One of the owners and operators of a Totowa, N.J., test preparation business made her initial court appearance Nov. 5 after being extradited from Latvia for stealing “live” licensing examination questions from the National Board of Medical Examiners, U.S. Attorney Paul J. Fishman has announced.

Egija Kuka, 38, who owned and operated Optima University with her former husband, co-defendant Eihab Suliman, was indicted in July 2011 by a federal grand jury on six counts of mail and wire fraud and conspiracy to commit mail and wire fraud.

She made her initial appearance before U.S. Magistrate Judge Joseph A. Dickson after being transported to the United States on Oct. 26, and was ordered detained without bail.

Suliman remains a fugitive, according to a press release from the U.S. Attorney’s Office in New Jersey.

According to the criminal complaint, Optima University was a test preparation business that provided courses designed to prepare students for the U.S. Medical Licensing Examination (USMLE), which is created and administered by the National Board of Medical Examiners (NBME).

The USMLE is used by medical licensing authorities throughout the United States to evaluate international medical school graduates seeking an initial license to practice medicine. NBME, according to the U.S. Attorney’s Office, goes to extensive lengths to keep test questions secure and examinees are advised that the test questions used in the USMLE are copyrighted and not to be distributed or reproduced.

Officials have warned that individuals who used Optima’s services are at risk of losing their medical licenses.

Beginning in December 2007, Suliman and Kuka solicited potential Optima University students by guaranteeing that the students would pass the USMLE, even if the student had previously failed it. Suliman and Kuka also assured potential students that any tuition paid to Optima University would be “risk-free,” and that any student who did not pass the USMLE could retake the Optima course at no additional cost.

On Dec. 2, 2007, Kuka applied via the Internet to take the USMLE in Milan, Italy, falsely stating that she had graduated from the University of Oradea, an accredited medical school in Romania, with a doctorate in medicine. On Dec. 18, 2007, Kuka submitted a “Certification of Identification Form” along with a copy of a fabricated diploma from University of Oradea’s medical school to enable her to take the exam and gain access to, steal, and reproduce the live test questions.

Kuka took Steps 1 and 2 of the USMLE in April 2008 in Milan. Video surveillance from those test sessions show Kuka using a small digital video recording device to record the live test questions that were displayed on the computer monitor. On May 28, 2008, Kuka sat again for Step 1 of the USMLE examination.

On May 28, 2008, a search was conducted at Optima University and live test questions were found. These live test questions were used by Suliman and Kuka on practice examinations provided to Optima University students.

Before charges could be filed against Kuka, she fled to Latvia. In September 2011, U.S. authorities requested Kuka’s extradition from Latvia.

Each count of the indictment is punishable by a maximum prison term of 20 years in prison and a fine of $250,000 or twice the gross gain or loss caused by the offenses.

In early 2009, the NBME sued Suliman and Optima University for copyright infringement. In a November 2009 summary judgement, the U.S. District Court in Memphis awarded NBME a total of USD $2.4 million in damages.