Hundreds of women have trusted him with their bodies, and their dreams of motherhood. Many depend on him as their doctor today.
But for nearly seven years, none of Dr. Ben D. Ramaley’s patients have known that the prominent obstetrician/gynecologist had been accused of an almost unimaginable act — substituting his own sperm for that of a patient’s husband during an artificial insemination procedure.
The allegation was made against the veteran Greenwich, Conn., doctor in a 2005 medical malpractice lawsuit – which was quickly settled, then sealed, the very court documents shredded. The suit was filed by a couple when a DNA test revealed that the husband was not the biological father of their twin girls, born after an insemination procedure performed by Ramaley.
The state Department of Public Health investigated after the lawsuit, but did not order Ramaley to undergo a DNA test – even though state law appears to give the department authority to do so. Instead, in a consent agreement negotiated with Ramaley’s attorney, they fined the doctor $10,000 for “using the wrong man’s sperm” in the procedure and allowed him to keep an unrestricted license.
The lawsuit was settled before Ramaley had to answer questions. Through a letter from his attorney, Ramaley denied the accusation to the DPH during its investigation. Contacted this week outside his Southport clinic, he said he had no comment.
A DPH spokesman insisted the department did not have jurisdiction to ask Ramaley to submit to the test, which would determine the truth or falsity of the claim that he fathered the twins himself.
Greenwich Time obtained much of the state’s investigative file on the matter through a Freedom of Information Act request.
The case began in 2002 when a woman visited Ramaley, 61, at Brookside Greenwich Ob-Gyn Associates to have an intrauterine insemination performed. She brought a sample of her husband’s sperm and the hope that the treatment might help the couple get pregnant.
Nine months later, she gave birth to twin girls.
It should have been a joyous occasion, but the mixed-race couple quickly noticed something wasn’t right. The twins had a strikingly fair complexion that seemed impossible considering their father was black.
Their appearance was so uncharacteristic of the couple, in fact, that people frequently asked if the twins were adopted, according the lawsuit.
After several months of speculation and anxiety, the couple sought a paternity test in March 2004, and discovered that the husband was not the twins’ biological father.
The couple filed a lawsuit several months later. One count alleged that Ramaley, identified in the suit only as “Dr. Roe,” had not only used the wrong sperm, but intentionally used his own in an “extreme and outrageous” act.
“Upon information and belief, Dr. Roe intentionally inserted his own sperm into (the patient), causing (the patient) to become pregnant and give birth to children biologically fathered by Dr. Roe,” stated the lawsuit.
“Dr. Roe intentionally concealed that he had inseminated (the patient) with sperm from someone other than (her husband), despite the fact that he knew he had done so.”
The DPH, responsible for medical discipline in the state, launched an investigation of the suit’s claims in January 2007. In October 2007, an outside consultant from the American Board of Obstetrics and Gynecology was brought in to review Ramaley’s case.
The consultant, Dr. Robert Gfeller, a Hartford-area gynecologist, reviewed medical records, DNA results from the twins and the 2005 lawsuit complaint. He determined that Ramaley made serious errors.
“The matter speaks for itself as a violation of this Standard of Care when DNA analysis of the products of IUI conception (the twins) do NOT have the genetic DNA material of the intended father and that, therefore, the sperm of another male was used in the insemination,” Gfeller’s report stated.
Gfeller also found that Ramaley did not properly label sperm specimens and failed to have a system in place to keep track of his procedures.
“Chart recordings are scant in detail, hardly legible… there is no indication who performed” the procedure, the report goes on to say.
Gfeller found there was no record that Ramaley’s patient had signed an “informed consent form,” which all patients undergoing invasive procedures are required to sign.
Gfeller’s inquiry did not include any DNA testing of Dr. Ramalay, which would have resolved the allegation that he used his own sperm for the intrauterine insemination.
“No DNA testing is reported that gives credible, positive evidence” that Ramaley substituted his own sperm for that of the patient’s husband, wrote Gfeller – but the DHP never asked for such a test.
Gfeller did not return several calls for comment.
In November 2007, a nurse consultant employed by the Department of Public Health summarized the findings of the investigation, faulting Ramaley for five instances where the standard of care had not been met. The DHP drew no conclusions and found no deviation from the standard of care with respect to the central allegation that Ramaley used his own sperm.
Responding to the fact that DNA evidence showed the twins did not have the genetic material of their intended father, the nurse, Pamela Pelletier, wrote that it was a “gross and very serious violation of the standards of care.”
Also included in the state’s report was a letter from Ramaley’s lawyer denying the charges against him. “The allegation that Dr. Ramaley is the biological father of the twins is denied,” wrote attorney Steven Errante.
In 2008, Ramaley signed a consent order agreeing, while not admitting guilt, that he would not contest the allegation that he used the wrong sperm. The consent order makes no mention of the allegation that he used his own sperm, but simply states that Ramaley inseminated a patient with “the wrong man’s sperm.” He received a $10,000 fine and was allowed to continue practicing. Although the consent order stated he is no longer practicing intrauterine insemination, it does not explicitly bar him from doing so.
The DPH confirmed this week that Ramaley has an unrestricted license.
In March 2009, New York state entered into a consent order with Ramaley as well in the same case. In a settlement offer, they proposed to fine him $10,000, suspend his license for one year and place him under three years’ probation. Instead, Ramaley voluntarily surrendered his New York license, noting he had not practiced in the state for many years and never intended to again.
