LOS ANGELES – Police are investigating a claim by a Los Angeles County coroner’s investigator that an anesthesiologist uses a painkiller to hasten the death of a seriously wounded boy to increase the likelihood that his organs could be harvested, without deterioration, a newspaper Monday.
The study includes an 8-year-old, who went to a cardiac arrest after nearly drowning in a washing machine in 2013 and was removed from life support at Ronald Reagan UCLA Medical Center, the Los Angeles Times said.
The county’s chief medical examiner at the time indicated the major causes of death, such as near-drowning, and fragile X syndrome, a genetic disorder that causes intellectual and physical disabilities.
At the time of the autopsy, coroner investigator Denise Bertone questions about the dose of the painkiller fentanyl were given to the boy and pressed for re-examination of the case to a subsequent medical examiner added fentanyl toxicity as a major cause of death.
However, the manner of death — accident or murder — remains open pending the outcome of the police investigation.
Bertone’s claim is described in a whistleblower lawsuit she filed in the last month that she suffered on the job in retaliation for raising questions. The province has yet to respond to the suit in the court.
The assertion is “factually wrong and patently offensive,” lawyer of the anesthesiologist, Dr. Judith Brill, said in an e-mail to the Times.
Lawyer Mark Werksman wrote that Brill’s “only concern was to ensure that this child, who was drowned, and never would recover, there would be no suffering, no pain after the removal of the life support.”
Brill, 65, a professor emeritus of clinical anesthesiology and perioperative medicine at the UCLA.
The case is a rare example of a criminal investigation in medical procedures used in organ donation. In 2007, a San Francisco surgeon accused of speeding up the death of an organ donor by the use of large quantities of drugs, but a jury acquitted him of the charge of dependent adult abuse.
“As you can imagine, this is very complicated,” said Captain William Hayes, who is in charge of the Los Angeles Police department’s Robbery-Homicide Division. “We must understand what was done and the consequences of those actions.”
The lawsuit does not name the child, but the Times said Bertone confirmed in an interview that he was Cole Hartman of Castaic.
According to the coroner’s report and a 911 recording, his father came in from mowing the lawn on July 31, 2013, and found Cole leaning in a spinning washing machine. His parents estimated that he could be underwater for up to 25 minutes.
The paramedics got his heart started again and he was driven by ambulance to a hospital and later flown by helicopter to Ronald Reagan UCLA Medical Center in Los Angeles.
Doctors told Cole’s family that he is not brain dead, but “would never recover from the normal neuro-function and . would never wake up,” according to an entry on his medical records.
His parents decided to take him off life support and his organs to donate.
The process requires organ harvesting is to wait until the fan was removed, and Cole’s heart stopped beating on its own, a procedure known as donation after cardiac death. The process has time limitations because organs can begin deteriorating immediately, which is still unsuitable for transplantation after 30 minutes.
In addition, the doctors do not know is whether patients in vegetative states experience pain, so that they administer painkillers.
The Times said that in a part of the medical record has been assessed, Brill has no mentions of fentanyl but wrote that “comfort care is available in the whole.”
UCLA’s policy allows the use of opioid drugs “at doses that are clinically suitable for prevention of discomfort,” the newspaper reported. Under the policy, ” interventions aimed at the preservation of organ function, but which may hasten death, are prohibited.”
Cole fan was removed at 10:40 am The chart said that his heart stopped at 10:59 pm and Brill declared the death of four minutes later.
The coroner’s office assigned to Cole’s case, Bertone, a nurse who was the only full-time pediatric death investigator.
Bertone, who said that they reviewed the full medical charts and autopsy records, claims in her lawsuit that the boy continued to gasp for air” and that Brill gave him fentanyl “with the purpose of inducing his death.”
Bertone is a suit and coroner’s records state that the administered dose is 500 micrograms. Bertone said it was concerned that the dose is given to a boy that weighed 47 pounds.