCSF), where he
has served since 2004 as
executive vice chancellor,
provost and professor of
gynecology, epidemiology and
health policy.

A 1976 graduate of the UCSF
School of Medicine,
Washington completed
graduate studies at both UC
Berkeley and Harvard schools
of public health and residency
training at Stanford University.
He worked for the Centers for
Disease Control and
Prevention before joining the
faculty at UCSF, where he co-
founded the Medical
Effectiveness Research
Center for Diverse
Populations. He also co-
founded the UCSF-Stanford
Evidence-based Practice
Center and, from 1996 to
2004, chaired the Department
of Obstetrics, Gynecology and
Reproductive Sciences.

Washington has amassed a
slew of honors and awards: He
is the UCSF School of
Medicine 1999 Alumnus of the
Year, the highest honor
awarded by the Alumni-Faculty
Association. The UCSF Martin
Luther King Jr. Award in 2002,
recognizing his extraordinary
efforts to promote campus
diversity. Induction into the
Gold-Headed Cane Society in
2006, for his significant
scholarly achievements.The
Outstanding Service Medal
from the U.S. Public Health
Service. And election to the
Institute of Medicine (IOM) of
the National Academy of
Sciences, where he serves on
the governing Council of IOM.
He also serves on the boards
of the Robert Wood Johnson
Foundation, the California
Wellness Foundation,
Common Sense Media, the
California HealthCare
Foundation and the
Congressionally-mandated
Scientific Management Review
Board of the National Institutes
of Health.

Encouraging, supportive …
and funny

Washington's colleagues and
peers have nothing but good
things to say about him: He’s
encouraging and supportive.
He’s collaborative and hands-
off, but deftly hands-on when
indicated. He loves mentoring
medical students, residents,
postdoctoral fellows and junior
faculty — deeply committed to
nurturing their professional
development.

[Maura Larkins'
comment: Sadly, Dr.
Washington and his
protégés have every
reason to laugh as
they are being
inducted into a culture
of greed and
disregard for many
patients.  It's a very
high class club Dr.
Washington is
presiding over.]

What’s more, he’s inspiring. He’
s funny.

“He is an extraordinarily
personable person,” said Dr.
Elena Fuentes-Afflick, vice
chair of the UCSF Department
of Pediatrics and chair of the
Academic Senate. She first
met Washington in 1994, when
she was a junior faculty
member, and he graciously
volunteered to mentor her. “He
loves meeting people, working
with people. He has this way of
bringing out the best in
people. He conveys the
confidence that you have the
skills and experience to do the
job that needs to be done.”

Over the last 15 years, Dr.
Nancy Adler, vice chair of the
UCSF Department of
Psychiatry and director of the
Center for Health and
Community, has worked with
Washington on a variety of
projects.

“He has a capacity to see
things in innovative ways and
to get people to work together
to do things," Adler said. "He’s
really a consensus builder.
Sometimes that can be waffly,
but his capacity to have a
strong vision and bring people
along to share in it, rather
than impose it on them, is what
characterizes him.”

A passion for health care

Washington views his UCLA
appointment as “an
outstanding fit, given my
interests and experiences and
from the perspective of it
providing me a new challenge.”

Nobel Prize laureate Dr. J.
Michael Bishop, who led UCSF
as chancellor through August
2009, said of him, “He has a
real passion for health care.
He’s well-known nationally…
and has served in very
substantial positions
internationally. At the same
time, he blends that with a
very deep and sophisticated
knowledge of the academic
mission of UCLA. I can’t
imagine a more perfect fit,
both as a scholar and a very
sophisticated health care
expert.”

In his new role as dean and
vice chancellor, Washington
intends to build on UCLA’s
success in educating the next
generation for practicing
medicine of the future,
creating new knowledge
through vigorous investigation,
delivering health care of the
highest quality and providing
public service that improves
the state of communities. He
noted that he is particularly
interested in improving quality
of life for faculty, staff and
trainees, fostering innovation
and collaboration across
campus, enhancing
organizational performance
and garnering new resources,
and strengthening and
expanding partnerships.

A native of Houston, Texas,
Washington’s view of medicine
as a social force for good
stemmed from his upbringing.
The youngest of five, he grew
up in a “very nurturing
community.” His father was a
minister, his mother a
homemaker, and they instilled
in Washington the values he
cherishes and lives by today.