The New York investigation file is not public under state law, a DPH spokesman said.
When asked why the department never asked Ramaley to take a paternity test, state officials said they simply didn’t have the authority to do so.
“The department has no jurisdiction to order a respondent to undergo DNA testing,” the DPH statement said.
Officials said they attempted to contact the patient, through her attorney, but she was uncooperative, making them “unable to prove the identity of the father,” according to the DHP statement.
Health law and DNA experts disagree with the state’s assertions.
“The state does have the authority to order a medical examination and that would include a DNA test (of Ramaley),” said Professor W. John Thomas, the head of the Health Law Department at Quinnipiac University School of Law.
Thomas said a state statute makes it clear the department has full discretion to order any doctor under investigation to take a medical exam, the scope of which the department can determine.
Statute 20-13e (b) states that “the Department of Public Health may order the physician to submit to a physical or mental examination… The department may seek the advice of established medical organizations or licensed health professionals in determining the nature and scope of any diagnostic examinations.”
The statute also says a Superior Court judge can order the respondent to submit to medical testing if he or she refuses.
“The only appropriate inquiry would be to conduct a DNA test and the state had the authority to do that,” Thomas said.
Asked about the statute, the Health Department spokesman declined comment, saying the department typically does not comment on investigations at all, and didn’t want to engage in “a back and forth” on the issue of the law.
Dr. Michael Baird, who has decades of experience in the DNA testing field through his company DNA Diagnostics Center, said if Ramaley submitted to a DNA test now, it would most likely be very easy to compare his results with the DNA profile of the twins, which is on file with the DPH.
“If the same system was used today to test the doctor, you can make a comparison quite easily,” said Baird.
Alicia Craffey, Instructor in Genetics & Developmental Biology at UConn’s Health Center, also said there would be no need to retest the twins.
Craffey said it would be easy to tell “whether this person cannot be the father or whether this person has a 99.9 percent chance he is the father.”
Baird said if his company were to test Ramaley, they would take four swab samples from the inside of his cheek and have the results in about a day.
State health officials also believe there was no need to turn over the case to the Chief State’s Attorney’s Office or any other jurisdiction to investigate whether a crime had been committed.
“We had no known victim to report to agencies that deal with criminal activity,” the DPH said in the statement. “Although the investigation was unable to prove the identity of the father, the Board took disciplinary action within the scope of its regulatory responsibility and there was no evidence to support criminal intent.”
Todd Fernow, professor of law and director of the Criminal Law Clinic at the University of Connecticut School of Law, said it is unclear exactly what charges might apply if a doctor intentionally used the wrong sperm in an artificial insemination.
“Theoretically, non-consensual intercourse is all that is required to prove a sexual assault and there’s a legal definition of intercourse this plainly satisfies,” said Fernow.
Fernow said that intentionally using the wrong sperm might also fall under a lesser degree sexual assault charge, where there does not need to be an element of force or threat to the crime.
Fernow said there could also be a number of common law crimes a prosecutor could look at charging if a doctor intentionally used the wrong sperm in an artificial insemination. For instance, in a 1992 case in Virginia, a fertility doctor was convicted of fraud after prosecutors proved he intentionally deceived patients and fathered some of their children, according to published reports.
Fernow said there could be a recklessness claim against the state, if it was proven that a doctor committed such a crime, the state learned about it, and the doctor went on to do it again. Normally, the state is protected under sovereign immunity, but that can be challenged by seeking permission from a state tribunal, Fernow said.
Today, Ramaley, who lives on Lejeune Court in Greenwich, is a practicing physician at Southport Women’s Healthcare, located at 2600 Post Road in Southport, Conn. He is also affiliated with Bridgeport Hospital, a Yale New Haven institution that is under the same umbrella as Greenwich Hospital. Ramaley joined both practices in 2006, just after the lawsuit settled and the same year he left Greenwich. According to records, Ramaley resigned from his practice, Brookside Obstetrics and Gynecology Associates, on June 30, 2006. That same day, he requested a leave of absence from Greenwich Hospital.
Ramaley obtained his medical degree at the University of Illinois in 1973. He completed his obstetrics and gynecology internship training at St. Vincent Hospital in 1974 and residency training at Cornell Medical Center in 1978, according to his biography posted online. Ramaley went on to become a principal at Brookside Obstetrics and Gynecology Associates, building a successful practice.
Ramaley did face another malpractice lawsuit in 2001 that was settled. It did not relate to a fertility procedure.
Ramaley’s record on the Department of Public Health’s Practitioner License Verification Database does show that he has been disciplined. But the consent order in the case of the twins was not online in the department’s database last week.
Upon inquiry by Greenwich Time, health officials acknowledged the form was missing but could not explain why.
“The Department is in the process of determining why the system used to post all public discipline regarding license practitioners does not currently reflect Dr. Ramaley’s consent order,” according to a written statement.
For patient advocates, Ramaley’s story is a prime example of why increased transparency is needed in the state health care system.
“Times have changed and transparency needs to be paramount,” said Jean Rexford, executive director of the Connecticut Center for Patient Safety, an organization aiming to improve the quality of health care through advocacy and accountability.
“When you go into a physician’s office there will be a license on the wall,” Rexford said. “That license is a promise that the state has done its due diligence. If there is a back story the public does not know about, I think it does a disservice to the patient.”