• It began with fear of pandemic bird flu. It ended with fear of retribution
• A driven leader, obsessed with public health, hoped to save the community
• Imported drugs were the answer, he thought. The only obstacles were unjust laws
The vision was noble. For a garage-sale price, Pierce County would gain a stockpile of imported bird flu medication – enough to combat a feared pandemic.
There was just one problem: It was completely illegal.
That didn’t stop Federico Cruz-Uribe, director of the Tacoma-Pierce County Health Department, 14-year veteran of battles for public health. In 2005, he launched an ill-fated scheme to buy 15,000 doses of generic medication from drug companies in India.
He knew the purchase would violate federal law. He said it was the only way – he couldn’t get the drugs from legal sources.
“In health, that’s what we do,” he recently told The News Tribune. “We challenge the status quo.”
His passion, coupled with a national case of bird flu anxiety, gave him early support and momentum. Then the legal risks became clear. Cruz-Uribe’s staff and his bosses at the Tacoma-Pierce County Board of Health urged him to abandon the project.
He didn’t. The plan progressed, without the board’s knowledge. It failed. The drugs were never purchased. Top-level managers smothered the idea by defying or deceiving Cruz-Uribe, ultimately stopping the buy.
Public money paid to a foreign middleman was spent for nothing. Careers collapsed for a fruitless dream.
It was Cruz-Uribe’s last crusade.
Under the radar
Whether laws were broken is unclear, but money spent on the plan sparked a complaint to the state auditor’s office, which has relayed the information to the federal Food and Drug Administration.
Health Department records show Cruz-Uribe personally approved but kept secret from the board $60,000 in contracts to advance the importation scheme. The contracts were separated into smaller amounts – deliberately set below the threshold that would trigger Health Board scrutiny.
Not all the money was spent – but before agency managers took action to close the contracts, the Health Department poured almost $23,000 into the venture, and came away with nothing.
In a meeting with subordinates, Cruz-Uribe suggested bringing the drugs across the U.S. border in packages labeled as veterinary supplies. He floated the idea of using Canadian sources as intermediaries.
Cruz-Uribe pursued the illegal drug purchase despite stern warnings from Susan Ferguson, the agency’s attorney at the time, who told Cruz-Uribe and Health Board members that she refused to help them commit a crime.
Up to that point, Health Board members had considered approving the unlawful purchase, and even privately discussed a public vote that would have spent the money while masking the illegal transaction. After Ferguson spoke out, board members retreated from the notion. Individual members say they told Cruz-Uribe to let the project die. He secretly persisted.
The dubious venture fractured the Health Department. Three managers, including Ferguson, resigned in quick succession earlier this year. A fourth announced his pending retirement.
The unexpected departures surprised the Health Board, prompted members to order an internal investigation and hastened Cruz-Uribe’s retirement from a position he’d held since December 1992.
Those incidents, which played out over the past two years, were never revealed to the public. They are chronicled in almost 700 pages of public records obtained by The News Tribune.
‘It didn’t happen’
In a Sept. 6 interview, Cruz-Uribe, 58, said he acted with the approval and knowledge of his bosses on the Health Board.
“This was all something that was done aboveboard with my board,” he said. “I could not act without the approval of my board. If they didn’t agree, it wasn’t gonna happen. They ultimately didn’t want to, so it didn’t happen.”
In a second interview Sept. 27, he added that he was merely setting up a framework that would make a purchase possible. Board members told him not to buy anything, he said - but they never gave a collective order to halt the project.
"It just quietly died," he said. "I wasn't told to stop."
Tacoma City Councilman Rick Talbert, chairman of the board, sees it differently.
“It’s obvious that there continued to be work on this issue that was being done without the knowledge of the board,” he said in a recent interview.
Cruz-Uribe never hid his willingness to defy authority in the interest of public health. He’d done it before, pressing for a countywide smoking ban, fluoridated water and expansion of a local needle exchange. He was ambitious – in 2003, he mounted and later abandoned a campaign for governor.
