Organ Harvest Case

Doctor testifies in failed organ transplant case; says high dosage for patient unnecessary

Laura Lubarsky is the first person to testify in the preliminary hearing for the S. F. transplant surgeon

By Sarah Arnquist

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.

The 34-year-old pleaded not guilty. If convicted of all charges, he could face up to eight years in prison and a $20,000 fine.

At the preliminary hearing, the prosecution must convince Superior Court Judge Martin Tangeman that there is enough evidence to try Roozrokh in what is thought to be the first case of its kind in the nation.

Lubarsky signed an immunity agreement with the District Attorney’s Office last week.

Lubarsky, who signed Navarro’s death certificate, testified Wednesday that she had encountered Navarro once in a hospitalization about a year before his death.

The night of the failed organ donation, she was covering for another doctor in her group, who had been treating Navarro during that hospitalization.

Since childhood, Navarro had lived with a disabling neurological condition. On Jan. 29, 2006, he stopped breathing and was taken to Sierra Vista Regional Medical Center in San Luis Obispo in a coma. He never recovered, and his mother, Rosa Navarro, agreed to donate his organs.

Roozrokh listened as Lubarsky described what happened in the Sierra Vista operating room Feb. 3 and 4, 2006, when the surgeon came with a transplant team from San Francisco to harvest 25-year-old Navarro’s organs.

Lubarsky testified that she had never participated in or been trained in organ donations after cardiac death, the less common type of donation, which was attempted in Navarro’s case.

Navarro qualified for donation after cardiac death because he was not legally brain dead. Normal protocol in this rarer, but increasingly promoted procedure, requires the critical care doctor to remove a patient from life support and to declare the patient dead after his or her heart stops. Then about five minutes later, the surgeons can enter the operating room and harvest the organs.

A donor must die within an hour of being removed from the ventilator or the organs are no longer viable. Navarro did not die until the following morning, and his organs were never used.

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.

After Navarro’s breathing tube was removed, Lubarsky testified, Roozrokh ordered a nurse to give Navarro “candy,” referring to the medications, morphine and Ativan, and that he suggested once that Navarro might be dead. Lubarsky said she listened to Navarro’s heart and determined he was not.

M. Gerald Schwartzbach, Roozrokh’s attorney, will continue cross-examining Lubarsky today. Other witnesses today could include Steve Crawford, county coroner investigator, and San Luis Obispo police Officer Chuck Riedel.

The preliminary hearing initially was expected to last until Monday. However, testimony Wednesday went more slowly than expected, so the length of the hearing is unclear.