An influence scandal involving the University of Maryland Medical System has exploded with Baltimore¡¯s mayor, Catherine Pugh, taking a leave of absence and the state¡¯s governor, Larry Hogan, calling for an investigation.

The mayor has been under pressure for the past two weeks following revelations that she was paid $500,000 (?380,000) by the university medical system for copies of a self-published promoting children¡¯s health.

The , revealed by The Baltimore Sun, has been leaving more questions than answers, including why the medical system ordered the books and whether they were ever delivered.

Ms Pugh announced on 20?March her from the board of the University of Maryland Medical System, a private entity closely affiliated with the state university system.

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Two other board members have resigned, and Mr Hogan? four others with business relationships with the medical system to take leaves of absence. At least two major health and medical insurance companies were also reported to have paid thousands of dollars for the mayor¡¯s books.

¡°These are deeply disturbing allegations,¡± Mr Hogan wrote in a letter to Emmet Davitt, the Maryland state prosecutor, setting out such details and asking for a criminal investigation of Ms Pugh¡¯s actions.

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Ms Pugh¡¯s office said in a statement that the 69-year-old mayor had been advised by her doctors to take a leave of absence to help her recover from a case of pneumonia that her hospitalised for several days.

The deal, as described by The Sun, called for the university hospital system to pay $500,000 over several years for 100,000 copies from the mayor¡¯s book series. In addition to quitting the system¡¯s board, the Democratic mayor said that she $100,000 for the last 20,000 books that had been planned in the series.

Ms Pugh told The Sun that the books bought by the university medical system were to be distributed to city schools and childcare centres, but she offered no details on the distribution. A spokesman for the university medical system said that it felt no need to inspect and monitor the donations of the books.

The Sun that the healthcare provider Kaiser Permanente paid Ms Pugh more than $100,000 for 20,000 copies of the books at a time when it was seeking a major new contract with the city. CareFirst BlueCross BlueShield, a company already having business with the city, bought $14,500 worth of the books, The Sun reported.

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paul.basken@timeshighereducation.com