Medical Marijuana Patient Dies After Being Refused Liver Transplant

Via NORML on the death of Timothy Garon:

The medical records will show that he died due to complications associated with massive liver failure. He would have likely survived longer if he received a timely organ transplant but was denied access because he followed his physician’s recommendation, used medical cannabis during his treatments for liver disease, therefore testing positive for THC metabolites and rather than receive the gift of a potentially longer life—instead doctors at the University of Washington deferred to federal prohibition laws and mores, handing Tim a death sentence.

There are no pharmacological or physiological reasons why Tim Garon, or any medical marijuana patient, should logically be denied access to life-saving or life-enhancing organ transplants.

Here's more on Tim Garon’s plight. You can watch this video with a moving news account of Tim and his family.

Here's a prewritten letter you can send Congress in favor of federal legislation that would prevent tragic stories such as these.

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    The drug lobby (5.00 / 2) (#3)
    by cawaltz on Fri May 02, 2008 at 02:13:27 PM EST
    ought to be ashamed of themselves. Just because they can't make money off it they have stood in the way of an effective treatment for patients. There have been studies that have shown that medical marijuana has immunosuppressive studies that might be helpful in RA in additon to the properties that appear to help those that have nausea and are not anxious to eat. If it were not effective they would not have created marinol and they wouldn't be looking at making a patch or inhalant(since ingesting it seems to cause time release issues.) Additionally, these doctors ought to be ashamed of themselves. Whatever happened to "committ no harm."

    Letter sent. (5.00 / 1) (#6)
    by sarcastic unnamed one on Fri May 02, 2008 at 02:28:35 PM EST
    Gotta say, I always thought liver and heart transplants and stuff were parceled out on a most-critical-need-first basis, but I guess the committees that decide who gets what consider other things as well:
    With the scarcity of donated organs, transplant committees like the one at the University of Washington Medical Center use tough standards, including whether the candidate has other serious health problems or is likely to drink or do drugs[...]But Reyes said that in addition to medical concerns, transplant committees _ which often include surgeons, social workers, and nutritionists _ must evaluate whether patients have the support and psychiatric health to cope with a complex post-operative regimen for the rest of their lives.
    Man, you couldn't pay me enough to be on one of these committees.

    I'd much rather... (none / 0) (#9)
    by MileHi Hawkeye on Fri May 02, 2008 at 02:46:49 PM EST
    ...sit on the committee than go through the transplant approval process.  I've walked down that road and would have definately prefered not to.    

    The transplant committee wasn't nearly as bad as all the testing and getting the HMO to approve the anticipated transplant.  


    Ouch. Sorry to hear that, (none / 0) (#11)
    by sarcastic unnamed one on Fri May 02, 2008 at 02:50:18 PM EST
    hope things are all good now.

    I just don't think I could sleep at night knowing my decisions are sentencing people to death, no matter how many people my decisions had sentenced to life.


    Nope... (none / 0) (#12)
    by MileHi Hawkeye on Fri May 02, 2008 at 02:55:24 PM EST
    ...still waiting.  At least I'm not knocking on death's door yet.

    If you aren't already... (5.00 / 1) (#13)
    by MileHi Hawkeye on Fri May 02, 2008 at 02:57:40 PM EST
    ...signed up to be an organ donor, please, please consider doing so.  

    Thank you.

    So many factors. (5.00 / 1) (#22)
    by wurman on Fri May 02, 2008 at 03:50:50 PM EST
    One of my brothers went through chemo then radiation, chemo / rad, c / r, etc. several times for a virulent cancer.  As per MD advice he used marijuana brownies & tea which were recommended for nausea control & improved appetite.

    Things worked out OK--about 18 years ago.  He returned to a job that drug tests, so gave up the weed.

    Something he presents, vehemently, when telling his story seldom comes up in other discussions.  He points out that the marijuana gave him a calming effect that reduced anxiety & quelled the sense of fear--very effectively.

    His doctors affirmed that to him.  The overall sense of relaxation is an immense relief to the patient.  It's palliative, but so what; it works.

    OTOH some of my patients (none / 0) (#31)
    by LHinSeattle on Fri May 02, 2008 at 04:03:41 PM EST
    have had their cognitive abilities bottom out, and/or become uncomfortable anxious on that same drug. People are not machines and can respond very differently from one another. For anxiety -- there are a number of "conventional" drugs which work well, and I don't mean the benzos. If that don't work, then trying mj makes sense.

