December 17, 2025 • 45 mins
Two former employees describe what they saw as the clinic unraveled. Their stories, and a look into public records, help piece together how CRH fell apart. Plus court documents reveal Dr. Vasquez’s version of events.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
We have like girls' night once once a month. We
get together and we get food and one time we've
did all of our nails. So it's like we get
to make fun of people that are pregnant sometimes, or
make fun of people who don't understand IVF a little bit.
So it's kind of like we use dark humor. We
also just laugh because that is the way you survive it.
Speaker 2 (00:21):
But it's been life saving. It's been absolutely life saving.
I mean, my husband's wonderful and he can listen to
me all day long, but at the end of the
day he cannot comprehend, whereas I can call you guys,
and you will spiral with me all the way down
and then bring me right back up, and that's what
I need.
Speaker 3 (00:39):
That's so we literally laugh and cry together.
Speaker 1 (00:41):
We just understand. We don't have to explain anything, Like
if we say this is how we're feeling, we understand
it completely.
Speaker 4 (00:49):
In August twenty twenty four, about four months after the
Center for Reproductive Health closed, I flew to Nashville to
meet with some of the former patients of the clinic,
so Sarah Davis and Penny co Sarah and Penny didn't
know each other, before all this happened, but they became
fast friends. They were in similar situations. Both had been
(01:11):
undergoing iuis at COH, not in vitro fertilization, so unlike
many former patients, neither had embryos in storage there, sparing
them the agony of wondering whether their genetic material was safe,
but that didn't make the experience any easier. Both women
still felt deeply violated by what had happened at the
(01:33):
clinic and were trying to figure out how to move forward.
I purposely planned my trip to coincide with the hearing
in the state's consumer protection case against doctor hime Vasquez
and the Center for Reproductive Health. I didn't know if
he'd show up, but I was hopeful I might be
able to meet him to get his side of the story.
(01:54):
I met up with Penny and Sarah before heading to
the courthouse.
Speaker 1 (01:58):
Oh do you like my earrings?
Speaker 5 (02:01):
You like my earring? Do you know what they are?
Speaker 2 (02:03):
Yes?
Speaker 1 (02:05):
I know, I'm like slightly rebellion.
Speaker 4 (02:07):
In honor of the court hearing, Penny was wearing special
earrings shaped like vulvas, handmade in shades of pink and cream,
with a pearl suspended in the middle. They were a
quiet act of protest, a statement that women's bodies and
healthcare should not be hidden away or shamed, but seen
and respected.
Speaker 1 (02:30):
Being in a red state, I just don't think women's
healthcare is where it should be. I think we're in
the top five for some of the worst women's healthcare.
Speaker 2 (02:37):
Most likely to die in the state we are if
you're pregnant.
Speaker 1 (02:39):
Which is terrifying. And I usually fall on the more
conservative side, but after all this, I'm like, no, I'm
falling more moderate, but I'm m advocating more on the
other side, which I don't like sides, but I would pick,
you know, women's healthcare.
Speaker 3 (02:55):
It's opened my eyes politically.
Speaker 4 (02:57):
Later that morning, we drove downtown the hearing and squeezed
into the elevator together.
Speaker 6 (03:03):
Oh my god, this is a.
Speaker 1 (03:04):
Very Did everybody wear deodorant?
Speaker 6 (03:10):
I can't cross, I'm not I'm sweaty. I wouldn't be
nervous to Sevasquez.
Speaker 7 (03:15):
I've never seen him before.
Speaker 6 (03:16):
You realized I've never met him.
Speaker 1 (03:18):
I've seen his name.
Speaker 4 (03:20):
Penny's offhand remark about having never met Vasquez revealed to
me in that moment how truly strange it was. The
person at the center of all this turmoil, who loomed
so large in their lives, was essentially a stranger. The
irony was the moment we exited the elevator we spotted
(03:41):
doctor Vasquez, though we didn't realize it right away.
Speaker 8 (03:45):
He looks just like that doctor.
Speaker 5 (03:47):
Same he.
Speaker 1 (03:50):
But it looks very similar now, she said, that's him.
Speaker 4 (03:55):
It was indeed, doctor Vazquez.
Speaker 7 (03:59):
Un left.
Speaker 4 (04:02):
He was in a blue shirt and striped tie, with
wire rimmed glasses perched slow on his nose, and he
looked weary as he entered the courtroom, surrounded by his lawyers.
We followed him in and took a seat at the
back where all the former patients sat. I watched him
during the proceedings, hoping for some sign of what he
(04:23):
was thinking or how he felt, but there was none.
So when the judge called a recess, I took my shot.
I approached him in the hallway and introduced myself, asking
for an interview. I could rupt this for one second.
I'm sorry, I just wanted to introduce myself.
Speaker 6 (04:38):
I'm Melissa Jelson.
Speaker 4 (04:40):
I'm a reporter and I'm working on a story about
this case. He didn't respond. His attorney spoke for him instead.
I just wanted to see if you wanted.
Speaker 7 (04:48):
To talk any of your No.
Speaker 1 (04:50):
Not right now?
Speaker 5 (04:50):
Is that? Yes?
Speaker 1 (04:52):
Yeah?
Speaker 4 (04:52):
And I'm working on a project that will take his
months in the making.
Speaker 6 (04:55):
You will obviously want to represent your position.
Speaker 7 (04:57):
If you can give me a court.
Speaker 5 (04:59):
Respond Thank you.
Speaker 4 (05:00):
So I did. Eventually hear back from his lawyer, but
doctor Vazgez, the man so many patients want answers from
who I want answers from declined to talk to me
directly to try to understand why his clinic shut down.
I'd have to do more digging. I'm Melissa Jelson from
(05:28):
School of Humans and iHeart podcasts. This is what happened
in Nashville Episode five, The Unraveling At its core, This
podcast is about the patients left reeling when the Center
for Reproductive Health suddenly closed its doors. The fallout touched
(05:51):
every part of their lives, their hopes for children, their savings,
their marriages, their families. But behind their stores es lies
a mystery. What went so wrong inside CRH? How does
a fertility clinic with decades of experience collapse overnight? And
if warning signs existed, why did no one act, especially
(06:15):
the man running it. Although doctor Vasquez declined to speak
to me directly, one of his lawyers, Dixie Cooper, agreed
to talk and we spoke on the phone for over
an hour. Though she didn't want me to use her audio. Still,
I was able to piece together Vazquez's account of the
circumstances surrounding the closure from my conversation with Cooper and
(06:36):
from court filings. What you'll hear next is parts of
a declaration he wrote explaining his version of events, and
other court documents read by a voice actor.
Speaker 9 (06:47):
The Center for Reproductive Hill was a family business from
its inception, with my wife Nancy stepping into serve as
a practice administrator. Within a year of the clinic company,
Missus Vaskus continued working at CRH four twenty years.
Speaker 4 (07:01):
Vasquez describes himself as a committed, hard working doctor who
ran a small business with his wife Nancy without any
significant issues for decades, and there's some evidence to suggest
that's mostly true. During the course of reporting this story,
I talked to over a dozen patients, all of whom
had good reasons for picking CRCH. Some were referred by
(07:25):
their doctors, others did their due diligence, reading as many
online reviews as they could, and some patients met with
doctors at different fertility clinics in Nashville and just felt
that CRCH was the best fit. As Vasquez tells it,
everything changed after twenty nineteen when his wife, Nancy stepped
(07:46):
down due to health problems and was later diagnosed with
Alzheimer's disease. Without her running the business side, Vazquez says
the clinics' finances began to decline. To keep the doors open,
he claimed he had to use his own money to
keep it Afloat Dixie Cooper told me that vascaz is
a very smart man, but not a good business person.
(08:10):
He was focused on patients, not on the money side
of things, and when financial problems did occur, he tried
to solve them himself.
Speaker 9 (08:19):
When c our Age experienced financial challenges, my wife and
I put a significant amount of time, energy, effort, and
our own money into the practice over the years, always
trying to ensure the best quality of treatment, continuity of
care for patients, and that employees will be pair family.
We incur personal debt into the form of our home
(08:40):
maquity loan and multiple other personal loans in order to
help see our age and the other affiliated businesses remain
financially stable.
Speaker 4 (08:48):
Doctor vaskaz said he stopped getting any form of compensation
from the clinic around mid August twenty twenty three.
Speaker 9 (08:55):
I chose to forego a salary for the entire time
from August twenty twenty three until the clinic was placing
into a core ordered receiveship on April twenty six, twenty
twenty four. I did this in and effort to preserve
the continuity of care for patients and to ensure that employees.
Speaker 4 (09:10):
Will be paid. He said he didn't realize the clinic
was so close to running out of money until his
daughter Elena, started looking closely at the books in April
twenty twenty four.
Speaker 9 (09:22):
Despite the employee as a medical director and working every
business day to make money to pay crh's obligations to
employees and onsite vendors, foroe going as salary was not
enough to financially stabilize CRH.
Speaker 4 (09:39):
Vazka has denied that any financial malfeasons on his behalf
had occurred. Instead, he blamed other more junior employees for
mismanaging funds.
