Re: It's not about money.

October 13, 2005

Its not the money. Who is getting the organs in Saudi Arabia, if they are

importing their terminally ill here to receive the very short quantity US

organs?

Sal

It's not about money.

As I said on my previous post, I am an Ambassador for One Legacy, the

So CA Organ Procurement Network. The same network that governs St

's....so before someone else posts this article and Ric says

that it's all about money,....and I get a few emails asking me how I

can be part of something so " turbid " ....I thought I'd post it

myself.....and tell you that for some of us....it really isn't about

money.

It's not about money when we go stand in the sun for health fairs,

walks and runs and tournaments or whatever it is we're helping with

this week. It isn't about money when we give up our Saturday so we

can be at the local mall's organ donation booth encouraging strangers

to consider donation.....and it sure as hell isn't about money when

we go decorate the Rose parade organ donaion float and have to put

our hands in uice water to get the flowers, or climb up high even

though we;re scared and somehow always end up with glue on our hair

that we can't remove for days.

I do this to build a net for those of you wqho don't clear....it

isn't perfect but that's all we have....and it is so much more than

money....

Silvia

Deception Behind Liver-Transplant Switch Proved to Be Fatal

By Ornstein and Alan Zarembo

Times Staff Writers

October 13, 2005

In January 2003, after more than two years on a waiting list for a liver

transplant, Saad Al-Harthi was finally considered sick enough to rank near

the top.

If a donated organ became available, he would have only a few hours to get

to St. Medical Center in Los Angeles.

But that same month, Dr. R. Jr., then-director of the

hospital's liver transplant program, told him he faced a long wait and was

better off at home in Saudi Arabia, according to Al-Harthi's son Majed.

That's where he was Sept. 8, 2003, when the hospital accepted a liver in his

name.

and Dr. Ramos, his assistant director, transplanted the organ

into another Saudi national 50 places behind him on the list,

St.

officials now acknowledge. The misallocation, reported by The Times

last month, is a serious breach of the national code governing placement of

donated organs.

Al-Harthi never knew any of this. He died less than a year later from liver

cancer that had spread throughout his body. He was 59.

" They killed my father, " Majed Al-Harthi said in a telephone interview from

Rome, where he works for a Saudi oil and gas company. " Intentionally or

unintentionally, they killed him, and they have to

be

punished for it. "

For months leading up to the inappropriate transplant, and for months

afterward, the hospital misled Al-Harthi, his family and the Saudi Embassy

in Washington about his prospects for a liver, according to letters and

e-mails from hospital staff that were reviewed by The Times.

Although the motive behind the transplant switch remains a mystery,

the

tactic was clear: use one patient's position on the list to obtain an organ

for somebody else. In doing so, the hospital bypassed not only Al-Harthi but

dozens of other patients in Southern California whose conditions were deemed

more dire than the recipient's.

Eventually the hospital lost track of Al-Harthi, a popular school principal

in his hometown of Taif. St. administrators learned of his death

from Times reporters this week.

Hospital and transplant officials did not identify the transplant candidates

in question, referring to them only as patients A and B.

The

Times has verified the names with three knowledgeable people,

including

two who have seen the names in hospital documents.

The sources requested anonymity because of patient privacy rules.

Medical leaders at the hospital have hired outside experts to

determine

if and Ramos acted improperly. has resigned from the medical

staff, said hospital spokesman Silva. Ramos remains on

the

staff but has stepped down from the chairmanship of the medical center's

bioethics committee.

The hospital administration is also looking at the conduct of other

employees, including two who have said they falsified records as instructed

either directly or indirectly by , according to Silva.

The hospital suspended all liver transplants more than two weeks ago after a

routine audit caught the problem, and officials are looking into whether any

other organs might have been improperly diverted.

Under national transplant rules, the hospital should have turned down the

liver because the intended recipient, Al-Harthi, was unavailable.

A

patient at UCLA Medical Center was next in line on the list, and doctors

there were ready to accept the organ.

In rare instances, physicians can transplant a liver accepted for one

patient into another - but only after consultation with the local organ

procurement agency. The hospital is also required to justify

such

actions to the United Network for Organ Sharing, which administers the

national transplant system.

Neither agency was consulted in this case.

For more than a year after the September 2003 transplant, St. filed

documents with the national network showing, falsely, that Al-Harthi had

received the liver and was doing well, the hospital has acknowledged.

In fact, the evidence suggests that the surgeons had little intention of

transplanting a liver into Al-Harthi.

----------------------------------------------------------------------

----------

Saad Al-Harthi, a father of five, had a home library of more than

2,000

books and was known around Taif for his charitable demeanor.

He began searching for a liver transplant center in 2000 after his doctors

told him he might have cancer.

It wasn't urgent, but his family was worried because he also had hepatitis

C, another potentially lethal disease of the liver.

Foreign nationals are allowed to seek transplants in the United

States,

and Al-Harthi settled on St. because several Saudi friends had

traveled there for treatment for a variety of ailments. When he

visited

for the first time that October, the hospital placed him on the regional

transplant list and he went home.