    Nausea/vomiting there does seem an advantage to mj. Also for some MSK and pain issues.


    Jesus H. Christ.... (none / 0) (#1)
    by kdog on Fri May 02, 2008 at 02:07:30 PM EST
    words can't describe how f*cked up this is.

    A drinker can abuse the sh*t out of their liver and qualify for a liver transplant no problem, but a reefer smoker with Hepatitis can't because of drug war bullsh*t?

    Just when I thought the drug war couldn't make me any angrier...and bitter.

    This is a new low...  

    if a patient kills their liver with booze they very likely won't be able to get a new one either, unless they area able to convince the transplant committee that they won't just go and ruin the new one with booze also.

    My sister is a nurse.... (none / 0) (#8)
    by kdog on Fri May 02, 2008 at 02:41:47 PM EST
    and she told me a story of a raging alcoholic who received a liver transplant at the hospital she used to work at.  She was kinda upset about it, saying if a person wants to destroy their liver with booze they shouldn't get a new one when people with liver disease through no fault of their won have to wait.

    A real hard-arse my sister.  We don't playfully call her Nurse Ratchet for nothing:)

    I've heard of lots of shadyness when it comes to transplant committees...people buying their way to the front of the list, personal favors, etc.  Maybe the patient she told me about had connections.


    Fair enough. (none / 0) (#10)
    by sarcastic unnamed one on Fri May 02, 2008 at 02:47:44 PM EST
    fwiw, Tim Garon said he got hep c from shooting speed.

    My sister would disqualify.... (none / 0) (#19)
    by kdog on Fri May 02, 2008 at 03:43:29 PM EST
    him for that reason.  Me?  I'm like you man, you couldn't pay me enough to make those choices.  

    If I had to it would be first come first serve...everyting else gets a little too subjective.

    At least we all agree following your doctor's orders shouldn't disqualify you.


    Phil Lesh (none / 0) (#26)
    by squeaky on Fri May 02, 2008 at 03:57:40 PM EST
    Got a new lease on life and always at the end of his concerts asks everyone to turn to the person next to them and tell them that you will donate your organs if you die on the way home.

    It is absurd that this guy was rejected because of legal med mj use. That is simply not fair.


    Mickey Mantle (none / 0) (#15)
    by LittleBit on Fri May 02, 2008 at 03:18:01 PM EST
    (a raging alcoholic, in recovery) received a liver transplant.

    It raised quite a stir at the time--I guess it helps to be famous!


    That's an example of the shadyness.... (none / 0) (#20)
    by kdog on Fri May 02, 2008 at 03:44:16 PM EST
    I'm talking about when it comes to transplant committees.

    Beyond shameful. (none / 0) (#2)
    by Marco21 on Fri May 02, 2008 at 02:07:32 PM EST

    That's horrible. (none / 0) (#4)
    by tigercourse on Fri May 02, 2008 at 02:20:21 PM EST

    gee, why does this sound like a (none / 0) (#5)
    by cpinva on Fri May 02, 2008 at 02:21:30 PM EST
    potential wrongful death suit to me? possibly even criminaly actionable as negligent homocide.

    i suspect a billion dollar civil suit would grab their attention.

    no way (5.00 / 1) (#16)
    by txpublicdefender on Fri May 02, 2008 at 03:20:00 PM EST
    Absolutely not.  Transplant committee protocols are the standard of care.  There is no wrongful death suit here and certainly no criminally negligent homicide.  That's pure nonsense.

    I disagree with the previous use of medical marijuana being a disqualifying factor, but that doesn't mean you can sue over it.  Not to mention how hard it would be to prove causation considering there is no evidence he would have gotten a liver anyway, even if he had been approved by the committee.

    I completely disagree with the notion that people who "did nothing to contribute" to their needing an organ should have priority over people who did, by the way.  Doctors are not supposed to be moral judges of who is deserving of treatment.  The criteria for the protocols aren't there as moral judgments.  They are trying to evaluate the chances of the transplant being successful because they are dealing with a scarce resource for which they must prioritize.


    I'm with you.... (none / 0) (#21)
    by kdog on Fri May 02, 2008 at 03:46:12 PM EST
    I think the only fair way to do it is a strict first come, first serve.

    It ain't perfect because it doesn't factor in the health of the patient, likelyhood of survival, etc...but any other way opens the door to alotta moral quandrys.