Speaker 9 (09:50):
Former employees of CRH who I trust to be honest
and ethical in performing their jobs and in the management
of the money coming in to the practice. We're engaging
in an appropriate behavior that I learned about when the
practice had to seize business due to lack of funds
in April of twenty twenty four. Those actions include not
(10:11):
submtium bills for payments by insurance companies and self pay,
given unauthorized races to various individuals in the practice, and
taking unauthorized trips using the CRCH bredit card, all of
which contribute to CRH being unable to make payroll, resulting
in CRH having to close the practice.
Speaker 4 (10:32):
His lawyer, Dixie Cooper, repeated this in her interview with me,
claiming that several employees were intent on sabotaging the clinic
and taking Vascuz down. She told me that after the
clinic shut down, Vasquez's top priority was keeping the embryo safe.
She said he went into the clinic every day personally
(10:52):
checking the tanks and disputed the state inspectors claim that
he'd handled them improperly. More broadly, Cooper criticized the state's
lawsuit against Vasquez, claiming it included false and exaggerated allegations
against her client, inciting unnecessary panic. She also said that
in the days after the closure, Vazquez had been working
(11:15):
to find a local clinic to buy CRCH and take over,
but the deal was scuttled because the state froze Vasquez's
assets and installed a receiver despite my knowledge and experienced.
Speaker 9 (11:27):
Not only was I never consulted for guidance to expedite
the process, I was completely shut out of this practice,
with no access to my office space, the medical records,
or any other information located at CRCH.
Speaker 4 (11:40):
Cooper explained that after the receivership began, Vasquez and his
legal team lost access to the clinics records, leaving them
unable to verify details, challenged the state's claims, or properly
defend themselves. She also added that doctor Vasquez is deeply
sorry for what happened and wishes it had never occurred.
(12:03):
She said he even offered the state what little money
he had left to reimburse patients who paid for services
they didn't receive, but the state never responded. He has
since declared bankruptcy. In Cooper's telling, the whole situation is
a tragedy, one that's harmed both doctor Vazquez and his patients.
(12:24):
She argues that he's a well meaning, well intentioned professional
who just got in over his head due to the
actions of wayward employees. I wasn't sure what to make
of this. It felt a bit to me like passing
the buck. As the owner and medical director, Vazquez was
(12:45):
the one in charge. I wanted to see what his
former employees had to say, and I reached out to
more than a dozen of them, hoping to understand their
perspective and to learn more about how the clinic operated
in its final years, but most didn't respond. Letters and
emails went unanswered. Eventually, though, one woman agreed to talk
(13:08):
a former lab employee whom doctor Vasquez has accused of
trying to destroy his practice, and she tells a very
different story.
Speaker 5 (13:22):
I have actually gone through treatments myself to get my baby,
and so I know like how emotionally invested you can get.
Speaker 4 (13:34):
Marie began her job at the Center for Reproductive Health
in twenty twenty two. Because she still works in the industry,
she asked us to use a pseudonym. We've also modified
her voice to protect her identity.
Speaker 5 (13:46):
Society tells women that your job and your goal as
a woman is to be a mother, and I was
one of those people and that had that ingrained, and
so who was really frustrating to be like, well, my
body doesn't work on the way that it's supposed too.
Speaker 4 (14:00):
Marie was hired to work in the lab. It was
her first real job after getting her bachelor's degree in biochemistry,
and she was excited to learn the ropes.
Speaker 5 (14:11):
I worked in both parts of the lab, so andrology
and ebriology, and then I also did all the ordering
for the lab stuff. I also kept up with any
tracking that we needed to for inspections, so for both
cap FDA inspections, like any documentation or records, and then
(14:33):
when we did things like the genetic testing and the
PGT reports came back, I was typically the person who
called the patients with like their fertilization reports and stuff
like that.
Speaker 4 (14:44):
At first, Marie loved the job.
Speaker 5 (14:47):
Being able to help people like use science in such
a cool, a niche way that enables them to reach
their goals and dreams. In that way, it was great.
Speaker 4 (14:58):
The work was intense in the hour were long, but
Marie bonded with the other employees over the high stakes.
They were, after all, helping to create life.
Speaker 5 (15:09):
When we were in cycle, it was really stressful because
we had a lot of patients and a lot of
work to do. We spent a lot of late nights there,
like six seven o'clock at night. Was not uncommon to
leave when we had gotten there at like eight o'clock
in the morning. I remember one cycle ended up being
so big that we took shifts and people came in
(15:31):
in like four hour blocks. And then when we were
out of cycle, we did a lot of paperwork and
it was a lot more chill.
Speaker 4 (15:39):
The staff were genuinely close, lending a warmth to the
whole operation.
Speaker 5 (15:44):
We were a big family. We all had lunch in
the lunch room together. There were several employees who hung
out after work together in different groups. There were a
couple of medical assistants who ended up getting married who
had other employees like as bridesmaids in their wedding and
things like that.
Speaker 4 (16:06):
Marie told me she'd enjoyed the sense of community she
found at the clinic, but professionally it wasn't what she'd
hoped for. She'd expected hands on mentoring and real training,
but the place felt rudderless by the time she arrived
Vazkez's wife, Nancy, had already left, and Marie said no
(16:27):
one seemed to really be in charge. Staff were left
to manage the day to day on their own, with
little oversight or direction. Doctor Vazkez didn't seem especially interested
in teaching, she said, and there was no full time
senior embryologist on staff. When per diem embryologists came in
a few days each month for egg retrievals or embryo transfers,
(16:49):
Marie would pepper them with questions, trying to absorb as
much as she could before they left again. Most of
the time it felt like she was learning on her own.
Speaker 5 (16:59):
It was a lot of reading protocols and following Britain instructions.
I signed up for additional training and took some online courses.
The plan was to eventually be certified in both andrology
and embryology, and so those courses were like part of
that path towards it.
Speaker 4 (17:21):
After about a year and a half at the clinic,
Marie realized she could no longer work there. She felt
there was no room to grow professionally, and she says
she'd started to notice things that made her feel uneasy.
Patients being told inaccurate information about their embryos, staff stretched
too thin, and protocols that seemed to shift depending on
(17:41):
the day.
Speaker 5 (17:44):
The hour started getting later and later. You shouldn't be
working more than eight hours because your eyes are going
to get tired. You need, you know, those breaks so
that you can rest and recover. Make sure that you're
staying at your best so that you can give the
patients the best and most accurate care possible. We started
(18:05):
dropping witnessing, which was concerning.
Speaker 4 (18:09):
Marie said. The clinic had stopped consistently doing what's called
human witnessing, which is where a second person observes lab
procedures as quality control.
Speaker 5 (18:20):
Verifying that you are moving the right eggs into the
right dish for the right patient, and then when they
become embryos, that you're using the right sperm that they've
signed for.
Speaker 4 (18:31):
As she saw it, employees were overworked, some were doing
jobs they weren't trained for. To her, it reflected a
culture of cutting corners, a looseness with the rules that
made mistakes feel not just possible, but inevitable. I asked
her what it was like to be inside the clinic
at that point, believing it was starting to come apart
(18:55):
and knowing how much patients were counting on them. You,
as someone who went through Fertility Tree, would you have
been comfortable at that stage choosing Center for Reproductive Health
as your clinic.
Speaker 5 (19:06):
No, but I had insider knowledge and a lot of
that information wasn't available to patients on the outside.
Speaker 4 (19:16):
In early twenty twenty four, Marie put in her notice
and she wasn't the only one. A lot of other employees, also,
frustrated by the working conditions, were leaving.
Speaker 5 (19:28):
Towards the end, more and more people were starting to
put in their notices as well, and those positions weren't
being filled or replaced. The smaller clinic, you have a
person doing multiple positions, and so when one person leads,
it's essentially like five positions that you're trying to fill
but with one person, and then that's not being replaced.
(19:48):
And then there are multiple of these scenarios in different
aspects of the clinic, like on the laboratory side, on
the clinical side, on the financial side, all different sides
this was happening. It was like a Okay, there's not
going to be anybody left to hold this clinic up,
Like it's going to fall. We could see it coming,
and so if we could see it coming, then there's
(20:09):
no reason doctor Rascus didn't see it coming.
Speaker 4 (20:13):
In court documents, doctor vask has claimed that Marie was
one of the disgruntled employees responsible for the clinic's financial ruin.
She denied the allegations and said that she had no
responsibilities involving billing, insurance, or other financial matters. Doctor Vasquez
also accused her of organizing the staff against him by
(20:34):
encouraging them to quit their jobs. Marie told me that
she did advise some employees to resign before they got
themselves into ethically or legally dubious professional situations.
Speaker 5 (20:46):
There were a couple of people who I worked with
who when I found out that they weren't going to
interview or hire for my position, I was like, I
would recommend that y'all also leave so that you are
not like stock or trapped in doing a lot of
these things that you're not qualified or trained for. You
(21:06):
could potentially have negative repercussions for your career later down
the road.
Speaker 4 (21:14):
Another employee who put in their notice around the same
time as Marie was doctor Ferrara Dyer, who was hired
in twenty twenty. You may remember Dire from episode three.
He's the one who did his medical training in the
UK and was practicing at CRH as a fellow. Though
some patients I interviewed were under the impression he was
(21:35):
their licensed doctor, he agreed to speak with me on
the record with his attorney present. I asked him about
the patients I'd spoken to who felt like they hadn't
been treated with honesty. Here's what he said.