“The two influences that have
shaped my life are high
expectations that I would excel
in school and even higher
expectations that I would use
my education to excel in public
service with the aim of
improving the lives of others,”
he said.

His deep commitment to
research across the  health
sciences — he has published
extensively in his major areas
of research, which include
prenatal genetic testing,
cervical cancer screening and
prevention, noncancerous
uterine conditions
management, reproductive
tract infections, quality of
health care and racial/ethnic
disparities in health outcomes
— will resonate at UCLA, one
of the world’s leading research
universities.

“He has always been
supportive of excellence in
research within both the UCSF
and broader research
communities,” noted UCSF’s
Elizabeth Blackburn, recipient
of the 2009 Nobel Prize in
Physiology or Medicine and
the Morris Herztein Professor
of Biology and Physiology in
the Department of
Biochemistry and Biophysics.

Part of what excites
Washington about coming to
UCLA is its international
presence and ability to shape
the future of health and
science. “I see that I’m joining
and leading an organization
with exceptional assets for
deepening its impact on the
health of local communities as
well as improving health
nationally and globally," he
said.

An experienced problem solver

“Gene brings an extraordinary
combination of skills that he
will adapt,” said Fuentes-
Afflick. “He hasn’t been at
UCLA, but he knows a lot
about the UC system. Times
like this, it will be helpful to
have someone who
understands the structure of it
and the strengths, but also the
limitations.”

At UCSF, Washington was a
noted problem solver. In 2005,
he co-chaired the
development of the university’
s first-ever, campus-wide
strategic plan.

“As chancellor,” recalled
Bishop, “I spent the first five
years of my 11-year tenure
getting us to mount a strategic
planning process. When Gene
took office, I found my man.”

The  two-year process
engaged thousands of faculty,
staff, students, alumni,
community members and other
campus stakeholders.

Blackburn, who served with
him on the Strategic Planning
Board, recalled, “He was a
superb chair — showing great
leadership through his
inclusiveness and vision.”

“Gene drove that process
relentlessly,” said Bishop.
“This was a big deal; 19,000
employees, a $3-billion budget
institution, which for the first
time in its history had an
explicit mission statement and
42 priorities arranged by the
leadership. It’s a model of its
kind, and Gene made it
happen.”

The resulting plan clearly
articulated strategic directions
for fulfilling UCSF’s mission of
advancing health worldwide,
from translating research
discoveries into improved
health to nurturing diversity
and promoting a supportive
work environment.

To listen, observe and
understand

Asked if he plans to launch a
similar effort at UCLA,
Washington said he first has
to do his homework. “My
highest priority is to engage
the UCLA community in the
broadest sense imaginable. I
will be spending time on
campus and off campus,
meeting with the many diverse
constituents connected to our
dynamic health sciences
enterprise. I will be listening
and observing and attempting
to understand more clearly our
opportunities and needs.”

Washington sees many
similarities between UCSF and
his new campus home.
Besides strong community
support and partnerships with
other institutions, both also
have “just exceptional people
who are not only remarkably
talented, but unfailingly
committed to higher calls of
improving human health, their
institutions and their
disciplines. I firmly believe that
it’s people that make great
institutions.”

Despite the financial
pressures facing the UC
system, both campuses share
another quality: an
unshakable determination to
be better. “I particularly
noticed this at UCLA,” said
Washington. “The question is
not just, 'How do we sustain
our current level of excellence
and achievement?' but 'How
do we elevate ourselves to the
next level?'”

Still, for all his wonderful
qualities, Washington does
have one trait that some might
be tempted to label a flaw: He
is universally known as an
extremely nice person.

“I think sometimes he doesn’t
get enough credit because he’
s so nice,” said Adler, who
recalled seeing Washington
calmly take over a chaotic
meeting in Washington, D.C.,
when the chair had a
meltdown. “By being nice, you’
re [often viewed as] not
decisive. That’s absolutely
wrong. He’s decisive and
visionary, and gets it done in a
much more collaborative way.”

“He’s got personal qualities
that make for a fine leader,”
said Bishop. “He’s extremely
gracious and affable, has a
heart of gold, a backbone of
steel. He’s a very highly
respected, beloved individual.

“The bottom line,” said Bishop,
“is UCLA is damn lucky to get
him.”
Dr. Eugene Washington, dean of medical school
UCLA pays $10 million to surgeon who was retaliated against
when he exposed doctors taking money from medical
companies

Patients say their health was harmed