Without his efforts, “we wouldn’t be where we are today,” Talbert said. “Doctor Cruz was a crusader. But it also was very difficult to rein that in when he did feel that he was on the side of righteousness.”
Birth of a notion
In 2005, fears of bird flu were high, fueled in part by the global health community’s concern about its potential spread. National media coverage stoked the prospects of pandemic flu. Cruz-Uribe kept tabs on the latest studies, including a report by the Trust for America’s Health that predicted an outbreak could kill 500,000 people.
The likeliest remedy, a product called Tamiflu, was scarce and expensive. State and local governments, including the state of Washington, were chafing under federal restrictions on imported medication.
Health Department records show Cruz-Uribe was interested in gathering a local stockpile of Tamiflu and Relenza, a sister product, to prepare for a flu outbreak.
He knew companies in India were producing cheaper generic versions, but FDA regulations prohibited importation, citing concerns about the safety of imported generic drugs.
Cruz-Uribe wondered if the rules could be circumvented. During a Feb. 28, 2005, meeting, Vivienne Kamphaus, the agency’s risk manager and human resources director, and David Vance, senior public health manager, discussed Cruz-Uribe's idea. Kamphaus and Vance declined to be interviewed for this story.
Notes from the meeting say Kamphaus suggested working through the Washington state Department of Health, which was also looking at the issue of drug importation. Better to let the state assume the legal risk, she said.
Vance wondered if the county Health Department could set up a third-party Web site that would allow consumers to buy bird flu drugs from foreign sources. He called it “a front,” the notes say.
Kamphaus again suggested working through the state. She didn’t like the Web site plan, and said it “would be creating a huge liability for our agency.”
The software engineer
Not long after the meeting, Cruz-Uribe and Vance set up a $5,000 contract with a software engineer in India. The connection was made through Vance, who had family and other connections in that country.
The engineer’s name was Sridhar Kodali. He worked for a company that provided computer technology to health care companies.
The Health Department contract assigned Kodali to research the possibility of buying Tamiflu from drug companies in India. How he was chosen for the task is unclear – Kodali didn’t respond to e-mails from The News Tribune sent to several of his listed addresses.
Health Department records show Kodali and Vance trading e-mails for the next few months, working out financial details, mailing addresses and provisions for exemptions from U.S. taxes. By June 2005, Kodali was carrying a letter of introduction, signed by Cruz-Uribe, addressed to drug vendors in India, and naming Kodali as the agency’s representative.
“To whom it may concern,” the letter began. “We are interested in purchasing large quantities of Tamiflu or a generic equivalent.”
The letter said the Health Department hoped to buy 100,000 treatment doses – 1 million capsules. The actual amount would depend on cost and exporting regulations.
“Thank you in advance for your consideration of our desire to purchase pharmaceuticals from your organizations,” the letter concluded.
The Health Department sent Kodali his first payment of $2,300 on July 14.
One obstacle
In mid-August 2005, Cruz-Uribe and Vance met with Bruce Pennell, Health Department planner, and discussed the progress of the importation project. Notes from Vance and Pennell provide an account of the conversation.
Pennell raised questions about quality control – how could they be sure the generic drugs were genuine?
Cruz-Uribe, dreaming big, suggested building an in-house testing facility. The department could hire its own pharmacist.
In the comfort of the Health Department offices, it all seemed possible, except for one obstacle.
“Issue: illegal,” Pennell wrote in his notes.
Cruz-Uribe saw a way to fool federal inspectors at the U.S. border. He suggested disguising the boxes of Tamiflu as veterinary supplies, according to notes taken by Vance and Pennell.
“FCU: Send them over as vet supplies and store them,” Pennell’s notes say, identifying his boss by his initials.
“Buy for ‘veterinary use,’ ” Vance’s notes say.
During a Sept. 6 interview, Cruz-Uribe said the idea was casual brainstorming, nothing more.
“People say stuff off the top of their heads,” he said. “If some weird or strange ideas or offensive ideas came out, that’s what a brainstorming session is.”
