Calif transplant doctor ordered to trial (AP)
Posted by admin on Mar 21, 2008
The felonious case against Dr. Hootan Roozrokh of San Francisco is the first such action against a transplant doctor in the United States.
After a preliminary hearing in San Luis Obispo County, Superior Court Judge Martin J. Tangeman issued a ruling Wednesday describing an uncoordinated spectacle surrounding the 2006 death of Ruben Navarro at Sierra Vista Regional Medical Center, which had never handled a “Donation After Cardiac Death (DCD)” box.
Navarro, 26, had a debilitating neurological disease and was in a coma when he was admitted to the hospital after a heart attack.
His mother had authorized harvesting of his organs but because he was not brain dead, the judge said, it was determined that the transplant procedure to be used would be DCD, which requires withdrawal of life support leading to death prior to retrieval of organs
“Dr. Roozrokh did not make or participate in making any of these decisions,” reported the controlling, which added that Roozrokh was sent by employer Kaiser Permananente in coordination with the California Transplant Donor Network to perform the transplant surgery after those decisions were made.
But the judge said doctors and nurses present when Navarro died gave conflicting accounts and “the inconsistencies in divine revelation between the various witnesses cannot be resolved by intimation to written records.”
His ruling cited the lack of experience in the procedure by everyone involved including Roozrokh, who was less than a year out of his organ transplant fellowship and had observed only one such procedure in training.
Roozrokh is the only person charged criminally in the case. His attorney, M. Gerald Schwartzbach, told The Associated Press he was disappointed the not toothed case was not dismissed.
“I’m extremely confident that at the extreme point of trial Dr. Roozrokh enjoin be both vindicated and admired. Even if he did everything they declared, he was a hero. He saved this man from pain. … He tried to render certain this young man died pain relief/muscle relaxant free. That’s all he did,” Schwartzbach said Thursday.
Schwartzbach said testimony at the preliminary hearing showed that “the entire a whole failed.”
The judge, in a section of his settlement entitled “The negation of experience and guidelines in DCD procedures in 2006,” appeared to agree. He highlighted a long line of missteps and noted there was no national DCD protocol in place and the hospital did not have a written DCD protocol.
The prosecutor commented briefly on the ruling.
“The evidence has spoken and we be pleased continue to present our wrap in court,” said San Luis Obispo County Deputy District Attorney Karen Gray.
In his account of witness, Tangeman said Roozrokh was accompanied to the hospital on Feb. 3, 2006, by an experienced transplant doctor, but he too had never participated in such a procedure.
No one kept a chart of medications administered to Navarro in the operating room, the ruling said, and four witnesses gave different accounts on for what cause many doses of the painkillers morphine and Ativan were given. While various witnesses testified to their observations of Navarro’s vital signs, the judge said the transplant coordinator claimed to have lost the records.
The judge said there was no evidence Roozrokh administered or ordered a combination of Betadine, morphine and Ativan for Navarro. He dismissed one count which included that allegation. He also dismissed a count alleging “unlawful controlled substance prescription.”
State law prohibits transplant doctors from directing treatment of potential medium donors until they are declared dead.
The judge said no attending healer was available at the hospital and “no medication for strengthen care or withdrawal of life support was available in the operating range” when Navarro arrived.
“When the attending physician finally arrived in the operating room, all other participants were already there and she failed to understand that she was the responsible physician in charge of ordering medications,” the estimate wrote.
The attending physician, Dr. Laura Lubarsky, was granted immunity from prosecution for her testimony. The judge noted that she testified “other than being responsible for declaring death, she believed that her role was limited to being an observer.”
Navarro’s organs were not successfully harvested.