Speaker 8 (21:50):
The journey for fertility medicine is an emotional and as
long and as our joous and and stuff. I just
hope that patients don't get discouraged because they feel as
though something went wrong with their treatment and my involvement
in it, when I know that there was nothing wrong
with my treatment and involvement with their process.
Speaker 5 (22:12):
True to be.
Speaker 8 (22:12):
Told, Looking backwards, I think that we helped a lot
of people.
Speaker 4 (22:17):
Dyer told me that the entire reason he started working
at CRH was because doctor Vasquez had promised to help
him get his license. Except according to Dyer, Vasquez kept
pushing the goalposts, saying he needed to work as a
fellow for two years, then four, then five before Vasquez
(22:38):
would sponsor him.
Speaker 8 (22:39):
I go in with Vasquez March the first of twenty
twenty and by the time I get to March of
twenty twenty four, he says that I need to have
another year. So his threat to me was, I don't
believe that you have completed all the curriculum that would
show that you were proficient enough to be your own
(23:00):
reproductive and a chronologists. I want you to give me
another year. I'm going to pay you fellowship money, which
is not a lot of money, and then you still
will work for me, and then we'll go next year
to the state.
Speaker 4 (23:15):
As we explored in episode three, it's unclear how this
arrangement would have led to dire attaining licensure. Still, he
says that was his belief.
Speaker 8 (23:26):
Emotionally, it's sort of tough where you put in four years,
somebody gives you a promise and then you know that
they're going to renee go on the promise. Not to
say that you give up, but you sort of lose
the passion that you had for said clinic.
Speaker 4 (23:44):
I asked doctor Vazquez's attorney for more information about any
assistance he provided Tore in gaining licensure and to respond
to Diyer's claims, but didn't hear back. Dyer says that
beyond his waning confidence in Vazquez's promises, he was also
dealing with complications from type one diabetes. These factors combined
(24:06):
told him it was time to leave.
Speaker 8 (24:08):
That had started with renal failure, that had gone blind,
and then I due to diabetic rednopathy, which I actually
got corrected. So I wrote a letter of resignation in January,
and then I told him, hey, I'll stay until my
four years are up in March. And then at that
(24:29):
point he sort of stopped talking to me. I stopped
seeing his patients in late February, and then I had
to write up all of my charts and whatnot, and
I was out by March twenty ninth.
Speaker 4 (24:47):
Both Marie and Dire quit before the final stretch of
the clinics operation, when things really went downhill. I wasn't
able to speak to any employee about those last days
of practice, but I know that Vazkez hired a new
junior embryologist, Jasmine Bills, less than a month before the
clinic shut down. She described her experience at CRCH in
(25:11):
an affidavit which was filed in the state's consumer protection
case against the clinic. Here, a voice actor reads parts
of her statement.
Speaker 3 (25:20):
My dream job was to work in embryology.
Speaker 4 (25:23):
Jasmine said. Her training consisted of three to four days
at CRH, learning from an embryologist who worked on a
par deem basis at the clinic.
Speaker 3 (25:33):
My first official day at the center was March twenty fifth,
twenty twenty four. It seems like the staff didn't know
how to direct me for this position due to it
being outside their scope of practice. I started looking at
training manuals from the World Health Organization because I didn't
know what the best practices were. Although I was the
junior embryologist, the center didn't have a full time senior
(25:53):
embriologist on staff. I was never given a comprehensive overview
of lab safety procedures. I just picked things up from
the employees who were training me.
Speaker 4 (26:02):
It was Jasmine's job to analyze sperm samples and prepare
them for intra uterine insemination procedures. She was also responsible
for maintaining the cryogenic tanks.
Speaker 3 (26:14):
The alarms on the storage tanks go off if the
tank's liquid nitrogen levels fall below a certain threshold, and
if there isn't enough nitrogen the embryos in the genetic
material could start to thaw and become non viable. An
alarm company had a list of people to call if
the alarms went off, but I was told the staff
weren't sure who was on the alarm call list because
of all the staff turnover, and to my knowledge, I
(26:36):
was not on the storage tank alarm call list.
Speaker 4 (26:39):
Jasmine had only been officially working at the clinic for
less than two weeks when she, liked the rest of
the staff, got an email from doctor Vazquez's daughter, Elena,
saying that the staff would not be paid due to
lack of funds. She came into work the following day regardless.
Speaker 3 (26:57):
I asked doctor Vasquez what was going to happen with
the sinner and being paid, but he didn't respond. He
just looked at me. I decided to gather my things
and leave.
Speaker 4 (27:08):
Still, Jasmine says she decided to come back to the
shuttered clinic the following week to prepare some specimens for transfer,
including it seems Sydney's embryos.
Speaker 3 (27:19):
Before it became evident I was not going to be paid,
I'd accepted embryo and sperm transfers, and I felt morally
obligated to complete those transfer requests, even though it was
unlikely for me to get paid for that work.
Speaker 4 (27:31):
While at the closed clinic, she checked the liquid nitrogen
levels in the tanks. They were low, she wrote, though
they hadn't yet reached dangerous levels. She filled them up
before she left, but didn't mark it in the records
as she was no longer technically an employee. This was
the last time she set foot in the Center for
(27:52):
Reproductive Health.
Speaker 3 (27:53):
I never received any communication from doctor Basquez or any
other CICH administrators about when I would be paid. I
could not apply for unemployment because I never got a
paycheck from CICH. My first paycheck was supposed to be
on April fifth. I'm back working at the pharmacy I
was at previously, but in a lower position.
Speaker 4 (28:12):
According to Jasmine's affidavit, doctor Vasquez appeared to be confused
about the clinic's deteriorating situation. Her account was echoed by
several patients who were called being told that operations were
merely on hold or experiencing low volume, as if normalcy
would soon return. One patient, Jacqueline Locke, told me about
(28:36):
a zoom meeting she had with doctor Vasquez on April third,
twenty twenty four, the day before staff were notified there
were no remaining funds to cover their pay.
Speaker 6 (28:46):
The call with him was to kind of go over
what our next steps would be. I hopped on the
call with him after he was like at least two
hours late, and he had no idea what the purpose
of the call was. I was thinking that we were
getting some really helpful information that was going to help
us move forward and get to our goal.
Speaker 4 (29:10):
The call went on for an hour and a half.
Jacqueline told me she struggled to follow doctor Vasquez's train
of thought. She'd already done two egg retrievals with him
and was debating whether to try again. It wasn't a
simple choice. She lives in Canada, so another round meant
more flights for her, her husband and their small children,
(29:32):
more time away from work, more strain on her body,
and more money they didn't really have to spend. And
through it all, Vazquez never said a word about the
clinic's financial trouble or that it might not even be
open much longer.
Speaker 6 (29:48):
That makes me feel sick to my stomach. I really
don't understand what went on in his head.
Speaker 4 (29:58):
Doctor Vasquez tells the story as an abrupt fall, a
good clinic suddenly running into financial trouble. In his version,
everything changed when his wife left in twenty nineteen and
the business began to slip. But based on my reporting,
that's not entirely true. I dug into the public records
(30:19):
related to the clinic to get a glimpse at what
was happening behind the scenes. This ended up being fairly complicated,
as there's no one government agency that regulates fertility clinics.
I was able to get some reports from the Tennessee
Department of Health, which inspected the clinic every other year,
as well as reports from the FDA, which inspects clinics
(30:42):
that handle donated reproductive tissue, eggs, sperm, that kind of thing.
According to the Tennessee Department of Health, the clinic had
been cited for deficiencies at least twice in the years
before doctor Vasquez's wife left. In two thousand and seven,
state inspectors discovered that one of the clinic's nurses did
(31:03):
not have documented training for two tests that she'd been
routinely performing. They also noted a couple of instances where
the clinic was not adhering to recommended quality control testing practices.
In twenty ten, state inspectors found that the clinic had
been using an expired solution to test Seaman samples for
(31:25):
about a month and a half. This meant there was
no reliable way to confirm the test was working or
that any of the patient results from that period were accurate.
The Federal inspection records reveal more troubling observations. In twenty seventeen,
FDA inspectors found that the clinic wasn't properly screening or
(31:48):
evaluating donors for infectious diseases. For example, they learned that
the clinic did not test all egg donors for Zeka
as required. They also documented one case where an egg
donor had been treated for chlamydia but was not tested
to see if she had recovered prior to her donating.
(32:08):
The FDA noted that the clinic didn't have appropriate procedures
in place for how donor screening and eligibility decisions should
be done. This matters because donor screening is what protects
patients from using sperm or eggs that carry infectious diseases
or serious genetic conditions. In twenty nineteen and twenty twenty two,
(32:31):
FDA inspectors went back to the clinic and found similar issues,
donors not screened properly before allowing them to donate, and
inadequate paperwork documenting required testing. The FDA classified all three
inspections from twenty seventeen to twenty twenty two as VAI,
(32:51):
meaning voluntary action indicated, a category used when violations are
objectionable but the agency believes that the clinic can correct
them without formal enforcement action. About a month before the
clinic shut down in April twenty twenty four, the FDA
inspected once more. This time they discovered that some donor
(33:14):
files still contained patient's real names, a breach of privacy
rules meant to protect both donors and recipients. Over the years,
the deficiencies the state and FDA documented did not trigger
serious action. They were considered minor fixable, not enough to
(33:35):
cause urgent concern. But these shortcomings did at times trickle
down to the patient experience. As Peter Ricci and his
wife learned in their time at RH.