    In an ideal world perhaps. (none / 0) (#24)
    by MileHi Hawkeye on Fri May 02, 2008 at 03:55:52 PM EST
    However, when dealing with transplants, there are many matching criteria that have to be considered.  Giving the person at the top of the list an organ isn't going to do any good if it is the wrong match for them.  

    For instance, I have to have a donor with specific blood type/rh factor.  

    You can't just slap on organ in someone and hope it doesn't get rejected.  


    Definitely.... (none / 0) (#27)
    by kdog on Fri May 02, 2008 at 04:00:55 PM EST
    I just meant you start at the first person on the list and work your way down till you've got a match.

    Best of luck to you with everything MileHi.


    Thanks! (none / 0) (#29)
    by MileHi Hawkeye on Fri May 02, 2008 at 04:02:38 PM EST
    i disagree (none / 0) (#34)
    by cpinva on Fri May 02, 2008 at 08:00:48 PM EST
    the factors considered for inclusion on the list should be those that bear medically. in this instance, it clearly didn't. they essentially denied a person the chance at a transplant, one they knew he needed to survive, not for legitimate medical reasons, but for purely social/moral reasons (in violation of the hippocratic oath), thereby contributing to his premature demise. that qualifies, imnsho, as criminal negligence, and is not standard medical protocol.

    as a current example, witness the trouble pharmacists, who denied women the "morning after" pill, because of religious convictions, got into as a result. not their call to make.

    watch and see if there isn't a lawsuit filed over this, and it won't be dismissed out of hand.


    dammit, i wish there was (none / 0) (#35)
    by cpinva on Fri May 02, 2008 at 08:05:38 PM EST
    an "edit" function here!

    i meant to add:

    my comments only apply if this is not a medically supportable reason to deny someone. obviously, if that's the case, my opinion would reflect inclusion of that information.


    I coordinate with the transplant departments at (none / 0) (#14)
    by kindness on Fri May 02, 2008 at 02:59:50 PM EST
    UCSF, UC Davis & Stanford for job with (an unnamed) HMO.  All 3 of them will kick you off any transplant list if you tell them you use Medical Marijuana.

    I was surprised to learn that.  Between vaporizors (the Volcano is definitely the best) & edible, I don't see why they would automatically do that.  But that's what they do.

    UCSF and UCLA will not approve anyone (none / 0) (#32)
    by oculus on Fri May 02, 2008 at 04:56:25 PM EST
    for liver transplant list who is actively smoking anything. Not a good use of, as they say, "this precious resource."  

    Isn't this (none / 0) (#17)
    by felizarte on Fri May 02, 2008 at 03:39:56 PM EST
    making doctors prosecutors, jurors; convicting someone of a crime without benefit of due process?  

    No. (none / 0) (#18)
    by sarcastic unnamed one on Fri May 02, 2008 at 03:41:10 PM EST
    Excerpts too simplistic (none / 0) (#25)
    by LHinSeattle on Fri May 02, 2008 at 03:56:11 PM EST
    Dr. Jorge Reyes, chief of the transplant division at UWMC, said that is not the only issue at hand. .... Doctors generally try to discourage smoking after transplant surgery because of the increased risk of infection from the administration of immunosuppressant drugs.

    slightly more detailed explanation here:

    Many doctors agree that using marijuana - smoking it, especially - is out of the question post-transplant. The drugs patients take to help their bodies accept a new organ increase the risk of aspergillosis, a frequently fatal infection caused by a common mold found in marijuana and tobacco.

    But playing devil's advocate, there may well have been other factors in this case. There are never enough available organs. Not knowing more about the patient's case, I still wouldn't blame it all on the pot issue. The panels have people on who are nurses, social workers, and other clinicians who see post-transplant patients and how they fare.

    BTW Medical marijuana in WA state involves -- at my facility -- a discussion of  risks/benefits, telling pt it may have some medical benefit per certain research. Just like I would with any drug I'd Rx. We do give them a form which may help if they encounter the police -- but some police will arrest anyway as possessing mj is still a federal crime.

    We don't actually give them a "prescription" that they can fill at our pharmacy. Much to some patients' sorrow!

    post-transplant v. pre-transplant (none / 0) (#33)
    by txpublicdefender on Fri May 02, 2008 at 06:43:54 PM EST
    I understand not giving the liver to someone who is not committed to not using medical marijuana post-transplant.  But, since he was apparently smoking the marijuana pre-transplant for the symptoms of his liver disease, and the transplant would remove the diseased liver, why would he be smoking post-transplant?

