"If you look at Klvana, you understand why there is a criminal sanction available," Kelberg said.
Maybe so, say physicians who defend Scott, but they say her case was in no way similar to Klvana's. There is room for disagreement over what she and her colleagues did, they say, but that is so in every complex medical case.
It is vital to distinguish, they say, between normal medical disagreements, the sort of gross negligence probed by the medical board and criminal negligence of the sort handled by prosecutors.
Throughout most of the investigation, Scott kept a low profile, and county and university administrators, to her dismay, remained mostly silent. But last year, when she decided to seek support from the wider medical community, it came fast and furious.
"I think when a surgeon who is well-trained and well-motivated gets into this kind of scrape . . . we rise up in defense," said Dr. Arthur E. Baue, former chairman of surgery at Yale University, who called the allegations "preposterous" and the probe "a witch hunt."
Committees of both the Society of Thoracic Surgeons and the Los Angeles County Medical Assn. independently reviewed medical records in the case and concluded the care met medical muster.
"The thing I'm concerned about is, if you have to guarantee success, then I can understand why surgeons would not want to be involved with the trauma patient" at all, said Claude H. Organ Jr., a professor of surgery at UC Davis and former chairman of the American Board of Surgery.
It was the medical board that came in for the most stinging criticism from Scott's advocates. It is the board's job to investigate medical quality issues, but it bowed to the district attorney, they said.
"The lack of courage of the medical board is amazing," Replogle said. "Somebody should have stepped in here and said, 'Wait a damn minute.' "
Medical Board Executive Director Ron Joseph, not the board's chief when the case first arose, declined to comment.
This year, after the board consulted with a wider array of experts and had a physician interview Scott, it dropped the accusations against Scott and Heard.
Still, the case did not die. The board tried to force the two doctors to take competency examinations. Both refused. Heard ultimately took the exam and passed. In August, the board notified Scott that she would not be required to take the test after all.
Scott has yet to be restored to her clinical duties and still is waiting to hear whether the county will pay to help her freshen up her surgical skills. But she hopes the worst is over.
"Most doctors when they get into a situation like this, they try to settle, they want it to go away. . . . I was not going to allow the D.A. and the medical board to push me into taking any position that would represent anything short of complete vindication."