To Pennell, the spectacle was “just unbelievable.” In a recent interview, he recalled how Cruz-Uribe viewed the illegal plan.
“It was literally, ‘This is good for public health – when the bird flu happens in this country, they’ll all thank me for doing this,’” he said. “I would tell him, ‘Federico, you don’t know if it’s going to happen. If there is no flu and you’ve done this, does the end justify the means?’”
The scheme to buy the drugs moved ahead. Kodali e-mailed Vance a 162-page report on drug policy in India. On Aug. 23, five days after the meeting with Vance and Pennell, Cruz-Uribe doubled Kodali’s contract to $10,000, according to a handwritten note from Vance.
The contract puzzled Marcy Kulland, an accountant at the Health Department. On Aug. 25, she looked at Kodali’s skimpy résumé – a Web site page where he introduced himself as a software engineer for an Indian health care company. He offered his e-mail address so friends and family could contact him.
That was about it – and the department was prepared to pay him $10,000.
“Qualified for contract?” Kulland wrote in a note.
‘Must do this’
The same day, Cruz-Uribe and Vance met with deputy director Vic Harris, risk manager Kamphaus and Ferguson, the agency’s attorney.
The three managers weren’t happy with the importation project, according to Vance’s notes of the meeting. All expressed reservations.
After the meeting, Cruz-Uribe called Vance into his office and closed the door. The boss was upset with the other managers. Vance’s notes recorded Cruz-Uribe’s statements in abbreviated quotes:
- “Must do this.”
- “Role as health officer is more important.”
- “Relying on (Vance) to make this happen.”
The next day, Cruz-Uribe sent Vance a memo titled “special work assignment.”
It ordered him to travel to India, study the possibility of importing Tamiflu and return with a report. The memo also went to Ferguson and Harris.
Vance would depart for India in three weeks. On Aug. 31, he walked into his boss’s office and braved a question: Hadn’t there been some talk about a pay raise for Health Department managers?
Cruz-Uribe’s reply appears in Vance’s notes.
“Pull off a miracle in India and it’s yours,” Cruz-Uribe said.
Federal connection
Vance spent three weeks abroad, from late September to mid-October. The trip, paid for with public money, cost more than $2,400.
When he returned, the boss got busy. Cruz-Uribe sent a note to Health Board member Lyle Quasim, discussing his plan to purchase drugs on the global market. (Last week, Quasim could not be reached for comment.)
“This is currently an illegal activity to buy these drugs abroad,” Cruz-Uribe wrote in Oct. 17, 2006 letter. “I wish nevertheless to pursue this purchase because the threat of a pandemic flu coming to Pierce County without our having a reliable antiviral stockpile represents a true public health emergency.”
Cruz-Uribe fired off another letter the same day. This one went to the federal Department of Health and Human Services. It urged Secretary Mike Leavitt to declare an emergency, which would allow public agencies to buy flu medicine from foreign sources without breaking the law.
Two days later, the Kodali contract was amended again, from $10,000 to $15,000.
In public meetings and news stories, Cruz-Uribe spread the bird flu gospel. The crisis was coming and the public didn’t have the medicine it needed.
He criticized the federal government’s response to the threat. He spoke of building a stockpile of imported drugs, even if it meant going around the law. He published an opinion piece in The News Tribune, covering similar ground.
While Cruz-Uribe’s public campaign progressed, Ferguson, the attorney, privately explained the stakes to Health Board members. In a Nov. 30 memo, she advised them that importing generic Tamiflu from India was illegal in the FDA’s eyes.
Meanwhile, Cruz-Uribe huddled with Vance, checking on the progress of importation. The two men talked transport and prices – Cruz-Uribe suggested extra payments to Kodali if he could keep the costs down.
Cruz-Uribe wanted to amend Kodali’s contract again. For 2006, he suggested upping it to $49,000 – but he didn’t want the Health Board to know. Vance’s notes describe the instructions he received from the boss on Dec. 15, 2005.
