The San Luis Obispo County sheriff-coroner has concluded that a 26-year-old potential organ donor died of natural causes, complicating a criminal inquiry into whether a transplant surgeon attempted to hasten the man's death.
Police have been looking into whether the surgeon, Dr. Hootan Roozrokh, ordered excessive doses of pain medication and sedatives for Ruben Navarro in February 2006 in order to harvest his organs more quickly.
Navarro did not die for several hours after he was given the drugs and removed from life support. His organs were not recovered, because they were no longer viable.
Roozrokh, then a surgeon at Kaiser Permanente's now-defunct kidney program in San Francisco, had been called to Sierra Vista Regional Medical Center in San Luis Obispo with a colleague to procure Navarro's organs. (He was working on behalf of the regional organ procurement agency, not Kaiser.)
The coroner's findings do not halt the police investigation into Roozrokh's actions, both agencies said. San Luis Obispo police are expected to turn their findings over to the district attorney in the next week or two, Capt. Ian Parkinson said.
"This subject died from natural causes," said Sheriff's Sgt. Brian Hascall, a coroner's spokesman. "However, that does not preclude the filing of charges based on the behavior of the doctor."
Officials have declined to specify what such charges might be.
The full coroner's report was not released, because it is part of a criminal investigation.
The findings closely mirror the conclusions of Navarro's treating physician at Sierra Vista, who said the patient died of natural causes.
Roozrokh's lawyer, M. Gerald Schwartzbach, said the findings came as no surprise.
"I do not believe that anything Dr. Roozrokh did or said adversely affected either the quality or the length of this patient's life," he said.
"Dr. Roozrokh killed no one," Schwartzbach said. "There's no question he has become a scapegoat."
A report by federal regulators said Roozrokh ordered 200 milligrams of the narcotic morphine and 80 milligrams of the sedative Ativan for Navarro. That is many times the normal dose of the drugs, experts said.
The report also found that nurses and others in the Sierra Vista operating room had concerns about the drugs being administered but did not raise their objections until afterward.
State law says transplant doctors are not allowed to direct the treatment of potential organ donors before they are declared dead. This restriction is designed, in large part, to ensure that organ retrieval does not take priority over patient care.
The federal report also said Roozrokh was not authorized to care for patients or order drugs at Sierra Vista, according to the hospital's own policies.
The Medical Board of California is also investigating Roozrokh and the other transplant surgeon who was in the room, Dr. Arturo Martinez.