California inmate who received heart transplant dies

Tuesday December 17, 2002

By JIM WASSERMAN
Associated Press Writer

SACRAMENTO (AP) A 32-year-old California prison inmate has died nearly a year after receiving a heart transplant that sparked a nationwide ethical debate about the propriety of organ transplants for convicted criminals.

State Corrections officials announced Tuesday that the inmate, who entered Stanford Medical Center on Nov. 23 with signs of rejecting the organ, died at 10:55 p.m. Monday, more than 11 months after receiving his new heart. The prisoner, believed by state officials to be the nation's first state prison inmate to receive a heart transplant, had been in critical condition and on life support since Nov. 30.

Officials have never identified the two-time felon who entered the California prison system in 1997 at Salinas Valley State Prison and was later transferred with a viral heart condition to the California Medical Facility at Vacaville.

But prison authorities said last week the inmate, serving a 14-year sentence for a 1996 Los Angeles robbery and eligible for parole in 2008, had failed to maintain rigorous medical routines following a transplant.

Department of Corrections spokesman Russ Heimerich said reports inside the prison indicated ``he was not a model patient.'' The hospital listed the cause of death as heart failure, but an autopsy is scheduled. It is not unusual for inmates to neglect their health, he said.

Post-transplant routines typically include compulsive personal monitoring and 10 to two dozen pills daily to ward off rejection and prevent infections.

Nationally, about 85 percent of heart transplant recipients live through their first year, while 69 percent survive five years, reported the California Transplant Donor Network.

The January transplant, performed on a day when more than 500 Californians were on waiting lists for new hearts, triggered angry reaction among talk radio listeners and others among the public who said criminals shouldn't be eligible.

Today, nearly 4,000 U.S. residents are on heart transplant waiting lists.

Mary Wallace, spokeswoman for the Oakland-based donor network, which helps find organs for recipients, said the inmate's case and the media coverage it provoked have caused people to call, saying ``they're ripping up their donor cards. They say, 'I won't be a donor unless you can guarantee my organ isn't going to a prisoner.'''

Stanford Medical Center spokeswoman Michelle Brandt, citing patient confidentiality, couldn't say whether doctors considered a second transplant for the inmate as his condition declined.

Medical professionals have defended the transplant, saying the recipient met medical criteria. Medical ethicists, such as Dr. Lawrence Schneiderman at the University of California at San Diego, said doctors don't have rights to make social decisions. And prison officials cited a 1976 U.S. Supreme Court ruling and 1997 California decision by the 9th U.S. Circuit Court of Appeals requiring them to meet inmate medical needs.

But Schneiderman noted the rulings can also give inmates priority over 7 million Californians who lack medical insurance. He said uninsured people generally are less likely to reach the top of transplant waiting lists.

Prison officials said the inmate's Medi-Cal coverage qualified him for the $900,000 transplant, while the United Network for Organ Sharing in Richmond, Va., placed him on the waiting list in 2001. A UNOS policy treats prisoners the same as other waiting Americans.

Heimerich said it cost California $12,500 a day to keep the inmate in Stanford's intensive care as he deteriorated, rallied last week and then died Monday. He said state costs have risen beyond $1 million for the inmate's transplant.

The transplant, subject of a Dec. 1 profile on CBS' ``60 Minutes,'' is widely considered the beginning of ethical challenges to come.

``It's just a matter of time, and at some point it's going to become a lot more interesting, for lack of a better word,'' said Heimerich. ``We'll have to decide whether a death row inmate should receive a heart. Should a prisoner sentenced to life without parole be eligible?''

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On the Net:

For more information on organ transplant issues, visit the California Transplant Donor Network at www.ctdn.org and the United Network for Organ Sharing at www.unos.org.

(Copyright 2002 by The Associated Press. All Rights Reserved.)