“Keep the contract amount (below) $50K for now and add to existing contract so it ‘stays under the radar, and does not have to go to BOH (Board of Health),’” Vance wrote.
Cruz-Uribe added one more caution: He didn’t want Vance mentioning this to Ferguson, the attorney.
After the meeting ended, Vance had a private chat with Harris, the deputy director. According to his notes, Vance was getting nervous about the boss’s moves. Harris told Vance to write everything down. Vance said he would.
On Dec. 28, Vance received the official version of Cruz-Uribe’s instructions: Increase the Kodali contract, tell Kodali to start negotiating prices and proceed with the drug purchase. Cruz-Uribe said he would let the Health Board and Ferguson know what was going on. Meanwhile, Vance was told to keep the matter confidential.
Start of a rebellion
Kulland, the accountant, didn’t like the looks of the Kodali contract that had been handed to her for processing. In February or March 2006 – Health Department records don’t provide exact dates – she shared her worries with Kamphaus.
“Talked to Viv about Kodali contract,” she wrote. “How did it start at 5K in 2005 and increase to 15K? Now they are submitting 49K without going to the Board.
“Took concerns to Susan (Ferguson) with Viv. I heard that this may be for the manufacture and stockpiling of drugs related to pandemic flu. How did they arrive on contract with India?”
Cruz-Uribe didn’t know it, but a rebellion was building. Soon, it erupted at the Health Department’s highest levels.
On April 5, 2006, Ferguson was called to an executive session of the Health Board, which surprised her, since she hadn’t been told it was taking place.
When she arrived, Cruz-Uribe was asking board members, at their next public meeting in May, to authorize the illegal importation of Tamiflu.
The seller was Cipla, an Indian drug manufacturer. Cruz-Uribe suggested running the purchase directly through India, or indirectly through Canada.
Spending the money would require a public vote. Health Department records say board members discussed a measure to approve the money for the drugs without revealing the illegal purchase. The board asked Cruz-Uribe to return with a plan, and asked Ferguson to provide more information at the next meeting.
She didn’t wait that long. Less than two weeks later, Ferguson sent board members and Cruz-Uribe a message that left the leaders reeling.
‘I cannot and will not’
Ferguson did not respond to multiple requests for an interview with The News Tribune. Accounts of her actions come from documents she authored, and the impressions of others who worked with her.
“Susan was very principled,” Pennell, the department planner, said recently. “And that’s a problem in that place – principles. It was not an environment she could work in.”
On April 17, 2006, Ferguson sent a memo to Cruz-Uribe, Harris, Vance and Health Board members. The title: “Illegal Importation of Generic Tamiflu.”
In it, she described her arrival at the executive session. She provided a pair of documents from the FDA that discussed the federal government’s probable reaction to illegal importation, which could include prosecution. She said she was withdrawing as the agency’s attorney on the importation issue. She told board members they needed a new lawyer.
“You are now being placed in the position of being asked to take illegal action,” she wrote. “I cannot and will not counsel you to engage in illegal conduct and may not assist you in engaging in that conduct.”
She told board members that she might be obligated to disclose “a future criminal act.” She chided them for considering a deceitful vote on illegal drug importation:
“It is important that that action be taken with full disclosure to the public, and not simply that monies are appropriated for the purchase of antivirals, with a secret understanding that the board is authorizing illegal activity.”
For board members, the memo struck like a thunderbolt.
“That’s basically where the brakes were put on,” Talbert told The News Tribune. “It became very clear from the board’s perspective that this conversation was over.”
According to Talbert, board members told Cruz-Uribe they were no longer comfortable with the importation scheme, though they didn't take a formal vote.
"We certainly didn't raise our hands and say who wants to continue and who doesn't," Talbert said. "But the message was clear at that time there would be no further work."
Board member Connie Ladenburg recalled telling Cruz-Uribe that importation was no longer an option. She said there was no way he could have missed the message.
