A lawyer for Dr. Milos Klvana told a jury Tuesday that the Valencia obstetrician is, "at worst," guilty of manslaughter, rather than second-degree murder in the deaths of eight infants and a fetus he treated in his clinics.
In his closing argument before a Los Angeles Superior Court jury, defense attorney Richard A. Leonard conceded that his client was a "terrible" practitioner of high-risk medicine, but did not know his shortcomings were deadly--knowledge that is a legal prerequisite for Klvana to be found guilty of murder.
"I'm not going to stand up here and tell you Dr. Klvana is Dr. Marcus Welby," Leonard said. "But he's not a murderer."
Klvana, 49, is on trial on nine counts of second-degree murder in the deaths, which occurred between 1982 and 1986.
The prosecution contends that Klvana caused the deaths by mismanaging high-risk pregnancies in which complications arose at his clinics. In each instance, Klvana failed to recommend hospital treatment when it became necessary, Deputy Dist. Atty. Brian R. Kelberg said.
Six of the nine deaths resulted from Klvana's misuse of Pitocin, a labor-inducing drug that expert witnesses have testified should only be used in hospitals equipped with the proper monitoring devices. Klvana's Valencia and Temple City clinics did not have such equipment.
Klvana is being prosecuted under the same legal theory as that used to obtain second-degree murder convictions against drunken drivers whose actions result in deaths. Under the theory, known as implied malice, a defendant can be convicted of murder if the prosecution proves the defendant knew his acts could cause someone's death.
Kelberg has maintained during the six-month trial that Klvana, who was trained in Czechoslovakia, was aware that he was incapable of handling risky medical situations because he had failed an obstetrics residency at a New York City hospital and because he was blamed for the death of a healthy patient during a subsequent residency in anesthesiology at Loma Linda University Medical Center in 1976.
The prosecutor said the babies' deaths further alerted Klvana to his inadequacies.
On Tuesday, Leonard acknowledged that Klvana was negligent in the nine deaths. But he suggested that Klvana's negligence was "at worst" manslaughter in five of the deaths. He said other people, including parents, were also blameworthy for the deaths.
He attacked doctors at Loma Linda for not reporting to medical authorities Klvana's poor record. He also noted that the state Board of Medical Quality Assurance reviewed several of Klvana's cases but took no action against his license.
In his rebuttal Tuesday, Kelberg noted that Judge Judith C. Chirlin had instructed the jury not to consider the acts of any others in determining whether Klvana had been criminally negligent.
The prosecutor also countered Leonard's point that doctors at Loma Linda, and elsewhere, should have reported Klvana's poor record. He said Loma Linda doctors had tried to steer Klvana away from high-risk medicine.
The prosecutor added that state medical board investigators "deserve lambasting," but alleged that Klvana had made it difficult for them to reach a proper conclusion because he lied to them.
During Kelberg's rebuttal, Klvana jumped to his feet and said: "I want to testify. This man is crazy."
While a bailiff forcibly escorted him from the courtroom, Klvana's wife, Svata, stood up in the spectators' area and also denounced Kelberg. Chirlin ordered her to leave.
Jury deliberations are expected to begin today. Conviction on a single count of second-degree murder carries a penalty of 15 years to life in prison.