Surgeon Accused of Hastening Death to Harvest Organs

A transplant surgeon from San Francisco faces charges of trying to speed up the death of a patient so as to harvest his organs, in the opening of a criminal case that is believed to be the first of its kind in the United States.

Hootan Roozrokh, the surgeon, has been accused of prescribing excessive amounts of painkillers and sedatives to a patient in February 2006. The prosecution alleges that he acted to accelerate the man's death to within the 30-minute limit that is needed to keep organs fresh enough for donation.

The case is believed to be unprecedented in the US, and has raised warnings from doctors and organ donor groups that it could have a damaging effect on transplant operations. National figures suggest that about 18 people die each day in the US awaiting transplants.

The surgeon has been charged with three criminal counts and if found guilty of all of them will face up to eight years in prison, with possible additional fines of up to £10,000.

The charges relate to the death of 25-year-old Ruben Navarro, who was on life support after falling into a coma following heart failure. He had a debilitating genetic disease diagnosed when he was nine, and that had led to the deterioration in his condition. After his cardiac arrest, he was put on a ventilator at the Sierra Vista Regional Medical Center, in San Luis Obispo, California. Doctors concluded a few days later that he had been so brain damaged his life support should be turned off. The patient's mother, Rosa, was informed, and she gave permission for his organs to be available for donation.

Under rules governing transplants, patients should be removed from a ventilator and left for up to five minutes to die before any attempt is made to take their organs. Transplant experts are forbidden from being in the room as death takes place to avoid any blurring of responsibilities.

But according to the criminal charge sheet, Roozrokh remained in the operating room for 41 minutes. He is alleged to have told nurses to administer to Navarro, then still alive, abnormally high does of morphine and the anti-anxiety drug Ativan, as well as the antiseptic Betadine.

One of the nurses present, who was later the whistle blower on the occasion, said the surgeon told her to give the patient more drugs when he did not die and referred to the medication as "candy", a label that appalled her.

Medical custom in the US is to give dying patients up to 10mg of morphine and less than 4mg of Ativan every hour to ease pain.

Yet records kept by the Californian hospital show that Navarro was injected with about 20 times those amounts of drugs during less than an hour in the operating room. One of the other doctors present said that the high doses were needed because the patient had a high tolerance of painkillers.

The prosecution claims Roozrokh's actions were motivated by a desire to accelerate death, and that he gave up the transplant attempt after the time limit for the organs remaining viable had passed. Navarro was returned to intensive care and died the following morning.

Roozrokh has pleaded not guilty. His lawyer, Gerald Schwartzbach, has said that the trial would show how unfairly he had been treated over months of what he called a witch-hunt.

Rosa Navarro has also filed a separate civil action against Roozrokh and the other doctors who were in theatre.