"We got the letter from the attorney and said no, we're not going there, and just said stop," she said. "I remember explicitly saying, 'No, we're not doing this. We're not buying drugs from overseas.' "
In his Sept. 27 interview, Cruz-Uribe told The News Tribune he understood the board didn't want him to buy the imported drugs, but he said the board also asked him for a plan - a specific proposal to acquire antiflu medication.
The Indian connections and contracts were part of that plan, he said - a mechanism to acquire the drugs if the board decided to move ahead.
"I was told to bring back to the board proposals, bring back specifics, bring back options," he said. "There was never, 'Don't do this, Federico.' "
Cruz-Uribe and Talbert agree on one point: After Ferguson sent her memo, Cruz-Uribe told the board he wouldn't raise the drug importation question again unless he could discuss it in a public meeting.
It never happened.
“I think it’s safe to say the entire board felt that the issue with regards to pursuing Tamiflu from outside sources was over,” Talbert said.
But it wasn’t.
Two days after Ferguson’s memo to the board, Cruz-Uribe met with Vance to talk about the importation. According to Vance’s notes, the boss said Ferguson was withdrawing as the Health Department’s lawyer on drug importation, but didn’t explain why. He said they were seeking another lawyer.
“What should we tell the India representatives?” Vance asked.
“Proceed with the business plan,” Cruz-Uribe said.
The spin doctor
Six weeks after the pivotal board meeting, The News Tribune published another opinion piece by Cruz-Uribe.
He led with jokes about a TV movie that depicted bird flu horror.
The lighthearted tone soon faded. Cruz-Uribe said the threat of pandemic bird flu was genuine, a critical issue. He rattled off sobering statistics – 30 percent of the community could be infected, and as many as 25,000 people could be hospitalized. Certain drugs could help, but they were scarce in the U.S. Under federal law, it was illegal to import the medication.
“This makes sense from a business standpoint,” he wrote. “From a public health perspective it is nonsense.”
He suggested defying federal regulations to build a stockpile of bird flu medication.
“We need to develop our own stockpile and the only practical way seems to be to buy it overseas in violation of our federal drug laws,” he wrote.
He didn’t mention that he’d already spent almost $15,000 in taxpayer money on the idea and signed off on $60,000 in under-the-radar contracts to Kodali. He didn’t say the department had been haggling with Indian drug companies for five months.
The public knew nothing of the backstage melodrama playing at the Health Department.
“I have not made a formal proposal to my board yet,” the column continued. “It is a big decision and there are clear and strict legal sanctions for those who violate our drug laws. But there is also a greater good that needs to be considered.”
The column closed with a small prayer for civic involvement – Cruz-Uribe wanted the people to have their say.
“I think a public discussion of this issue could be a healthy part of our community preparation for a pandemic flu,” he wrote.
staying the course
On June 2, Cruz-Uribe called Vance into his office.
He asked what it would take to buy Tamiflu using money from the Kodali contract – if changes to the terms were necessary he would approve them. Vance asked how much Tamiflu they were talking about.
Cruz-Uribe said he would decide.
By now, Ferguson’s memo was six weeks old. Her position was plain: Importing the drugs would break federal law, and the FDA was willing to prosecute violators.
Vance’s notes describe what he said next, and how his boss responded.
“Is this OK? Is going ahead and proceeding with purchase OK?” Vance asked. “I will take responsibility for this,” Cruz-Uribe replied.
Later that day, Vance met with Kamphaus. She told him the department’s new lawyers were reaching the same conclusion as Ferguson: Agency managers couldn’t hide behind the boss’s orders. They could be held responsible for their actions.
‘Meeting with FCU’
Health Board members didn’t know about the internal struggle between Cruz-Uribe and his managers, according to Talbert. The board thought the illegal drug buy was off the table.
It wasn't, according to Health Department records. On June 8, Cruz-Uribe met with deputy director Harris, discussed the legal implications of moving ahead with the purchase and resisted suggestions to discuss his plan with board members.
The record of the meeting is a single page, titled “Meeting with FCU,” and written by Harris.
The two men were friends. They had worked together through parts of three decades, dating back to the 1980s. At each stop on Cruz-Uribe’s career path, Harris had followed. Now, after years of collaboration, they stood at odds.