Speaker 7 (33:47):
The worst irony when it comes to our experience with
Centers for Reproductive Health is that our initial experiences were
actually very good.
Speaker 4 (33:56):
Peter is a thirty six year old writer and editor
and his wife first went to the Center for Reproductive
Health in twenty twenty two.
Speaker 7 (34:04):
My wife is an ovarian cancer survivor, so we knew
from when we started dating that we would have to
find alternate means to be parents, which is something we
both very much want to do.
Speaker 4 (34:18):
At the time, they were living in Nashville and were
drawn to doctor Vazquez's egg and embryo donation program called
American Embryo Adoption Agency or AEAA.
Speaker 7 (34:29):
We're really impressed with Center for Reproductive Health and the
number of egg donors they had, and our early interactions
with them were actually very encouraging.
Speaker 4 (34:42):
Their plan was to purchase donor eggs and use peter
sperm to create embryos for a surrogate.
Speaker 7 (34:48):
They had an extensive database we were able to look
through and see who we could potentially be matched with.
My wife is African Americans, so we liked that there
were black donors who we were able to consider because
we thought, ideally, will have a biracial child, then that
will match what a biological child of ours might have
(35:10):
looked like.
Speaker 4 (35:12):
In the summer of twenty twenty two, they obtained eight eggs.
Seven were successfully fertilized with peter sperm, but only one
developed into a healthy embryo. They were disappointed, but not deterred.
As a backup, they began considering the purchase of additional
donor embryos just in case they needed them.
Speaker 7 (35:33):
It was when my wife was looking back on the
CRCH database to see about purchasing embryos that she saw
the profile for the person whose eggs we had used
for our own creation, and she recognized the photo. She
could tell that it was the same person, but this
(35:54):
time around, there was a disclaimer on the profile that
they were a silent carrier for a spinal disorder.
Speaker 6 (36:05):
Ian.
Speaker 7 (36:05):
This was not something that was on the profile when
we considered it, and it was not something that they
had reached out to us to say.
Speaker 4 (36:15):
The egg donor Peter and his wife had used to
create an embryo was a silent carrier of alpha thalacemia,
a blood disorder, and spinal muscular atrophy, a genetic neuromuscular disease.
Peter's wife sent an email to CRCH asking for more information,
like why they were not told about the donor's status
(36:36):
when they purchased the eggs. The CICH employee who responded
said that the donor was not tested at the time.
It wasn't until quote much later that this information became available.
The disorders the donor carried were recessive. They would only
pose a risk if Peter was also a carrier, and
(36:56):
he wasn't, so they decided they would still move forward
with their one embryo. By this point, the couple had
moved to Chicago. They began the process of trying to
move the embryo from CRCH to their fertility clinic in Illinois.
Speaker 7 (37:12):
We're working with the new clinic and they begin going
through a rigorous process to evaluate that embryo. And it
was through that process that we learned a number of
things involved in the creation of an embryo, and then
the different things that were not done that CIH should
(37:35):
have done. For starters, there was no record of CRH
compiling what's called a summary of records. Now, what that
basically means is it's a summary of my healthcare information
relevant to embryo creation, so an easy list of things
(37:56):
for a clinic to look over and to say, Okay,
everything is good. They were unable to produce a summary
of records. They just weren't able to provide it.
Speaker 4 (38:10):
After extensive review, the Chicago clinic said it would not
accept the embryo for two reasons, one because it was
missing the summary of records, which meant they could not
confirm that CRCH followed FDA protocols, and two because the
egg donor was a silent carrier of a spinal condition.
In an email, the clinic noted that this second reason,
(38:33):
in particular, is their standard policy, one that it said
many IVF centers follow.
Speaker 7 (38:40):
It's quite devastating to get that far down the line
and then to realize, oh, we're unable to use the embryo.
You feel like a fool. When you're in these circumstances.
You think, why was I not asking these questions? Why
did I take their word for it? Why was I
(39:01):
not thinking ahead of what complications could arise. It's very
difficult to resist those thoughts and feelings when things goes
so horribly wrong.
Speaker 4 (39:17):
Peter and his wife decided to sue, arguing that CRH
had broken its contract. Online, the clinic had advertised that
it followed guidelines from the American Society for Reproductive Medicine,
the group that sets best practices for fertility clinics. Nationwide.
Those guidelines specifically call for genetic screening of egg donors
(39:38):
for conditions like cystic fibrosis, spinal muscular atrophy, and thalacemia,
but the donor they used turned out to be a
silent carrier for two of those very disorders. In an
email to Peter's wife, a staff member at CRH admitted
that they do not routinely run genetic tests on egg donors, said,
(40:00):
relying on family histories for known genetic conditions.
Speaker 7 (40:04):
That seemed pretty clear cut, Okay, breach of contract. They
claimed to be members of these different associations. They did
not follow these things. They made certain promises to us
when we agreed to work with them and signed contracts
for it. So we're going to file a lawsuit then
(40:26):
to have everything that we put in compensated.
Speaker 4 (40:31):
But it wasn't so clear cut. The clinic argued the
case could only be brought under Tennessee's healthcare liability law,
meaning that if the clinic won, the financial consequences for
the Richies would be severe.
Speaker 7 (40:46):
They were responding in such a way that if we
decided to take things to trial and they triumphed, so
we were not awarded damages and so on Tennessee law
allows them to then compel us to pay their legal
(41:07):
fees and expenses.
Speaker 4 (41:09):
Ultimately, that was not a risk they were willing to take.
They needed to save their money to pursue fertility treatments.
Speaker 7 (41:18):
We had to accept that the satisfaction of getting our
money back from what we had put in and them
admitting the wrong they had done, that it was not
going to happen. So we made the tough call to
voluntarily dismiss the case with prejudice.
Speaker 4 (41:39):
A month or two later, their lawyer reached out again
with some surprising news.
Speaker 7 (41:44):
Johnny calls me up and says, you are not going
to believe this. Crh's offices were just rated. Their finances
have been frozen. They are in absolute turmoil, and that
was when we saw then the floodgates open.
Speaker 4 (42:03):
Looking back, Peter said he noticed a lot of red
flags at CRCH. He described forgotten appointments, a lack of organization,
and what seemed to him like a casual attitude towards
the rules.
Speaker 7 (42:17):
There was a slowly creeping suspicion of dysfunction in the space,
and anyone is free to ask, well, why did you
keep going with them? And the simple answer is, you
get deeper and deeper into this process, it becomes harder
and harder to walk away, and you're not really in
(42:37):
the position to then stop and go somewhere else. They're
not giving you a refund if things do not work out.
Speaker 4 (42:47):
Peter and his wife are still feeling the fallout of
their time at CRCH. It's a struggle that since the
clinic's closure, they now share with other former patients.
Speaker 7 (42:58):
It's been the wildest of ex experiences of feeling isolated
and used and disregarded, and then learning that we're not
the only ones, that others have also experienced this, and
they have their own horror stories. You're not going into
(43:20):
fertility treatment from any position of strength, and it's a
uniquely vulnerable kind of healthcare, meaning fertility and creating new life.
Speaker 4 (43:33):
When I last spoke with Peter, more than three years
after he and his wife first walked in the door
of the Center for Reproductive Health, their fertility journey remained ongoing.
Speaker 7 (43:44):
We're still not parents, by the way.
Speaker 4 (43:50):
Next time, on the final episode of What Happened in Nashville,
the patients grapple with unanswerable question questions and the long
term consequences of crh's collapse. I immediately just started questioning everything.
I honestly thought, like, would my outcome have been different
(44:12):
had I gone somewhere else.
Speaker 2 (44:13):
I was so focused at a certain point on the
betrayal and the mistrust, and obviously that's never going to
go away, that's always going to be there.
Speaker 4 (44:23):
And the shortcomings of one clinic serve as a cautionary
tale for the industry at large.
Speaker 8 (44:29):
It has shaken my trust in healthcare and medical professionals.
Speaker 5 (44:34):
I don't trust that the industry is not out for
the profit.
Speaker 4 (44:37):
They see desperation and they see dollar signs.
Speaker 2 (44:41):
Patients are left in the dark to steal themselves against
the consequences of medicine when it goes awry.
Speaker 6 (44:50):
The question is how much regulation of those clinics do
we want?
Speaker 4 (45:00):
What Happened in Nashville is a production of School of
Humans and iHeart Podcasts, written, reported, and hosted by me
Melissa Jelson. Our producer is Etily's Perez. Our senior producer
is Amelia Brock, with additional production by Emily Seiner and
Carl Catle. Theme song by Jesse nice Swanger, Sound design,
(45:20):
scoring and mixing by Jeremy Thal and Jesse Ny Swanger.
