Dr. Michael Kamrava

CALIFORNIA— The license of a fertility doctor has been revoked, as he helped Octomom Nadya Suleman in become the mother of 14 children through multiple repeated in vitro treatments, according to a decision made public by the state medical board on Wednesday.
The Medical Board of California said it was mandatory to revoke Dr. Michael Kamrava’s license in order to protect the public. The revocation will be effective from July 1.
The Beverly Hills fertility doctor acknowledged that he had implanted 12 embryos into Suleman, who was 33 then, before this pregnancy that produced her octuplets. This no. was six times the no. considered normal for a woman of her age.
It was recommended earlier to give Kamrava five years of probation but the board had rejected it to dole out the harsher punishment. The board now says that it was a mistake.
The board in its 45-page decision said that the evidence might not clearly establish Kamrava as a deviant physician, who is oblivious to standards of care in IVF practice, but it certainly demonstrated that he did not make a sound judgment when he decided to transfer twelve embryos into Suleman. Henry Fenton, Kamrava’s lawyer did not return phone calls when he was approached for a comment on the case.
In January 2009, Suleman gave birth to octuplets and puzzled the medical community and public as to how a doctor could have implanted so many embryos into one patient and how those babies could be carried to premature birth.
Fertility doctors generally avoid mega-births in their practice, as high number multiple births and the process involved in the same, can put the mother at risk of serious complications and death. Crowding can occur in the mother’s uterus which could also result in premature birth, developmental delays, cerebral palsy or other health problems in the babies.
Suleman’s octuplets are the world’s longest surviving set till date. At the time when they were born, the non working single mother already had six children who were also previously conceived through Kamrava’s treatments. She was living with her mother in a very small house that would soon be foreclosed on.
Suleman had praised about Kamrava’s care in her early interviews but she had put out a wrong claim of being implanted with six embryos, two of which had split up to become twins.
With a sobbing apology, Kamrava testified at his last year’s hearing that he did implant Suleman with 12 embryos because she insisted on the same. She had also consented to undergo fetal reduction if in case too many babies became viable.
To that defense, the board responded by writing that a fetal reduction procedure involves heavy risks, including the loss of entire pregnancy. To put the slightest of responsibility on a patient who elects to become pregnant and then opts out of the procedure that may jeopardize her prized objective is telling and troubling.
Kamrava said in the hearing, that before implanting 12 embryos, he had tried most conservative ways to help this woman become pregnant and also she wanted to have a big family.
Kamrava at the Oct. 21 hearing, wiped his tears and said that he was sorry for what happened and also that he wished he would have never done it. He added that it was a very risky and unhealthy pregnancy. She was lucky to have made it through, both for herself and the babies.
Kamrava said that after the treatment, months went by but he never heard from her, despite trying to contact her, several times. He said that Suleman contacted him again only after the babies were born.
The state said that a major factor in the decision to revoke his license was that he was also found negligent in the care of two other patients. So, this was a case of repeated negligent acts, the board decision read.
Kamrava had also implanted seven embryos, once, in a 48-year-old patient, which resulted in quadruplets. One fetus in that case had died before birth.
Kamrava said at the hearing that he had recommended four embryos only but the patient insisted on implanting seven.
Kamrava had gone ahead with in vitro fertilization in another case even after tests detected atypical cells, which indicates the presence of a tumor. The patient was eventually diagnosed with stage-three cancer and had to undergo a surgery to have her uterus and ovaries removed before she could take chemotherapy.
Kamrava said he thought of referring her to a gynecological oncologist but at the same time, since the news broke about Suleman’s octuplets, he got too distracted to follow up with the patient’s care.
A judge had recommended in February, that the board should put Kamrava on five years of probation, but the ultimate decision had to be taken by the board. The judge said that since Suleman’s case has witnessed much negative publicity, it was unlikely for Kamrava to make similar mistakes again.
The board disagreed with that assessment adamantly, stating that the doctor had already used an excuse for not being able to care properly for the fertility patient who by al means should have been referred to a cancer specialist.
Accordingly, the board does not think that relying on the public or media to fulfill board’s role of public protection is a sound policy, as stated in the decision reads.
Jennifer Simoes, Medical board spokeswoman said Kamrava had the right to petition for the board to reconsider the decision of revocation, but it’s not likely that the decision would be changed since the board chose to take its own call on Kamrava’s license instead of accepting a proposed decision.
Kamrava can petition for reinstatement after three years, as per law.

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