“Met with Federico,” Harris wrote. “Told him I could not support illegal action – was not only putting staff in tenuous legal situation, it was also putting Dept at risk.”
Cruz-Uribe replied that it was “his job as Director to make such judgment calls.”
Harris said he would not process any payments for imported drugs.
“Then I will,” Cruz-Uribe said.
Harris said he couldn’t allow that to happen. He reminded Cruz-Uribe of the advice from the new lawyers, who had recommended consulting the board. Cruz said he was still seeking more legal advice.
According to his notes, Harris already knew Vance had been ordered to proceed with the drug buy – but Vance had sworn him to secrecy, so Harris kept the knowledge to himself. To Cruz-Uribe, he offered a warning:
“I reiterated that I did not want to have to take any actions that would be bad for him, me or dept., but will if pressed,” Harris wrote.
An unseen mutiny
June 2006 was winding down, and Vance was getting anxious. Cruz-Uribe wouldn’t give up on the drug buy.
Vance faced a painful choice: Defy his boss or break the law.
He shared his worries with Kamphaus and Harris on June 28, again recording his impressions in handwritten notes.
The climate at the office was icy. Cruz-Uribe had been giving Ferguson the cold shoulder, isolating her. The three managers feared Ferguson would quit and file a lawsuit.
Should they go to the board, and explain what was going on? Kamphaus was all for it, Vance wrote, but Harris advised caution. Better to think things through, meet again soon and discuss their options.
One thing was certain – the Kodali contract was a continuing liability. They had to shut it down. The trick was doing it without revealing the mutiny.
Tough choices
Two days later, Vance met with Harris to figure out how to tell the boss. According to Vance’s notes, they settled on a plausible lie: Vance would say the people in India had a bigger project, so they were ending the contract with the Health Department.
Going to the board would cause “more problems than not,” Harris said. If the board found out, the members would confront Cruz-Uribe.
“He in turn could turn on us,” Harris said.
Ending the Kodali contract would solve the problem. The legal risk to the board would vanish, Harris said. He suggested allowing a last payment for June, but the invoice would be marked “final” and “contract end.”
After talking to Harris, Vance shared the latest news with Kamphaus. His notes say she was still fretting about whether to tell the board what was going on. Saying nothing was a risk, but so was talking. If they went to the board and Cruz-Uribe found out, all their jobs might be in danger.
Vance said he’d been keeping notes of his conversations with the boss for more than a year. Kamphaus said she’d been doing the same thing.
The holiday weekend was coming – July Fourth. Hot dogs and fireworks. Vance and Kamphaus agreed to talk in a few days.
The lie
Vance’s long-running notes show that he stepped into Cruz-Uribe’s office on July 5 and shared some unfortunate news.
The contractors in India had taken jobs with Microsoft, he said. The deal for imported flu medication was dead.
Cruz-Uribe was taken aback. Did they still have a contract to buy Relenza, the other drug they’d discussed?
“No,” Vance said, but he offered some happier information. It looked like the feds were finally coming through. The Health Department could buy Tamiflu through legal sources at a reduced rate – cheaper than the price India had offered.
After some small talk about Microsoft’s uncanny influence in India, Vance left.
Within minutes, he told Harris and Kamphaus what happened. The boss was buying the story. They were free and clear. Health Department records show a final payment of $2,300 to Kodali, dated July 14, 2006.
Over the course of a year, the agency had paid Kodali $20,000 in public money. Apart from numerous e-mails and the 162-page dissertation on Indian drug policy, Pierce County taxpayers got nothing in return.
Fallout
In September, Pierce County got its flu medicine. This time, the arrangement was legal.
The Health Board voted to spend up to $293,000 on 15,000 doses, purchased by arrangement with the state Department of Health and the federal government. If federal matching money kicked in, the price would drop by $70,000.
The vote was unanimous. No one mentioned India.
Two months later, the board conducted its annual evaluation of Cruz-Uribe’s performance.