Fact checking by Savannah Hugley and Austin Thompson. Our production
manager is Daisy Church. Voice acting by Tony Guerrero and
Taylor Church. Executive producers are Jason English, Virginia Prescott, Brandon Barr,
and Elsie Crowley. If you're enjoying the show, tell everyone
(45:42):
you know and don't forget to leave a rating in
your favorite podcast app
We have like girls' night once once a month. We
get together and we get food and one time we've
did all of our nails. So it's like we get
to make fun of people that are pregnant sometimes, or
make fun of people who don't understand IVF a little bit.
So it's kind of like we use dark humor. We
also just laugh because that is the way you survive it.
Speaker 2 (00:21):
But it's been life saving. It's been absolutely life saving.
I mean, my husband's wonderful and he can listen to
me all day long, but at the end of the
day he cannot comprehend, whereas I can call you guys,
and you will spiral with me all the way down
and then bring me right back up, and that's what
I need.
Speaker 3 (00:39):
That's so we literally laugh and cry together.
Speaker 1 (00:41):
We just understand. We don't have to explain anything, Like
if we say this is how we're feeling, we understand
it completely.
Speaker 4 (00:49):
In August twenty twenty four, about four months after the
Center for Reproductive Health closed, I flew to Nashville to
meet with some of the former patients of the clinic,
so Sarah Davis and Penny co Sarah and Penny didn't
know each other, before all this happened, but they became
fast friends. They were in similar situations. Both had been
(01:11):
undergoing iuis at COH, not in vitro fertilization, so unlike
many former patients, neither had embryos in storage there, sparing
them the agony of wondering whether their genetic material was safe,
but that didn't make the experience any easier. Both women
still felt deeply violated by what had happened at the
(01:33):
clinic and were trying to figure out how to move forward.
I purposely planned my trip to coincide with the hearing
in the state's consumer protection case against doctor hime Vasquez
and the Center for Reproductive Health. I didn't know if
he'd show up, but I was hopeful I might be
able to meet him to get his side of the story.
(01:54):
I met up with Penny and Sarah before heading to
the courthouse.
Speaker 1 (01:58):
Oh do you like my earrings?
Speaker 5 (02:01):
You like my earring? Do you know what they are?
Speaker 2 (02:03):
Yes?
Speaker 1 (02:05):
I know, I'm like slightly rebellion.
Speaker 4 (02:07):
In honor of the court hearing, Penny was wearing special
earrings shaped like vulvas, handmade in shades of pink and cream,
with a pearl suspended in the middle. They were a
quiet act of protest, a statement that women's bodies and
healthcare should not be hidden away or shamed, but seen
and respected.
Speaker 1 (02:30):
Being in a red state, I just don't think women's
healthcare is where it should be. I think we're in
the top five for some of the worst women's healthcare.
Speaker 2 (02:37):
Most likely to die in the state we are if
you're pregnant.
Speaker 1 (02:39):
Which is terrifying. And I usually fall on the more
conservative side, but after all this, I'm like, no, I'm
falling more moderate, but I'm m advocating more on the
other side, which I don't like sides, but I would pick,
you know, women's healthcare.
Speaker 3 (02:55):
It's opened my eyes politically.
Speaker 4 (02:57):
Later that morning, we drove downtown the hearing and squeezed
into the elevator together.
Speaker 6 (03:03):
Oh my god, this is a.
Speaker 1 (03:04):
Very Did everybody wear deodorant?
Speaker 6 (03:10):
I can't cross, I'm not I'm sweaty. I wouldn't be
nervous to Sevasquez.
Speaker 7 (03:15):
I've never seen him before.
Speaker 6 (03:16):
You realized I've never met him.
Speaker 1 (03:18):
I've seen his name.
Speaker 4 (03:20):
Penny's offhand remark about having never met Vasquez revealed to
me in that moment how truly strange it was. The
person at the center of all this turmoil, who loomed
so large in their lives, was essentially a stranger. The
irony was the moment we exited the elevator we spotted
(03:41):
doctor Vasquez, though we didn't realize it right away.
Speaker 8 (03:45):
He looks just like that doctor.
Speaker 5 (03:47):
Same he.
Speaker 1 (03:50):
But it looks very similar now, she said, that's him.
Speaker 4 (03:55):
It was indeed, doctor Vazquez.
Speaker 7 (03:59):
Un left.
Speaker 4 (04:02):
He was in a blue shirt and striped tie, with
wire rimmed glasses perched slow on his nose, and he
looked weary as he entered the courtroom, surrounded by his lawyers.
We followed him in and took a seat at the
back where all the former patients sat. I watched him
during the proceedings, hoping for some sign of what he
(04:23):
was thinking or how he felt, but there was none.
So when the judge called a recess, I took my shot.
I approached him in the hallway and introduced myself, asking
for an interview. I could rupt this for one second.
I'm sorry, I just wanted to introduce myself.
Speaker 6 (04:38):
I'm Melissa Jelson.
Speaker 4 (04:40):
I'm a reporter and I'm working on a story about
this case. He didn't respond. His attorney spoke for him instead.
I just wanted to see if you wanted.
Speaker 7 (04:48):
To talk any of your No.
Speaker 1 (04:50):
Not right now?
Speaker 5 (04:50):
Is that? Yes?
Speaker 1 (04:52):
Yeah?
Speaker 4 (04:52):
And I'm working on a project that will take his
months in the making.
Speaker 6 (04:55):
You will obviously want to represent your position.
Speaker 7 (04:57):
If you can give me a court.
Speaker 5 (04:59):
Respond Thank you.
Speaker 4 (05:00):
So I did. Eventually hear back from his lawyer, but
doctor Vazgez, the man so many patients want answers from
who I want answers from declined to talk to me
directly to try to understand why his clinic shut down.
I'd have to do more digging. I'm Melissa Jelson from
(05:28):
School of Humans and iHeart podcasts. This is what happened
in Nashville Episode five, The Unraveling At its core, This
podcast is about the patients left reeling when the Center
for Reproductive Health suddenly closed its doors. The fallout touched
(05:51):
every part of their lives, their hopes for children, their savings,
their marriages, their families. But behind their stores es lies
a mystery. What went so wrong inside CRH? How does
a fertility clinic with decades of experience collapse overnight? And
if warning signs existed, why did no one act, especially
(06:15):
the man running it. Although doctor Vasquez declined to speak
to me directly, one of his lawyers, Dixie Cooper, agreed
to talk and we spoke on the phone for over
an hour. Though she didn't want me to use her audio. Still,
I was able to piece together Vazquez's account of the
circumstances surrounding the closure from my conversation with Cooper and
(06:36):
from court filings. What you'll hear next is parts of
a declaration he wrote explaining his version of events, and
other court documents read by a voice actor.
Speaker 9 (06:47):
The Center for Reproductive Hill was a family business from
its inception, with my wife Nancy stepping into serve as
a practice administrator. Within a year of the clinic company,
Missus Vaskus continued working at CRH four twenty years.
Speaker 4 (07:01):
Vasquez describes himself as a committed, hard working doctor who
ran a small business with his wife Nancy without any
significant issues for decades, and there's some evidence to suggest
that's mostly true. During the course of reporting this story,
I talked to over a dozen patients, all of whom
had good reasons for picking CRCH. Some were referred by
(07:25):
their doctors, others did their due diligence, reading as many
online reviews as they could, and some patients met with
doctors at different fertility clinics in Nashville and just felt
that CRCH was the best fit. As Vasquez tells it,
everything changed after twenty nineteen when his wife, Nancy stepped
(07:46):
down due to health problems and was later diagnosed with
Alzheimer's disease. Without her running the business side, Vazquez says
the clinics' finances began to decline. To keep the doors open,
he claimed he had to use his own money to
keep it Afloat Dixie Cooper told me that vascaz is
a very smart man, but not a good business person.
(08:10):
He was focused on patients, not on the money side
of things, and when financial problems did occur, he tried
to solve them himself.
Speaker 9 (08:19):
When c our Age experienced financial challenges, my wife and
I put a significant amount of time, energy, effort, and
our own money into the practice over the years, always
trying to ensure the best quality of treatment, continuity of
care for patients, and that employees will be pair family.
We incur personal debt into the form of our home
(08:40):
maquity loan and multiple other personal loans in order to
help see our age and the other affiliated businesses remain
financially stable.
Speaker 4 (08:48):
Doctor vaskaz said he stopped getting any form of compensation
from the clinic around mid August twenty twenty three.
Speaker 9 (08:55):
I chose to forego a salary for the entire time
from August twenty twenty three until the clinic was placing
into a core ordered receiveship on April twenty six, twenty
twenty four. I did this in and effort to preserve
the continuity of care for patients and to ensure that employees.
Speaker 4 (09:10):
Will be paid. He said he didn't realize the clinic
was so close to running out of money until his
daughter Elena, started looking closely at the books in April
twenty twenty four.
Speaker 9 (09:22):
Despite the employee as a medical director and working every
business day to make money to pay crh's obligations to
employees and onsite vendors, foroe going as salary was not
enough to financially stabilize CRH.
Speaker 4 (09:39):
Vazka has denied that any financial malfeasons on his behalf
had occurred. Instead, he blamed other more junior employees for
mismanaging funds.
Speaker 9 (09:50):
Former employees of CRH who I trust to be honest
and ethical in performing their jobs and in the management
of the money coming in to the practice. We're engaging
in an appropriate behavior that I learned about when the
practice had to seize business due to lack of funds
in April of twenty twenty four. Those actions include not
(10:11):
submtium bills for payments by insurance companies and self pay,
given unauthorized races to various individuals in the practice, and
taking unauthorized trips using the CRCH bredit card, all of
which contribute to CRH being unable to make payroll, resulting
in CRH having to close the practice.
