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Dr. Hootan C. Roozrokh has been charged with dependent adult abuse, mingling a harmful substance and prescribing controlled substances for non-medical purposes. If convicted on all counts he faces eight years in prison. He has not been charged with murder. The case concerns the 2006 death of Ruben Navarro. Navarro, who suffered from a neurological disorder known as adrenoleukodystrophy, was admitted to Sierra Vista Regional Medical Center in San Louis Obispo, Calif. on Jan. 29. He had been found unconscious in the assisted care facility where he lived and was determined to have suffered from respiratory and cardiac arrest that led to brain damage. After a few days, a doctor informed Navarro's mother that her son would not recover and that doctors had decided to remove him from life support. That night, she received a call from the nonprofit California Transplant Donor Network and agreed to donate her son's organs. On Feb. 3, Roozrokh arrived at the hospital as part of a transplant team to carry out an organ donation procedure known a "donation after cardiac death." While removing organs after a patient's heart has stopped was popular in the first half of the 20th century; it fell out of fashion when medical advances in life support and detection of brain activity caused a change in the definition of death. Yet, because roughly 18 people in the United States die each day from lack of organs for donation, there has been a recent push to move back toward cardiac-death donation. In 2007, the number of cardiac donations was at its highest for the decade, with 670 cases. By comparison, 12,553 brain-dead donations took place. A different protocol governs cardiac-death than the more common brain-dead donations. In brain-dead donations, a patient's organs are kept viable by machines after their brain activity ceases. In cardiac death donations, however, a donor is disconnected from a ventilator and doctors wait until the heart activity ceases on its own. Under transplant protocol, doctors must then wait a further five minutes before declaring a patient dead and allowing transplant teams into the room. According to the criminal complaint against Roozrokh, the transplant team was allowed into the room during the removal of Navarro's ventilator, against donation protocol. Roozrokh was also allowed to give orders for medication, another violation. The complaint alleges that Roozrokh ordered excessive doses of morphine and the anti-anxiety medicine Ativan above and beyond what would normally be given to calm a dying patient. He is also accused of internally introducing the topical antiseptic Betadine. which may be lethal if ingested. A nurse who witnessed the incident said that when Navarro did not die immediately after being disconnected from his ventilator, Roozrokh ordered a nurse to administer more drugs. Navarro died eight hours later, with his organs too deteriorated for donation. The coroner ruled his death natural. Roozrokh has denied any wrongdoing and pleaded not guilty to all charges. His lawyer, M. Gerald Schwartzbach, Roozrokh's lawyer, said his client did "nothing that adversely affected the quality or length" of Navarro's life. Instead, he says, witnesses unfamiliar with the cardiac-death donation procedure misinterpreted what occurred on the night of Navarro's death. Transplant advocates have expressed concern with the effects that the case might have on people's willingness to donate their organs. The case has "given some support to the myths and misperceptions we spend an inordinate amount of time telling people won't happen," said David Fleming, executive director of Donate Life America. Navarro's mother, Rosa Navarro, has filed a lawsuit against Roozrokh and other doctors who were present and the California Transplant Donor Network. She has settled a lawsuit with the hospital. "He didn't deserve to be like that, to go that way," she said. "He died without dignity and sympathy and without respect." Related CounterThink Cartoons:
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