    That explanation either doesn't wash or there is more to the story that we are not being told.  It's difficult to know because I would guess the hospital has HIPPA issues to be concerned with about revealing all the reasons why he was rejected.


    Does using marijuana in moderation even.... (none / 0) (#37)
    by kdog on Sat May 03, 2008 at 09:10:24 AM EST
    harm the liver? I don't think so, but I could be wrong.

    Why should any liver disease suffering slob have to make an oath not to smoke a joint post-transplant in order to qualify to stay alive?  Who the hell do these transplant committees think they are, the police? god?

    All they should be doing is watching the list and making sure nobody gets special favors.


    My God, (none / 0) (#36)
    by Patrick on Fri May 02, 2008 at 11:27:50 PM EST
    Didn't the man understand what his Doctor was recommending when he got it?  Wow, I wonder if the doctor was familiar with the pharmaceutical substitues for marijuana?   I know they don't work as good, but perhaps he wouldn't have been rejected for transplant then.   This is horrible.  A death sentence for following a doctor's recommendation.  Oh wait, you mean he wanted to smoke MJ.  Well that changes it.  If there aren't enough livers to go around, give it someone who wants it bad enough not to get high.  

    You really comfortable making.... (5.00 / 1) (#38)
    by kdog on Sat May 03, 2008 at 09:15:43 AM EST
    those choice Pat?  Sure, most people would probably agree that a hard-core drunk shouldn't get a liver over a nun who runs an orphanage...but it gets complicated.

    Should the guy who eats rice cakes and does yoga everyday get one before the guy who eats cheeseburgers and sits on his couch all day? Should we stick a private eye on the tail of everbody waiting for a liver and determine who deserves it more?  That slope is damn slippery my friend...I like first come, first serve.  Best we can do I think, without playing god.


    In circumstances (none / 0) (#39)
    by Patrick on Sat May 03, 2008 at 11:50:29 AM EST
    like this one, I am pretty comfortable.   I'm sure there would be situations that were difficult calls and understand your point.  

    His choice to "medicate" with marijuana was just that, his choice.  I'd have a lot harder time with it if the circumstances that made him a bad candidate were beyond his control.  


    You and my sister... (none / 0) (#40)
    by kdog on Sat May 03, 2008 at 12:11:57 PM EST
    would hit it off man:)

    Me, speaking as an organ donor, I'd give my organs to people who abused drugs and/or alcohol, including this poor guy...got no problem with that.  


    scarce organs (none / 0) (#41)
    by diogenes on Sat May 03, 2008 at 10:04:15 PM EST
    But would you give your organ, if it were the only one available, to an alcoholic or to a teetotaler?

    Is she cute? (none / 0) (#42)
    by Patrick on Sat May 03, 2008 at 11:00:58 PM EST
    Seriously, it's not a hard heart, it's more like who has the best chances with a limited resource.  You yourself have made very valid points about personal choices and their consequences.   This is exactly one of those points.  The trouble I have is people using this to make political points, claiming it's about the drug war or some other nonsense.   Really it's about the effects of marijuana and the personal choice to use it and the viability of a transplant organ.  

    It's Easy (none / 0) (#43)
    by Oldog4tz on Wed May 28, 2008 at 05:16:49 PM EST
    to have strong opinions when you are not affected. Attitudes change when we're talking about sisters and fathers. I have a somewhat unique perspective. I needed a liver transplant, was suspended from the list by UCSF in 2004 for medical cannabis, made to complete a "drug treatment" program, and wait 12 months before being eligible for transplant.

    The general rules come from something called UNOS, which divides the country into regions, each of which has several transplant centers. These centers follow the general guidlines that the organ itself shall not be put at risk - when one comes in there's usually more than one possible recipient literally lying there waiting - however each hopsital has considerable latitude. UCSF and West Coast hospitals in general are pretty rigid - East (particularly Fla and TX) are less so, particularly when it comes to the big drug, which is alcohol. However some hospitals kick you off for 3 or 6 months, some for a year.

    All this said, I quit using till i got my transplant and have been vaporizing since. The year suspension almost killed me, and i believe contributed to complications afterward (diabetes, stroke, kidney damage) -