Doctor kills to get man's organs

[livecam]

Livecam comments - Doctors often use medications to help a person die sooner at the end of life.  It isn't talked about much but it happens.  I know personally of a case where a retired MD did this for a dying friend.  Causing a person to pass sooner in order to take his or her organs hasn't happened much as far as we know.  Then again, who is going to tell?


Transplant surgeon charged with trying to hasten patient's death
The physician faces felony counts alleging he tried to hasten a man's demise to make use of his organs.
By Charles Ornstein and Tracy Weber, Times Staff Writers
July 31, 2007

 

A San Francisco transplant surgeon was criminally charged Monday with excessively prescribing drugs to a 25-year-old disabled man last year in order to hasten his death and harvest his organs sooner.

The felony charges are believed to be the first in the nation against a physician for his role in a transplant.

Experts said the case is likely to raise uneasiness among potential organ donors and could prompt doctors to shy away from a somewhat controversial practice of retrieving organs before a patient is brain dead.

The San Luis Obispo County district attorney's office accused Dr. Hootan Roozrokh, 33, of dependent adult abuse, administering a harmful substance and prescribing controlled substances without a legitimate medical purpose.

The surgeon allegedly ordered massive amounts of narcotic painkillers and sedatives for Ruben Navarro, a physically and mentally disabled man, on Feb. 3, 2006. In addition, Roozrokh is accused of administering the antiseptic Betadine through a feeding tube into Navarro's stomach, a sterilization procedure typically done after a donor is dead.

"The law and the facts indicated that Dr. Roozrokh … tried to accelerate [Navarro's] death to facilitate the harvesting of his organs," said Chief Deputy Dist. Atty. Stephen Brown.

Navarro survived for more than seven hours after he was removed from life support and given the drugs. By that time, his organs were no longer viable and could not be recovered.

Roozrokh's lawyer, M. Gerald Schwartzbach, called his client an "extremely dedicated and accomplished organ transplant surgeon" and said the charges filed against him were "unfounded and ill-advised."

"Dr. Roozrokh did not commit any crime," Schwartzbach said in a written statement.

If convicted of the three counts, Roozrokh could receive up to eight years in state prison and a $20,000 fine, the district attorney's office said. A warrant has been issued for Roozrokh's arrest, and he is expected to turn himself in this week. He will be required to post a $10,000 bond.

Roozrokh was a surgeon with Kaiser Permanente's now-defunct kidney transplant program in San Francisco when he and a Kaiser colleague went to Sierra Vista Regional Medical Center in San Luis Obispo to retrieve Navarro's organs. However, the two surgeons were not working on behalf of Kaiser when they went to Sierra Vista but for the group that procures and distributes organs in much of Northern and Central California.

Navarro had been on life support after being found unresponsive Jan. 29, 2006, at a nearby long-term care facility. His family agreed to donate his organs.

Late in the evening of Feb. 3, he was taken to the operating room and removed from life support. As at least six people stood by, including Navarro's treating physician, Roozrokh ordered a total of 200 milligrams of the narcotic morphine and 80 milligrams of the sedative Ativan for him, according to a report by federal inspectors. Those were many times the normal doses of the drugs, experts have told The Times.

After Navarro had been off life support for about 30 minutes — the time limit set to ensure the viability of organs — the process was ended. Navarro was returned to the intensive care unit, where he died early the next morning, five days before his 26th birthday. (Authorities and The Times have sometimes said incorrectly that Navarro was 26 at the time of his death.)

The case came under scrutiny by medical and law enforcement authorities after the operating room staff expressed concerns about the actions of the doctor and of the nurse who was administering the drugs. Under state law, transplant doctors cannot direct the care of organ donors before they are declared dead.

The San Luis Obispo County coroner's office ruled this March that Navarro died of natural causes. But "the central issue of the case was the mistreatment of a severely disabled adult," said Brown of the district attorney's office.

