Close call in death ruling of potential organ donor

Only after the man's 26-year-old daughter and a nurse became suspicious was a third doctor, a neurosurgeon, brought in. He determined that John Foster, 47, was not brain-dead, a condition that would have cleared the way for his organs to be removed, records of the Feb. 21 incident show.

"It kind of blew my mind," said the daughter, Melanie Sanchez, "like they were waiting like vultures, waiting for someone to die so they could scoop them up."

Foster, who had suffered a brain hemorrhage, died 11 days later at Community Regional Medical Center in Fresno. By then, Sanchez said, his organs were not viable for donation.

The apparent close call is the second in recent months to raise questions about whether, amid a national organ shortage, doctors might be compromising the care of prospective donors. Law enforcement authorities in San Luis Obispo County are investigating whether a transplant surgeon tried to hasten the death of a 26-year-old patient last year by ordering high volumes of pain medication.

Contacted Wednesday, Community Medical Center's spokesman John Zelezny characterized Foster's case as "unusual" and said it "wouldn't surprise me" if the medical staff launched an internal review.

"This hasn't fully played out yet," he said. National experts said they believe that it is uncommon for a patient to be declared brain-dead incorrectly. But the ramifications are great, they said, both for the potential donors and for the integrity of the organ donation process.

"It is one of those things that is pretty spooky when it happens," said Dr. Michael A. Williams, chairman of the ethics committee of the American Academy of Neurology. "It's a rare, but high-stakes, error."

Said Dr. David J. Powner, a professor of neurosurgery and internal medicine at the University of Texas Health Science Center at Houston: "It only takes one or two of those situations to really sour the public and sour those upon whom we depend so much for donation."

Brain death means that a person has suffered a total and irreversible loss of brain function. The patient is comatose, cannot breathe without support and lacks reflexes. It often is determined by a mixture of physical examination and clinical tests, and meets the legal standard for death.