At least 850 women in Southern California are being notified by letter that their physicians are being investigated for allegedly illegally obtaining contraceptives from unlicensed Internet- or Mexico-based vendors, state health officials said.
The contraceptive, known as an intrauterine device or IUD, is made of plastic or metal and is placed within the uterus. Though widely used worldwide, less than 1% of women who use contraceptives in the United States choose that method.
Doctors in California are required to buy IUDs from licensed distributors in the U.S.
"The physicians under investigation have failed to provide proper evidence that shows they purchased federally approved IUDs from FDA-approved sources," California public health officer Dr. Mark Horton said in a statement.
"Their safety and effectiveness are unknown," he wrote.
No specific health threat was identified Saturday. IUDs used abroad do "seem to be effective and safe in the countries they are used," said Dr. Susann Steinberg, another state health official.
Authorities ordered the eight physicians identified in the probe to send letters to all women who had received IUDs since Jan. 1, 2005, whether they were being treated in a state-funded program or not. Patients were advised to consult with a physician on whether to leave any unapproved IUD in place. Women who have already had such IUDs removed do not need to take any action.
Officials identified one physician, Dr. Hezekiah Moore of Long Beach, who they alleged has not agreed to notify his patients as directed. Health authorities are seeking to suspend Moore from receiving state money for providing care to the poor under Medi-Cal and the Family PACT program.
Because Moore has refused to send the letters, the state will send letters notifying the 52 patients in those programs.
Moore said he has been notifying his patients about the issue but objected to the state's request that he send a letter implying that he might have violated state and federal law.
Moore said that, as far as he knew, he purchased IUDs from a legitimate supplier and believed them to have been approved by the Food and Drug Administration. He said the IUDs he bought were identical to one health officials told him had been approved by the FDA and were made by the same New York manufacturer.
None of his patients have voiced complaints about the IUD, he said. State officials "have been putting pressure on me, trying to get me to say I knowingly did something wrong. I didn't knowingly do something wrong," Moore said.
Authorities declined to name the other seven physicians because they remain under investigation. They have offices in Alhambra, Downey, Glendale, Hemet, Los Angeles, Norwalk, Santa Ana and Van Nuys.
Health officials said their investigation was a result of a probe of Medi-Cal and Family PACT.
The cases are being referred to the state Justice Department, the FDA and the state medical board. Health officials said they were extending their probe across the state.