He got a raise. His annual salary increased to $145,704. He scored high on organizational skills, long-range planning, leadership and his passion for public health.
In terms of business management and relationships with the board, he didn’t do so well, scoring a 3 and a 2 on a 5-point scale.
“Federico’s business decision involving Tamiflu did not reflect legally defensible business practices, nor did it engender trust with the board,” the evaluation states.
At the time, according to Talbert and Ladenburg, board members didn’t know that Cruz-Uribe’s pursuit of Indian Tamiflu had continued into the summer. They didn’t know about the ruse Vance and Harris had concocted to derail the plan.
But Kamphaus did – and now she was sitting in an executive session with Cruz-Uribe and the board, taking notes on his evaluation, recording criticisms and marking down the scores.
In the weeks to come, she began to think the boss was blaming her for it.
Exodus
By January 2007, attorney Ferguson decided it was time to leave the Health Department. She sent her resignation to Harris on Jan. 31 in a three-sentence e-mail. It didn’t mention imported drugs.
In her exit interview, Ferguson listed several changes she felt the agency needed to consider.
“Do not allow Director of Health to interfere with attorney’s communication to the board,” was one.
“Deal with Director of Health’s use of ‘isolation’ as punishment (to control information and person),” was another.
Seven days later, Kamphaus sent her own resignation to Harris.
“With the recent course of events, I feel that I have become marginalized by leadership and unable to provide the level of service the agency deserves,” she wrote.
She sent the same note to Cruz-Uribe, minus the sentence about being “marginalized by leadership.”
The next day – Feb. 8 – Harris sent a note to department staff. He said he would retire in one year, when he reached his 65th birthday. Harris recently told The News Tribune his decision had nothing to do with the Tamiflu matter.
Whatever the reasons, top department staffers were leaving one after another, with departure dates scheduled in the coming months. Pennell, the department planner, joined the exodus – he’d announced that he was leaving the previous summer, but he’d lingered a little to help the department find a replacement. Now he saw no reason to stay.
“The Tamiflu incident was the final event to convince me that working for the Health Department was just not compatible,” Pennell said.
Talbert and other board members were taken aback by the flurry of resignations.
“There was no announcement to the board,” he said. “It just was very odd. It certainly set up a big red flag – what is going on over there when the bulk of senior management is all choosing to leave about the same time?”
Investigation
Board members wondered if the resignations had something to do with Cruz-Uribe, Talbert said. They decided to start an internal investigation. By early March, interviews were under way: Kamphaus, Ferguson and Harris spent hours with an investigator, records say. So did Cruz-Uribe.
Vance didn’t, though he expected the call at any time. He prowled around the department offices, gathering what information he could.
On the morning of March 27, he asked Harris how the investigation was progressing. Harris wasn’t sure, according to Vance’s notes.
“It could lead nowhere or up to and including the dismissal of FCU,” Harris said. “There could be far-reaching implications.”
Later that day, Vance checked in with Kamphaus. Her resignation wasn’t effective until May, and she’d just had an extended interview with the investigator.
“She went on to discuss her frustrations with FCU and how he has handled her resignation,” Vance wrote in his notes. “She is frustrated that the other managers do not know the real reason she is leaving, having to do with the way that FCU has handled the antiviral purchase process and how he has treated Susan F. ever since then. She also said that FCU has turned against her ever since the BOH completed his performance evaluation.”
The two managers shared more worries and stories. Vance mentioned “the ruse” from 2006 – how they had conspired to stop Cruz-Uribe.
Vance, the only conspirator who wasn't leaving, feared the boss would find out and retaliate.
Kamphaus couldn’t believe what had happened.
“VK said she has never experienced anything like this in her 46 years,” Vance wrote.
‘You’re not happy’
At some point in the spring, Cruz-Uribe had a talk with Pennell.
As Pennell recalled it, the boss was blue. He’d been down for a while. Back in December, he’d mused that the job wasn’t much fun anymore. Now the board was conducting its investigation, and who knew how that would turn out.