The Saudi government agreed to pay his medical bills and travel expenses, as

it commonly does for its most seriously ill citizens. Majed, who speaks

English, routinely served as a long-distance translator between his father

and the medical staff at the hospital.

In January 2003, on Al-Harthi's fourth visit to St. , he was told

that his condition was stable and that he was still an excellent candidate

for a transplant.

" It is crucial that Mr. Al-Harthi return to the United States at least once

a year to update his evaluation and status on the waiting list, " wrote

to the Saudi Embassy in a letter dated Jan. 13, 2003.

But Al-Harthi's score on the standardized medical assessment used to rank

liver transplant candidates showed the situation to be more

urgent

than suggested.

By the end of that month, Al-Harthi's score, 30, had put him in strong

contention for a liver, said Tom Mone, chief executive of OneLegacy, the

regional organ procurement agency.

A score of 30 or higher typically ensures an imminent transplant, said Dr.

Busuttil, the head liver transplant surgeon at UCLA. He

said

he would tell such a patient that " you need to come and live right

Back in Saudi Arabia, Al-Harthi was nervous about his health. He

prayed

for a liver, and his suitcase was always packed.

All summer, his name crept up the list, as patients ahead of him got livers

or died.

His turn came Sept. 8.

OneLegacy called the St. transplant coordinator to say a donated

liver had become available for Al-Harthi, Mone said. The fact that the

patient was in Saudi Arabia didn't stop the hospital from accepting the

organ.

There was someone else in the hospital who could use it.

Abdullah Al-Bugami, 42, also happened to be a Saudi national - and was,

according to the Saudi Embassy, a poor man. Suffering from hepatitis B and

liver failure, he had been on the regional waiting

list

since February 2002, according to the embassy. But he was still not sick

enough to qualify for a top spot, hospital officials said.

Despite the ranking, Al-Bugami had been in the hospital for a month.

" He was very sick ... swelling all over, " said Debbie Wahler, a nurse

practitioner who worked in the liver transplant program at the time. " He was

in a lot of abdominal pain. "

headed to an Inland Empire hospital to remove the liver from a

brain-dead donor, Mone said.

At 9:46 a.m., placed a clamp on the aorta, cutting blood flow to the

organs, Mone said. Thirty-two minutes later, the surgeon removed the liver,

put it on ice and returned to St. . Al-Bugami was waiting.

Ramos led the transplant.

His lawyer, Evelina Serafini, said Ramos knew the organ had been intended

for Al-Harthi but assumed that staff had received permission from organ

procurement officials for it to be reallocated. Ramos

always

left the paperwork to the administrative staff, Serafini said.

referred calls to his attorney, Fisher, who declined to comment.

Al-Bugami's surgery was completed by 5 p.m., said Mone - about seven hours

after the liver was removed from the donor.

It was a quick turnaround for a donated liver. They can remain viable for

transplant up to 12 hours, depending on the quality of the organ.

" We would have had time to make other calls and transport the organ to

another facility, " Mone said.

----------------------------------------------------------------------

----------

The coverup began the next day.

A clerk logged on to the national organ registry and accurately reported

that Al-Bugami had received the liver, hospital officials said.

But about three hours later, the officials said, the clerk signed on again

to say that he had erred and that it was Al-Harthi who had received the

organ.

The clerk later told hospital officials that a nurse had asked him to

falsify the electronic record at the request of , St. President

Gus Valdespino has said.

Al-Harthi was scratched from the list but left to believe that his

turn

would still come.

wrote to the Saudi Embassy to arrange Al-Harthi's next visit.

The

doctor was not in a hurry.

" This reassessment is not urgent and could take place any time over

the

next 3-4 months, " he wrote Jan. 12, 2004. " This will be necessary to

determine if his liver disease has progressed significantly and to estimate

the timing of his transplant operation. "

Al-Harthi's prayers were growing more desperate.

He was losing weight, and his Saudi doctor had detected dark spots on his

liver, according to his son.

When Al-Harthi finally came to the United States in mid-April 2004,

gave him the bad news: Cancer had spread throughout his body, disqualifying

him from the list. told Al-Harthi that his best option was to " go back

and spend the rest of his days with his

family, "

the son said.

At his funeral four months later, 2,000 people showed up, he said.

" My family still feels like he died a month ago, " he said.

As for Al-Bugami, who received the liver, he is doing well, according to a

spokesman at the Saudi Embassy.

The Saudi government, which paid for the transplant, is contemplating

whether it should send any more of its citizens to St. , the

spokesman said.

Copyright C 2005, The Los Angeles Times

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October 13, 2005

Silvia

Its never about the money with you and me... I am totally convinced that some of

us do this because we really care about people.. the drug companies, well, they

are a different story...

You keep up your wonderful work here hon, we ALL DO appreciate what you do to

help us...

love you hon

jax

Sally Hines <shines@...> wrote: