Organ Donation Gone Bad....

[markomalley]

From the San Luis Obispo Tribune:

The mother of a San Luis Obispo man who died after an attempted organ donation at Sierra Vista Regional Medical Center last year claims she never gave hospital officials consent to take her son off life-support and was misinformed when agreeing to the organ harvest, according to a wrongful death lawsuit.

Rosa Navarro also alleges in her June 29 civil lawsuit that a transplant surgeon misrepresented himself as her son’s doctor, an allegation the surgeon’s attorney strongly denies. She also said she agreed to the organ donation only because she believed her son had no chance of survival.

(snip)

Ruben Navarro, who was dying of a rare metabolic disorder, had been on life support for four days and was expected to die. His mother agreed to donate his organs, and the California Transplant Donor Network dispatched its transplant team to Sierra Vista.

Rosa Navarro said during an interview from her Oxnard home Tuesday that when she arrived at the hospital she asked about her son’s condition. She said a hospital nurse told her to speak with the doctor.

“He came over and approached me and said I’m in charge of Ruben,” Navarro said of Roozrokh, who was part of the surgical team from San Francisco dispatched by Oakland-based Organ Transplant Donor Network.

“I asked him, ‘Doctor could you do anything for my boy?’ and he said, ‘Oh, no. Oh no… There’s nothing I can do for a patient like him.’ ”

Navarro said through sobs that Roozrokh asked her if she planned to watch him disconnect her son from life-support.

“He didn’t even ask me, ‘What do you want me to do Ms. Navarro? Do you want me to keep him on the machine or whatever?’ ” Navarro said.

Roozrokh’s attorney, M. Gerry Schwartzbach, told The Tribune on Tuesday that his client never spoke with Rosa Navarro and was not in charge of her son’s medical care.

“He did not have any conversation with her with regard to taking Ruben off the respirator. … Dr. Roozrokh was in the Bay Area,” Schwartzbach said. “I feel very bad for Ms. Navarro because she’s going through a great deal, but unfortunately someone misled her because she never met (Roozrokh) and she never spoke to him. That is absolutely clear.”

Schwartzbach said a local physician made the decision to remove Ruben Navarro from life support.

(snip)

An operating-room nurse reported that standard medical procedures weren’t followed when Navarro was taken off life support.

The lawsuit alleges Roozrokh ordered Ruben Navarro be given lethal doses of morphine and Ativan, an accusation also reported as a finding in a federal investigation by the Centers for Medicare and Medicaid Services.

The report showed an intensive care nurse gave Ruben Navarro 220 milligrams of morphine and 80 milligrams of Ativan.

(snip)

He (the hospital spokesman) did say a surgeon contracted with the donor network assumed responsibility for Navarro in violation of hospital policy, which requires a doctor to be credentialed by the hospital to treat a living patient.

(snip)

So, if the allegations are true, did the doctor even do anything wrong?

Or, since the kid was going to die anyway, was it OK to cause him to OD so as to speed the availability of his organs?

[ChasUFarley]

Reading between the lines here because the truth is somewhere in the middle of what Ms. N., Dr. R., and the patient's medical record:

Mrs. N's son's age is not disclosed - if he was not an adult, and Mrs. N. made a medical decision for him based on the information she had been given by his attending physician, then she acted in, what she felt, was her son's best interests. If her son was an adult, the story does not tell us if (1) he had a living will; OR - (2) he had made his wishes known via advance directives, etc., or by some other means. Because Mrs. N asks, "Can anything be done for my boy..." I assume that he was a minor.

IF the surgeon responsible for harvesting the organs misrepresented himself or did not follow protocols for the surgical procedure, then YES, he did something VERY WRONG.

IF the surgeon ordered the lethal doses of morphine and ativan for the patient AND a nurse administered the doses did not question the order or even try to stop it - as it was way beyond regular "care and comfort measures" than YES, he and the nurse did something VERY WRONG.

Organ harvesting has to be done while the organs are basically still "living". After a patient is pronounced dead (brain dead - the body is kept 'alive' via artificial means) by an attending physician, the surgical procedure to remove the organs and tissues begins. Hospitals have very strict and careful protocols and guidelines to make certain that mis-communications like this do not happen at these very stressful and sensitive times.

I suspect there was a breakdown in communication between the mother and attending physician and surgeon. It does not make it right - it is very unfortunate. Nothing was gained by speeding up that death and now that mother will always wonder "what if?" Organ and tissue donation can be a wonderful thing in the midst of a very dark time if it is done with tact and professionalism - and with regard for the family of the patient. Stories like this are rather 'sensational' and I would be very interested in knowing more about this and if there was a medical error.

[excathedra]

An operating-room nurse reported that standard medical procedures weren’t followed when Navarro was taken off life support.

?

[ChasUFarley]

An operating-room nurse reported that standard medical procedures weren’t followed when Navarro was taken off life support.

That could mean about anything - and without looking at the medical record, it would be hard to judge.

If things were horribly off, then there are many ways that a procedure can be STOPPED by a nurse or other surgeon. I don't know of a single case of organ harvesting where there is only one surgeon in the OR with the patient. It's two - sometimes more - plus nurses, OR techs, etc. ALL of them are trained in how to harvest organs but also know protocols and procedures for "speaking up" to stop an error.

This story is written like this surgeon swept in, lied to the patient's mother, bumped off the patient, and then forcefully ripped out the patient's organs. I suspect there's more we don't know from this event... A LOT MORE!

[Eagle]

No, not okay. Draw the line somewhere. And this is a good line. Morphine should have only been used to treat his pain, not OD him. If he was brain dead, then that id dead. No such report. Life support should have continued until he died. I know this means the organs would all be damaged, but the patient was not there to make the decision to offer his own life and the mother was asking for treatment until he died. Harvesting of organs is a lucrative business. They cannot get into the business of killing others for saving others because the motivation is not grounded in medical ethics or any standard of ethics at all. The motivation was money.

The man was killed for money.

[templelady]

THe bottom line:

if drugs were given to the minor, who was unable to give informed consent, that caused said minor to die THAT IS MURDER.

There are no excuses, there is no justification. There is pain management which is a legitimate medical practice. Sometimes in order to sucessfully control the pain the increase in dosage leads to death by OD. This is a recognized possibility and a risk I would take for myself or a loved one who was dying and in pain.

What I read is that these drugs were not given in the doses they were for pain management but rather deliberately high doses were given for the sole purpose of hastening death so that organs could be harvested. NOT ACCEPTABLE.

Where does it end--who decides that a person should die so another can live??? Even with a "living will" this would not be acceptable. "First do no harm"--I can think of no greater harm than deliberately causing someone to die for the benefit of another.

Edited July 6, 2007 by templelady

[Watered Garden]

Be interesting to know who the donated organs were going to, and if they were wealthy folk, not that us poor folk like me could ever afford such a luxury. something's very fishy here. I can't imagine any of the nurses I know cheerfully administering fatal doses of morphine and Ativan.

WG

[Galen]

It does sound fishy

[ChasUFarley]

Working in healthcare quality management and knowing the laws and regulations surrounding this AND patient privacy, I am more suspicious of this news article than anything else. It smacks of sensationalism and there's so much that's NOT said in this, that should have been. The medical facts about the case that are quoted by a nurse are unprofessional and could do more damage to the mother's case *IF* blame is placed on the practitioners involved with this and IF their intent was truly foul. I suspect there was more of a misperception by the mother, a miscommunication between the medical professionals, and the this isn't the monstrous situation that the article has made it out to be... I'd love to follow this more...

[ChasUFarley]

After making my last post on this, above, I did a quick Google on the physician's names and practice:

http://www.venturacountystar.com/news/2007...-in-mans-death/

-Organs were NOT harvested

-The pt did NOT die as a result of the injections, although they were within lethel limits

-The physicians involved do NOT work for a private organ transplant or harvesting company - but the one for the state of CA - it's a network. In other words, they had little/nothing to gain (money wise) by this issue.

This is more of a DEATH gone bad - the lack of regard for this boy's life (he was 25) and his mother's wishes were not fully considered.

This article states that CONSENT was given for organ harvest:

http://blogs.eastbayexpress.com/92510/2007...plant_doc_u.php

Nonetheless... this is a set back for organ donation, no doubt about it.

[excathedra]

sad, huh ?