Organ Surgeon Faces Felony Trial

That horrible case in San Luis Obispo, in which Dr. Hootan Roozrokh, an organ transplant surgeon is accused of attempting to hasten the death of Ruben Navarro, a dependent adult to harvest his organs, is going to trial. From the story:

A judge dismissed two charges against a Bay Area transplant surgeon Wednesday but ordered him to stand trial on one felony charge related to the failed harvest of a disabled San Luis Obispo man's organs at a local hospital in 2006. A jury will decide whether Dr. Hootan Roozrokh is guilty of dependent-adult abuse.

I believe in the presumption of innocence in criminal cases, and so I won't comment on whether Dr. is criminally liable. But seems undisputed that he utterly violated the most important organ procurement ethical protocols and should face professional discipline. And he's not the only one who should face such consequences, as described by the defense attorney M. Gerald Schwartzbach:

No transplant surgeon in the world, he said, has ever been in similar circumstances, in which the hospital had no cardiac-donation protocol; its staff hadn’t been trained; the attending physician didn't understand her role; and the surgeon and coordinator had only observed one such donation. "This is a situation where the entire system failed," Schwartzbach said.

No doubt, but that doesn't excuse abuse. And this comment from Schwartzbach seems outrageous to me:

"Nothing this man did, nothing this man said, adversely affected the quality of Mr. Navarro's life," Schwartzbach said, gesturing to Roozrokh.

Trying to speed death up so the patient can be an organ donor--and perhaps not coincidentally, Roozrokh would not be paid otherwise--is abuse regardless of the patient's condition. Otherwise, no dying person is safe.

Killed for Organs? The Preliminary Hearing

Readers of SHS may recall the terrible San Luis Obispo case of a transplant surgeon named Hootan Roozrokh who is charged felonious wrongdoing in trying to kill a profoundly disabled patient so his organs could be procured under a "heart death" protocol. I wrote about the case here and here.

The preliminary hearing is ongoing now, in which a judge will determine whether there is sufficient evidence to have the matter proceed to a full blown trial. The standard of evidence is lower than for a conviction, and usually the defendant does not testify nor present a formal defense. Indeed, it is an opportunity for the defense lawyer to force prosecution witnesses to get their stories set in stone for later attacks on credibility, which is to say that it is not fair to reach a final conclusion based on the outcome of a preliminary hearing or evidence presented therein.

That being said, the victim's doctor sure presented some damning evidence. From the story:

Ruben Navarro showed no signs of pain the night he was removed from a ventilator, the disabled man's last attending physician testified Wednesday, and in her opinion did not need large amounts of painkillers and sedatives ordered by a San Francisco organ transplant surgeon. Laura Lubarsky, a pulmonologist who has practiced for 12 years with Central Coast Chest Consultants, was the first witness to testify in Hootan Roozrokh's preliminary hearing, which began Wednesday in San Luis Obispo Superior Court.

Prosecutors charged Roozrokh in July with three felonies, alleging he attempted to hasten the death of the potential organ donor by ordering a nurse to give excessive amounts of medications. They also accused Roozrokh of injecting Betadine, a topical antiseptic, into Navarro’s feeding tube. Roozrokh is charged with dependent adult abuse, unlawful prescribing of a controlled substance and administering a harmful substance, Betadine.

Can there be any excuse for putting Betadine in a feeding tube? According to Healthline, that should only be done after death because it is a poison that can cause iodine poisoning! If Dr. Roozrokh actually did that, he should consider himself fortunate not to be charged with attempted murder.

Still, it is important to emphasize that this case is an anomaly. However, it reflects a dire need within transplant medicine to create uniform standards for obtaining organs that apply universally. And better training for all concerned! This is a devastating admission by the witness about how very bad her training in organ procurement protocols had been:

Based on her conversations with the California Transplant Donor Network and her lack of knowledge of organ donation after cardiac death, Lubarsky said she thought her role that night was to be an independent observer and declare Navarro's death if and when he died. She said she believed the transplant team would direct Navarro's care.

Good grief! Under cardiac death protocols, she was to be in charge of the care and Dr. Roozrokh should have had no contact with the patient until death had occurred!

And here is another disturbing thing: Maybe I am just not aware of it, but the crying need for energetic reform that this case exposes does not seem to have lit the fire. Indeed, from what I can tell--and again I could be wrong and would love to hear it here--it seems to me like business as usual.