Pennell, a short-timer himself, offered some advice.
“Federico, if I were you, I would go get my knee surgery done and I would just retire,” he remembered saying. “Because no matter what happens at this point in time, whether the investigation comes back negative, comes back positive – you have no relationship with your board anymore. You’re not happy with them. They’re not happy with you.”
Whether it was that conversation or another factor, or a combination, Cruz-Uribe spoke to Talbert in late April and said he wanted to resign.
Once more, Talbert was surprised. The investigation wasn’t finished, but this development changed the landscape.
By this time, Talbert and board members had received updates on the investigation. Talbert and Ladenburg recently told The News Tribune that this was when they first learned Cruz-Uribe had forged ahead on Tamiflu without their knowledge. Talbert said he expected the board would soon give the director a choice: Retire or resign.
“It certainly made that part of it easier,” Talbert said. “Once he indicated his desire to retire, it became, under which circumstances are we going to accept this: his terms, or we could set our own terms.”
Cruz-Uribe suggested he could stay through December. Speaking for the board, Talbert said it had to be faster: the end of July.
The official letter was dated April 25, 2007. Cruz-Uribe’s last day would be Aug. 1.
“It is time for me to move on to new challenges,” Cruz-Uribe wrote to his staff. “I wish to thank the board for their confidence in me and for their ongoing support over the last 15 years.”
There was no golden parachute, no gift-wrapped severance. He got the standard package: payment for leftover vacation, half of the value of his accumulated sick time, and the standard pension for Tacoma employees.
A News Tribune story published May 12 took note of his retirement. Cruz-Uribe said the Health Board had hired him in 1992 “to shake things up.” Now things were different.
“They don’t need me to shake things up,” he said. “They need a maintainer. That’s not me.”
The story quoted Dr. Summer Schoenike, head of the Pierce County Medical Society, who called Cruz-Uribe “one of the most courageous public health officers I’ve ever known.”
The story said Cruz-Uribe had no particular plans for the future, apart from knee surgery.
Aftermath
The internal investigation was never finished. Board members halted it once Cruz-Uribe announced his retirement, Talbert said.
“The investigation itself was basically put on hold,” he said. “We abandoned any further work on that. The issue with regards to Doctor Cruz in the board’s opinion had been resolved.”
During his interview with The News Tribune on Sept. 6, Cruz-Uribe said his fundamental reason for retiring was his health. He said his last evaluation didn’t affect his decision. He saw it as a good one. The board gave him a raise.
While admitting the Tamiflu venture didn’t work out, he said the cost to taxpayers was minor – $23,000 in the context of a $40 million budget, a fraction of a fraction.
“We’re not dealing with a lot of money here,” he said, adding that the county ultimately got its stockpile of bird flu drugs through legal sources.
“Eventually, years later, the feds got their act together,” he said.
At The News Tribune's request, Cruz-Uribe reviewed a draft of this story on Sept. 27 and discussed it with a reporter and two editors. Asked to address any potential inaccuracies, he focused on his interactions with the Health Board in spring 2006.
He said the board never gave a collective order to abandon the drug importation project, though he said individual members expressed concern.
"Some of them didn't like it," he said. "It was the group that had to make the decision. Many of them never articulated it. There was a lot of passivity."
He said the board told him not to buy the drugs, so he didn't. He drew a distinction between buying the drugs and setting up a mechanism that would make it possible to buy them. He said he told board members about his efforts to set up that mechanism.
He downplayed the low-level contracts with Kodali, and said such agreements with vendors were routine in his experience at the agency. He said the board launched the internal investigation without his knowledge, and board members never asked him about the concerns that prompted it.
A soft-spoken man, he shrugged and smiled when asked about staff members who said they feared his reactions.
"I do like people to stand up to me," he said. "I've had many managers stand up to me, and I appreciate it. I look for managers who can handle my wrath."
He has no regrets about his behavior or his decisions.
"If you really feel strongly that it's the right thing to do, that's what you do," he said.
Sean Robinson: 253-597-8486