Brown said it would have been difficult to pursue a more serious charge of murder or attempted murder because Navarro survived for hours after being given the drugs. No one besides Roozrokh has been criminally charged.

Schwartzbach said Monday that Roozrokh is blameless.

"Nothing that Dr. Roozrokh did or said at the hospital that night adversely affected the quality of Mr. Navarro's life or contributed to Mr. Navarro's eventual death," he said.

Roozrokh was placed on administrative leave by Kaiser in May 2006 after HMO officials became aware of the allegations against him. He was reinstated in January but the next month voluntarily agreed not to see patients, Kaiser spokesman Matthew Schiffgens said. With the filing of criminal charges Monday, the surgeon once again has been placed on leave.

"The case did not involve a Kaiser Permanente patient, or a Kaiser Permanente hospital," Schiffgens said in a written statement, adding that Kaiser was cooperating fully with the investigation.

Similarly, Sierra Vista officials said in a statement that Roozrokh was not a member of its staff and that the hospital continues to cooperate with authorities.

Although prosecution of doctors for medical performance is rare and generally opposed by physician groups, some ethicists and doctors said Monday that strong action was warranted in this case.

If his intention was "to kill the person, have the person die sooner, but the person didn't actually die, that's attempted murder," said Michael Shapiro, an ethicist and law professor at USC.

But some transplant professionals worried that the charges might prompt surgeons to be overly cautious in how and when they recover organs — especially in the type of organ retrieval attempted in Navarro's case, known as "donation after cardiac death."

Surgeons "will pull back. They will be more careful," said Dr. Goran Klintmalm, head of the Baylor Regional Transplant Institute in Dallas and president of the American Society of Transplant Surgeons. "They will turn situations down because they don't want to have any exposure."

Donation after cardiac death involves patients who have suffered a devastating brain injury and require ventilators to breathe but who still have minimal brain function.

In such cases, patients are removed from life support with their families' consent. Generally, their hearts stop within minutes and they are declared dead. Their organs are then harvested.

Such procedures have become more common in recent years as doctors have sought to expand the donor pool. But some hospitals question the ethics of removing life support from a patient for the purpose of retrieving organs.

As of Monday, nearly 97,000 people were on the national waiting list for organs.

Some transplant experts and medical ethicists said the charges against Roozrokh tap into a primal fear about transplants and concerns that organs might be taken too soon.

"You get one case like this and people get worried," said Dr. Michael Grodin, director of medical ethics at Boston University's School of Public Health.

"This could be a major, major setback for actually appropriate donation. This is an example of something that could be really, really scary for the public at large."

Navarro's mother said that her son, 80 pounds and cognitively impaired, was exploited.

"They mistreated him and they abused him and they took advantage of him and me," said Rosa Navarro, who is suing Roozrokh, the regional transplant procurement group, Sierra Vista and others.

"He didn't die with dignity, and I didn't have the chance to really say goodbye to him. I don't think it's right. These people need to pay for what they did to him."


--------------------------------------------------------------------------------
charles.ornstein@latimes.com

tracy.weber@latimes.com

[livecam]

I saw this story on the CBS Evening News tonight....they showed the doctor's pathetic attorney in court trying to get him off on a racial discrimination platform because Hootan Roozrokh sounds foreign or so says the lawyer.  If you can't win on the facts play the race card, pathetic.

[st789]

I agree here come the race car again.  I believe there is more to the story than is reported.

[Rerun]

I think this 33 year old doctor is just a young buck or butt trying to get things done his way.  Hope he goes to prison.  What is with the $20,000?  Shit that isn't even the cost of a kidney biopsy!!!

[whitehorse]

only in California (and China)

[BigSky]

IMO I do not see any malicious attempt by the doctor.  Sure he put the cart before the horse and go ahead of himself.  However it seems from the article that no one thought the young man was going to live much longer, it was only by a fluke of nature that the body kept going despite indications that it should not.



