Wednesday, January 27, 2010

Donation Difficulties in San Luis Obispo: the End of the Story

Two and a half years ago, concerns were raised in the field of organ transplantation. A respected transplant surgeon was accused of serious misconduct. Specifically, he was alleged to have given excessive doses of morphine to a dying patient who might have been a donor in donation after cardiac death. As a result, the physician was charged with three crimes: dependent adult abuse, administering a harmful substance, and prescribing a controlled substance without a legitimate medical purpose. A judge dismissed the latter two charges, but the charge of dependent adult abuse went to trial. I wrote about the case at the time here and here.

In my second post on this case, I noted the difficulties involved with allegations about “excessive” doses of drugs. In this case, the patient was not “narcotic na├»ve;” that is, the patient had a history with these drugs, a history that allowed his body to develop a tolerance, and so require significantly higher doses than would be appropriate in a healthy patient, or in a patient without that tolerance.

Now we’ve heard the results of that case. On NBC’s Dateline this past Sunday night there was a detailed report.  You can find that here, and while there is a transcript, I encourage you to watch the story. The physician was acquitted, in no small part because the Prosecution brought a poor case with poor evidence. Especially important was the failures of the Prosecution to produce either critical portions of the chart, or the nurse who would have been responsible for them.

I complain often enough about medical journalism. In so many cases reporters go for the sensational at the expense of the informative. I was frankly concerned when I saw this report announced that the same thing would happen with this story. However, to give credit where due, Keith Morrison and NBC have done justice to this story. They have certainly acknowledged the sensational aspects of this story, and how sensationalism at the time really served no one. More to the point, they have provided accurate information about this surgeon, and about donation after cardiac death.

So, take the time to read or, better, to watch this report. Sure, it’s got some of that television tension; but it’s also got the facts.

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