Speaker 4 (10:32):
His lawyer, Dixie Cooper, repeated this in her interview with me,
claiming that several employees were intent on sabotaging the clinic
and taking Vascuz down. She told me that after the
clinic shut down, Vasquez's top priority was keeping the embryo safe.
She said he went into the clinic every day personally
(10:52):
checking the tanks and disputed the state inspectors claim that
he'd handled them improperly. More broadly, Cooper criticized the state's
lawsuit against Vasquez, claiming it included false and exaggerated allegations
against her client, inciting unnecessary panic. She also said that
in the days after the closure, Vazquez had been working
(11:15):
to find a local clinic to buy CRCH and take over,
but the deal was scuttled because the state froze Vasquez's
assets and installed a receiver despite my knowledge and experienced.
Speaker 9 (11:27):
Not only was I never consulted for guidance to expedite
the process, I was completely shut out of this practice,
with no access to my office space, the medical records,
or any other information located at CRCH.
Speaker 4 (11:40):
Cooper explained that after the receivership began, Vasquez and his
legal team lost access to the clinics records, leaving them
unable to verify details, challenged the state's claims, or properly
defend themselves. She also added that doctor Vasquez is deeply
sorry for what happened and wishes it had never occurred.
(12:03):
She said he even offered the state what little money
he had left to reimburse patients who paid for services
they didn't receive, but the state never responded. He has
since declared bankruptcy. In Cooper's telling, the whole situation is
a tragedy, one that's harmed both doctor Vazquez and his patients.
(12:24):
She argues that he's a well meaning, well intentioned professional
who just got in over his head due to the
actions of wayward employees. I wasn't sure what to make
of this. It felt a bit to me like passing
the buck. As the owner and medical director, Vazquez was
(12:45):
the one in charge. I wanted to see what his
former employees had to say, and I reached out to
more than a dozen of them, hoping to understand their
perspective and to learn more about how the clinic operated
in its final years, but most didn't respond. Letters and
emails went unanswered. Eventually, though, one woman agreed to talk
(13:08):
a former lab employee whom doctor Vasquez has accused of
trying to destroy his practice, and she tells a very
different story.
Speaker 5 (13:22):
I have actually gone through treatments myself to get my baby,
and so I know like how emotionally invested you can get.
Speaker 4 (13:34):
Marie began her job at the Center for Reproductive Health
in twenty twenty two. Because she still works in the industry,
she asked us to use a pseudonym. We've also modified
her voice to protect her identity.
Speaker 5 (13:46):
Society tells women that your job and your goal as
a woman is to be a mother, and I was
one of those people and that had that ingrained, and
so who was really frustrating to be like, well, my
body doesn't work on the way that it's supposed too.
Speaker 4 (14:00):
Marie was hired to work in the lab. It was
her first real job after getting her bachelor's degree in biochemistry,
and she was excited to learn the ropes.
Speaker 5 (14:11):
I worked in both parts of the lab, so andrology
and ebriology, and then I also did all the ordering
for the lab stuff. I also kept up with any
tracking that we needed to for inspections, so for both
cap FDA inspections, like any documentation or records, and then
(14:33):
when we did things like the genetic testing and the
PGT reports came back, I was typically the person who
called the patients with like their fertilization reports and stuff
like that.
Speaker 4 (14:44):
At first, Marie loved the job.
Speaker 5 (14:47):
Being able to help people like use science in such
a cool, a niche way that enables them to reach
their goals and dreams. In that way, it was great.
Speaker 4 (14:58):
The work was intense in the hour were long, but
Marie bonded with the other employees over the high stakes.
They were, after all, helping to create life.
Speaker 5 (15:09):
When we were in cycle, it was really stressful because
we had a lot of patients and a lot of
work to do. We spent a lot of late nights there,
like six seven o'clock at night. Was not uncommon to
leave when we had gotten there at like eight o'clock
in the morning. I remember one cycle ended up being
so big that we took shifts and people came in
(15:31):
in like four hour blocks. And then when we were
out of cycle, we did a lot of paperwork and
it was a lot more chill.
Speaker 4 (15:39):
The staff were genuinely close, lending a warmth to the
whole operation.
Speaker 5 (15:44):
We were a big family. We all had lunch in
the lunch room together. There were several employees who hung
out after work together in different groups. There were a
couple of medical assistants who ended up getting married who
had other employees like as bridesmaids in their wedding and
things like that.
Speaker 4 (16:06):
Marie told me she'd enjoyed the sense of community she
found at the clinic, but professionally it wasn't what she'd
hoped for. She'd expected hands on mentoring and real training,
but the place felt rudderless by the time she arrived
Vazkez's wife, Nancy, had already left, and Marie said no
(16:27):
one seemed to really be in charge. Staff were left
to manage the day to day on their own, with
little oversight or direction. Doctor Vazkez didn't seem especially interested
in teaching, she said, and there was no full time
senior embryologist on staff. When per diem embryologists came in
a few days each month for egg retrievals or embryo transfers,
(16:49):
Marie would pepper them with questions, trying to absorb as
much as she could before they left again. Most of
the time it felt like she was learning on her own.
Speaker 5 (16:59):
It was a lot of reading protocols and following Britain instructions.
I signed up for additional training and took some online courses.
The plan was to eventually be certified in both andrology
and embryology, and so those courses were like part of
that path towards it.
Speaker 4 (17:21):
After about a year and a half at the clinic,
Marie realized she could no longer work there. She felt
there was no room to grow professionally, and she says
she'd started to notice things that made her feel uneasy.
Patients being told inaccurate information about their embryos, staff stretched
too thin, and protocols that seemed to shift depending on
(17:41):
the day.
Speaker 5 (17:44):
The hour started getting later and later. You shouldn't be
working more than eight hours because your eyes are going
to get tired. You need, you know, those breaks so
that you can rest and recover. Make sure that you're
staying at your best so that you can give the
patients the best and most accurate care possible. We started
(18:05):
dropping witnessing, which was concerning.
Speaker 4 (18:09):
Marie said. The clinic had stopped consistently doing what's called
human witnessing, which is where a second person observes lab
procedures as quality control.
Speaker 5 (18:20):
Verifying that you are moving the right eggs into the
right dish for the right patient, and then when they
become embryos, that you're using the right sperm that they've
signed for.
Speaker 4 (18:31):
As she saw it, employees were overworked, some were doing
jobs they weren't trained for. To her, it reflected a
culture of cutting corners, a looseness with the rules that
made mistakes feel not just possible, but inevitable. I asked
her what it was like to be inside the clinic
at that point, believing it was starting to come apart
(18:55):
and knowing how much patients were counting on them. You,
as someone who went through Fertility Tree, would you have
been comfortable at that stage choosing Center for Reproductive Health
as your clinic.
Speaker 5 (19:06):
No, but I had insider knowledge and a lot of
that information wasn't available to patients on the outside.
Speaker 4 (19:16):
In early twenty twenty four, Marie put in her notice
and she wasn't the only one. A lot of other employees, also,
frustrated by the working conditions, were leaving.
Speaker 5 (19:28):
Towards the end, more and more people were starting to
put in their notices as well, and those positions weren't
being filled or replaced. The smaller clinic, you have a
person doing multiple positions, and so when one person leads,
it's essentially like five positions that you're trying to fill
but with one person, and then that's not being replaced.
(19:48):
And then there are multiple of these scenarios in different
aspects of the clinic, like on the laboratory side, on
the clinical side, on the financial side, all different sides
this was happening. It was like a Okay, there's not
going to be anybody left to hold this clinic up,
Like it's going to fall. We could see it coming,
and so if we could see it coming, then there's
(20:09):
no reason doctor Rascus didn't see it coming.
Speaker 4 (20:13):
In court documents, doctor vask has claimed that Marie was
one of the disgruntled employees responsible for the clinic's financial ruin.
She denied the allegations and said that she had no
responsibilities involving billing, insurance, or other financial matters. Doctor Vasquez
also accused her of organizing the staff against him by
(20:34):
encouraging them to quit their jobs. Marie told me that
she did advise some employees to resign before they got
themselves into ethically or legally dubious professional situations.
Speaker 5 (20:46):
There were a couple of people who I worked with
who when I found out that they weren't going to
interview or hire for my position, I was like, I
would recommend that y'all also leave so that you are
not like stock or trapped in doing a lot of
these things that you're not qualified or trained for. You
(21:06):
could potentially have negative repercussions for your career later down
the road.
Speaker 4 (21:14):
Another employee who put in their notice around the same
time as Marie was doctor Ferrara Dyer, who was hired
in twenty twenty. You may remember Dire from episode three.
He's the one who did his medical training in the
UK and was practicing at CRH as a fellow. Though
some patients I interviewed were under the impression he was
(21:35):
their licensed doctor, he agreed to speak with me on
the record with his attorney present. I asked him about
the patients I'd spoken to who felt like they hadn't
been treated with honesty. Here's what he said.