Personally if I was in the state that the disabled man, Ruben Navarro, was in with no chance for survival and death was expected within hours or a few short days.  I would rather have whatever was needed done to push me into death right away so that any organs that could be transplanted would remain viable for someone else to use. 

[livecam]

The San Luis Obispo County district attorney's office accused Dr. Hootan Roozrokh, 33, of dependent adult abuse, administering a harmful substance and prescribing controlled substances without a legitimate medical purpose.

"The law and the facts indicated that Dr. Roozrokh … tried to accelerate [Navarro's] death to facilitate the harvesting of his organs," said Chief Deputy Dist. Atty. Stephen Brown.

Trying to accelerate a person's death is called murder.  You don't see any malicious attempt by the doctor?  What if your loved one was lying there comatose and that ghoul was pumping that person full of lethal doses of painkillers and other drugs.  What would you say then?

[BigSky]

Trying to accelerate a person's death is called murder.  You don't see any malicious attempt by the doctor?  What if your loved one was lying there comatose and that ghoul was pumping that person full of lethal doses of painkillers and other drugs.  What would you say then?

Then by your own terms the family tried to commit murder by accelerating his death by pulling him from life support.


It all has to do with circumstances.

In the situation you describe of being comatose is a far cry different than the one that happened in which the person was on life support and expected to die very shortly after life support was removed.

However if it was in the same situation as was in the article and I had family members on life support, and I had terminated it so they could pass on, I would rather have it occur shortly after with a doctors help so organs could go to others instead of waiting days or weeks watching my loved one slowly be  dehydrated and starved to death.  After which no organs could be used to save anyone.

That is what I say!  Everyone has their own view.






However I do not buy what the mother claims at the end of the article just for the fact that she moved to pull him from life support herself. 

Also you might note the DA is all about headlines in the case and making a name for themselves IMO.

The very fact that the DA says he cannot charge the doctor with murder or EVEN ATTEMPTED murder speaks volumes about the case.  The DA claims it is because the man survived. 

Hmm.....last I knew that is why the charge of attempted murder was around because the person survived the attempt.

[livecam]

Ok points well taken but look at it this way.  If the patient is already comatose why is the doctor pumping him full of painkillers...the answer is to suppress his respiration other vitals to make him die sooner.

You also ask yourself, "why is such a big deal being made of this case"?  The answer is that we don't want this kind of thing happening on a regular basis. 

If I was dying I would want the people treating me to make the maximum attempt to keep me going and bring me back if possible.  I would be very hesitant to allow cadaveric donation of my organs if I thought I might be attended by a Dr. Roozrokh or someone like him.

What this case does also is to scare off many other potential organ donors.  We are told repeatedly by organ procurement organizations and others that cadaveric donors are treated respectfully and that organs are not taken until the person is essentially deceased. 

What happened here was neither ethical or respectful.

[BigSky]

Ok points well taken but look at it this way.  If the patient is already comatose why is the doctor pumping him full of painkillers...the answer is to suppress his respiration other vitals to make him die sooner.

You also ask yourself, "why is such a big deal being made of this case"?  The answer is that we don't want this kind of thing happening on a regular basis.

Sooner???  That a relative term now isn't it.  So sooner rather than a week later after suffering from dehydration and being starved.  Remove the doctors actions and in the end, no matter what the individual was going to die because of life support removal.

 

If I was dying I would want the people treating me to make the maximum attempt to keep me going and bring me back if possible.  I would be very hesitant to allow cadaveric donation of my organs if I thought I might be attended by a Dr. Roozrokh or someone like him.

Sorry.... but you keep bringing up stuff that is in no way in the same arena as this case.   

There is a clear difference between someone who can possibly be treated and be brought back and the person in this case who was clearly past that stage in that his family removed him from life support to let him die.

[whitehorse]

Euthanasia for for the donor and consider all the recipients of those needed organs. In the case of his liver , heart and lungs it would save a life in a state
like California, know for wasting organs. How much brain dead did the donor need to be ?