Speaker 8 (21:50):
The journey for fertility medicine is an emotional and as
long and as our joous and and stuff. I just
hope that patients don't get discouraged because they feel as
though something went wrong with their treatment and my involvement
in it, when I know that there was nothing wrong
with my treatment and involvement with their process.
Speaker 5 (22:12):
True to be.
Speaker 8 (22:12):
Told, Looking backwards, I think that we helped a lot
of people.
Speaker 4 (22:17):
Dyer told me that the entire reason he started working
at CRH was because doctor Vasquez had promised to help
him get his license. Except according to Dyer, Vasquez kept
pushing the goalposts, saying he needed to work as a
fellow for two years, then four, then five before Vasquez
(22:38):
would sponsor him.
Speaker 8 (22:39):
I go in with Vasquez March the first of twenty
twenty and by the time I get to March of
twenty twenty four, he says that I need to have
another year. So his threat to me was, I don't
believe that you have completed all the curriculum that would
show that you were proficient enough to be your own
(23:00):
reproductive and a chronologists. I want you to give me
another year. I'm going to pay you fellowship money, which
is not a lot of money, and then you still
will work for me, and then we'll go next year
to the state.
Speaker 4 (23:15):
As we explored in episode three, it's unclear how this
arrangement would have led to dire attaining licensure. Still, he
says that was his belief.
Speaker 8 (23:26):
Emotionally, it's sort of tough where you put in four years,
somebody gives you a promise and then you know that
they're going to renee go on the promise. Not to
say that you give up, but you sort of lose
the passion that you had for said clinic.
Speaker 4 (23:44):
I asked doctor Vazquez's attorney for more information about any
assistance he provided Tore in gaining licensure and to respond
to Diyer's claims, but didn't hear back. Dyer says that
beyond his waning confidence in Vazquez's promises, he was also
dealing with complications from type one diabetes. These factors combined
(24:06):
told him it was time to leave.
Speaker 8 (24:08):
That had started with renal failure, that had gone blind,
and then I due to diabetic rednopathy, which I actually
got corrected. So I wrote a letter of resignation in January,
and then I told him, hey, I'll stay until my
four years are up in March. And then at that
(24:29):
point he sort of stopped talking to me. I stopped
seeing his patients in late February, and then I had
to write up all of my charts and whatnot, and
I was out by March twenty ninth.
Speaker 4 (24:47):
Both Marie and Dire quit before the final stretch of
the clinics operation, when things really went downhill. I wasn't
able to speak to any employee about those last days
of practice, but I know that Vazkez hired a new
junior embryologist, Jasmine Bills, less than a month before the
clinic shut down. She described her experience at CRCH in
(25:11):
an affidavit which was filed in the state's consumer protection
case against the clinic. Here, a voice actor reads parts
of her statement.
Speaker 3 (25:20):
My dream job was to work in embryology.
Speaker 4 (25:23):
Jasmine said. Her training consisted of three to four days
at CRH, learning from an embryologist who worked on a
par deem basis at the clinic.
Speaker 3 (25:33):
My first official day at the center was March twenty fifth,
twenty twenty four. It seems like the staff didn't know
how to direct me for this position due to it
being outside their scope of practice. I started looking at
training manuals from the World Health Organization because I didn't
know what the best practices were. Although I was the
junior embryologist, the center didn't have a full time senior
(25:53):
embriologist on staff. I was never given a comprehensive overview
of lab safety procedures. I just picked things up from
the employees who were training me.
Speaker 4 (26:02):
It was Jasmine's job to analyze sperm samples and prepare
them for intra uterine insemination procedures. She was also responsible
for maintaining the cryogenic tanks.
Speaker 3 (26:14):
The alarms on the storage tanks go off if the
tank's liquid nitrogen levels fall below a certain threshold, and
if there isn't enough nitrogen the embryos in the genetic
material could start to thaw and become non viable. An
alarm company had a list of people to call if
the alarms went off, but I was told the staff
weren't sure who was on the alarm call list because
of all the staff turnover, and to my knowledge, I
(26:36):
was not on the storage tank alarm call list.
Speaker 4 (26:39):
Jasmine had only been officially working at the clinic for
less than two weeks when she, liked the rest of
the staff, got an email from doctor Vazquez's daughter, Elena,
saying that the staff would not be paid due to
lack of funds. She came into work the following day regardless.
Speaker 3 (26:57):
I asked doctor Vasquez what was going to happen with
the sinner and being paid, but he didn't respond. He
just looked at me. I decided to gather my things
and leave.
Speaker 4 (27:08):
Still, Jasmine says she decided to come back to the
shuttered clinic the following week to prepare some specimens for transfer,
including it seems Sydney's embryos.
Speaker 3 (27:19):
Before it became evident I was not going to be paid,
I'd accepted embryo and sperm transfers, and I felt morally
obligated to complete those transfer requests, even though it was
unlikely for me to get paid for that work.
Speaker 4 (27:31):
While at the closed clinic, she checked the liquid nitrogen
levels in the tanks. They were low, she wrote, though
they hadn't yet reached dangerous levels. She filled them up
before she left, but didn't mark it in the records
as she was no longer technically an employee. This was
the last time she set foot in the Center for
(27:52):
Reproductive Health.
Speaker 3 (27:53):
I never received any communication from doctor Basquez or any
other CICH administrators about when I would be paid. I
could not apply for unemployment because I never got a
paycheck from CICH. My first paycheck was supposed to be
on April fifth. I'm back working at the pharmacy I
was at previously, but in a lower position.
Speaker 4 (28:12):
According to Jasmine's affidavit, doctor Vasquez appeared to be confused
about the clinic's deteriorating situation. Her account was echoed by
several patients who were called being told that operations were
merely on hold or experiencing low volume, as if normalcy
would soon return. One patient, Jacqueline Locke, told me about
(28:36):
a zoom meeting she had with doctor Vasquez on April third,
twenty twenty four, the day before staff were notified there
were no remaining funds to cover their pay.
Speaker 6 (28:46):
The call with him was to kind of go over
what our next steps would be. I hopped on the
call with him after he was like at least two
hours late, and he had no idea what the purpose
of the call was. I was thinking that we were
getting some really helpful information that was going to help
us move forward and get to our goal.
Speaker 4 (29:10):
The call went on for an hour and a half.
Jacqueline told me she struggled to follow doctor Vasquez's train
of thought. She'd already done two egg retrievals with him
and was debating whether to try again. It wasn't a
simple choice. She lives in Canada, so another round meant
more flights for her, her husband and their small children,
(29:32):
more time away from work, more strain on her body,
and more money they didn't really have to spend. And
through it all, Vazquez never said a word about the
clinic's financial trouble or that it might not even be
open much longer.
Speaker 6 (29:48):
That makes me feel sick to my stomach. I really
don't understand what went on in his head.
Speaker 4 (29:58):
Doctor Vasquez tells the story as an abrupt fall, a
good clinic suddenly running into financial trouble. In his version,
everything changed when his wife left in twenty nineteen and
the business began to slip. But based on my reporting,
that's not entirely true. I dug into the public records
(30:19):
related to the clinic to get a glimpse at what
was happening behind the scenes. This ended up being fairly complicated,
as there's no one government agency that regulates fertility clinics.
I was able to get some reports from the Tennessee
Department of Health, which inspected the clinic every other year,
as well as reports from the FDA, which inspects clinics
(30:42):
that handle donated reproductive tissue, eggs, sperm, that kind of thing.
According to the Tennessee Department of Health, the clinic had
been cited for deficiencies at least twice in the years
before doctor Vasquez's wife left. In two thousand and seven,
state inspectors discovered that one of the clinic's nurses did
(31:03):
not have documented training for two tests that she'd been
routinely performing. They also noted a couple of instances where
the clinic was not adhering to recommended quality control testing practices.
In twenty ten, state inspectors found that the clinic had
been using an expired solution to test Seaman samples for
(31:25):
about a month and a half. This meant there was
no reliable way to confirm the test was working or
that any of the patient results from that period were accurate.
The Federal inspection records reveal more troubling observations. In twenty seventeen,
FDA inspectors found that the clinic wasn't properly screening or
(31:48):
evaluating donors for infectious diseases. For example, they learned that
the clinic did not test all egg donors for Zeka
as required. They also documented one case where an egg
donor had been treated for chlamydia but was not tested
to see if she had recovered prior to her donating.
(32:08):
The FDA noted that the clinic didn't have appropriate procedures
in place for how donor screening and eligibility decisions should
be done. This matters because donor screening is what protects
patients from using sperm or eggs that carry infectious diseases
or serious genetic conditions. In twenty nineteen and twenty twenty two,
(32:31):
FDA inspectors went back to the clinic and found similar issues,
donors not screened properly before allowing them to donate, and
inadequate paperwork documenting required testing. The FDA classified all three
inspections from twenty seventeen to twenty twenty two as VAI,
(32:51):
meaning voluntary action indicated, a category used when violations are
objectionable but the agency believes that the clinic can correct
them without formal enforcement action. About a month before the
clinic shut down in April twenty twenty four, the FDA
inspected once more. This time they discovered that some donor
(33:14):
files still contained patient's real names, a breach of privacy
rules meant to protect both donors and recipients. Over the years,
the deficiencies the state and FDA documented did not trigger
serious action. They were considered minor fixable, not enough to
(33:35):
cause urgent concern. But these shortcomings did at times trickle
down to the patient experience. As Peter Ricci and his
wife learned in their time at RH.
Speaker 7 (33:47):
The worst irony when it comes to our experience with
Centers for Reproductive Health is that our initial experiences were
actually very good.
Speaker 4 (33:56):
Peter is a thirty six year old writer and editor
and his wife first went to the Center for Reproductive
Health in twenty twenty two.
Speaker 7 (34:04):
My wife is an ovarian cancer survivor, so we knew
from when we started dating that we would have to
find alternate means to be parents, which is something we
both very much want to do.
Speaker 4 (34:18):
At the time, they were living in Nashville and were
drawn to doctor Vazquez's egg and embryo donation program called
American Embryo Adoption Agency or AEAA.
Speaker 7 (34:29):
We're really impressed with Center for Reproductive Health and the
number of egg donors they had, and our early interactions
with them were actually very encouraging.
Speaker 4 (34:42):
Their plan was to purchase donor eggs and use peter
sperm to create embryos for a surrogate.
Speaker 7 (34:48):
They had an extensive database we were able to look
through and see who we could potentially be matched with.
My wife is African Americans, so we liked that there
were black donors who we were able to consider because
we thought, ideally, will have a biracial child, then that
will match what a biological child of ours might have
(35:10):
looked like.
Speaker 4 (35:12):
In the summer of twenty twenty two, they obtained eight eggs.
Seven were successfully fertilized with peter sperm, but only one
developed into a healthy embryo. They were disappointed, but not deterred.
As a backup, they began considering the purchase of additional
donor embryos just in case they needed them.
Speaker 7 (35:33):
It was when my wife was looking back on the
CRCH database to see about purchasing embryos that she saw
the profile for the person whose eggs we had used
for our own creation, and she recognized the photo. She
could tell that it was the same person, but this
(35:54):
time around, there was a disclaimer on the profile that
they were a silent carrier for a spinal disorder.
Speaker 6 (36:05):
Ian.
Speaker 7 (36:05):
This was not something that was on the profile when
we considered it, and it was not something that they
had reached out to us to say.
Speaker 4 (36:15):
The egg donor Peter and his wife had used to
create an embryo was a silent carrier of alpha thalacemia,
a blood disorder, and spinal muscular atrophy, a genetic neuromuscular disease.
Peter's wife sent an email to CRCH asking for more information,
like why they were not told about the donor's status
(36:36):
when they purchased the eggs. The CICH employee who responded
said that the donor was not tested at the time.
It wasn't until quote much later that this information became available.
The disorders the donor carried were recessive. They would only
pose a risk if Peter was also a carrier, and
(36:56):
he wasn't, so they decided they would still move forward
with their one embryo. By this point, the couple had
moved to Chicago. They began the process of trying to
move the embryo from CRCH to their fertility clinic in Illinois.
Speaker 7 (37:12):
We're working with the new clinic and they begin going
through a rigorous process to evaluate that embryo. And it
was through that process that we learned a number of
things involved in the creation of an embryo, and then
the different things that were not done that CIH should
(37:35):
have done. For starters, there was no record of CRH
compiling what's called a summary of records. Now, what that
basically means is it's a summary of my healthcare information
relevant to embryo creation, so an easy list of things
(37:56):
for a clinic to look over and to say, Okay,
everything is good. They were unable to produce a summary
of records. They just weren't able to provide it.
Speaker 4 (38:10):
After extensive review, the Chicago clinic said it would not
accept the embryo for two reasons, one because it was
missing the summary of records, which meant they could not
confirm that CRCH followed FDA protocols, and two because the
egg donor was a silent carrier of a spinal condition.
In an email, the clinic noted that this second reason,
(38:33):
in particular, is their standard policy, one that it said
many IVF centers follow.
Speaker 7 (38:40):
It's quite devastating to get that far down the line
and then to realize, oh, we're unable to use the embryo.
You feel like a fool. When you're in these circumstances.
You think, why was I not asking these questions? Why
did I take their word for it? Why was I
(39:01):
not thinking ahead of what complications could arise. It's very
difficult to resist those thoughts and feelings when things goes
so horribly wrong.
Speaker 4 (39:17):
Peter and his wife decided to sue, arguing that CRH
had broken its contract. Online, the clinic had advertised that
it followed guidelines from the American Society for Reproductive Medicine,
the group that sets best practices for fertility clinics. Nationwide.
Those guidelines specifically call for genetic screening of egg donors
(39:38):
for conditions like cystic fibrosis, spinal muscular atrophy, and thalacemia,
but the donor they used turned out to be a
silent carrier for two of those very disorders. In an
email to Peter's wife, a staff member at CRH admitted
that they do not routinely run genetic tests on egg donors, said,
(40:00):
relying on family histories for known genetic conditions.
Speaker 7 (40:04):
That seemed pretty clear cut, Okay, breach of contract. They
claimed to be members of these different associations. They did
not follow these things. They made certain promises to us
when we agreed to work with them and signed contracts
for it. So we're going to file a lawsuit then
(40:26):
to have everything that we put in compensated.
Speaker 4 (40:31):
But it wasn't so clear cut. The clinic argued the
case could only be brought under Tennessee's healthcare liability law,
meaning that if the clinic won, the financial consequences for
the Richies would be severe.
Speaker 7 (40:46):
They were responding in such a way that if we
decided to take things to trial and they triumphed, so
we were not awarded damages and so on Tennessee law
allows them to then compel us to pay their legal
(41:07):
fees and expenses.
Speaker 4 (41:09):
Ultimately, that was not a risk they were willing to take.
They needed to save their money to pursue fertility treatments.
Speaker 7 (41:18):
We had to accept that the satisfaction of getting our
money back from what we had put in and them
admitting the wrong they had done, that it was not
going to happen. So we made the tough call to
voluntarily dismiss the case with prejudice.
Speaker 4 (41:39):
A month or two later, their lawyer reached out again
with some surprising news.
Speaker 7 (41:44):
Johnny calls me up and says, you are not going
to believe this. Crh's offices were just rated. Their finances
have been frozen. They are in absolute turmoil, and that
was when we saw then the floodgates open.
Speaker 4 (42:03):
Looking back, Peter said he noticed a lot of red
flags at CRCH. He described forgotten appointments, a lack of organization,
and what seemed to him like a casual attitude towards
the rules.
Speaker 7 (42:17):
There was a slowly creeping suspicion of dysfunction in the space,
and anyone is free to ask, well, why did you
keep going with them? And the simple answer is, you
get deeper and deeper into this process, it becomes harder
and harder to walk away, and you're not really in
(42:37):
the position to then stop and go somewhere else. They're
not giving you a refund if things do not work out.
Speaker 4 (42:47):
Peter and his wife are still feeling the fallout of
their time at CRCH. It's a struggle that since the
clinic's closure, they now share with other former patients.
Speaker 7 (42:58):
It's been the wildest of ex experiences of feeling isolated
and used and disregarded, and then learning that we're not
the only ones, that others have also experienced this, and
they have their own horror stories. You're not going into
(43:20):
fertility treatment from any position of strength, and it's a
uniquely vulnerable kind of healthcare, meaning fertility and creating new life.
Speaker 4 (43:33):
When I last spoke with Peter, more than three years
after he and his wife first walked in the door
of the Center for Reproductive Health, their fertility journey remained ongoing.
Speaker 7 (43:44):
We're still not parents, by the way.
Speaker 4 (43:50):
Next time, on the final episode of What Happened in Nashville,
the patients grapple with unanswerable question questions and the long
term consequences of crh's collapse. I immediately just started questioning everything.
I honestly thought, like, would my outcome have been different
(44:12):
had I gone somewhere else.
Speaker 2 (44:13):
I was so focused at a certain point on the
betrayal and the mistrust, and obviously that's never going to
go away, that's always going to be there.
Speaker 4 (44:23):
And the shortcomings of one clinic serve as a cautionary
tale for the industry at large.
Speaker 8 (44:29):
It has shaken my trust in healthcare and medical professionals.
Speaker 5 (44:34):
I don't trust that the industry is not out for
the profit.
Speaker 4 (44:37):
They see desperation and they see dollar signs.
Speaker 2 (44:41):
Patients are left in the dark to steal themselves against
the consequences of medicine when it goes awry.
Speaker 6 (44:50):
The question is how much regulation of those clinics do
we want?
Speaker 4 (45:00):
What Happened in Nashville is a production of School of
Humans and iHeart Podcasts, written, reported, and hosted by me
Melissa Jelson. Our producer is Etily's Perez. Our senior producer
is Amelia Brock, with additional production by Emily Seiner and
Carl Catle. Theme song by Jesse nice Swanger, Sound design,
(45:20):
scoring and mixing by Jeremy Thal and Jesse Ny Swanger.
Fact checking by Savannah Hugley and Austin Thompson. Our production
manager is Daisy Church. Voice acting by Tony Guerrero and
Taylor Church. Executive producers are Jason English, Virginia Prescott, Brandon Barr,
and Elsie Crowley. If you're enjoying the show, tell everyone
(45:42):
you know and don't forget to leave a rating in
your favorite podcast app
Host
Melissa Jeltsen
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