Liver transplant denial questioned; marijuana use examined

During early May, The Daily printed a story about the death of Seattle resident Timothy Garon. He was denied a liver transplant at two local hospitals and later died. Some believe this was due to his previous marijuana use, and the case was picked up by national media. The UW Medical Center and Garon’s lawyer and doctor go on the record about his death.

Timothy Garon appeared frail and gaunt. His abdomen was bloated from liver failure, making him look pregnant, said Sunil Aggarwal, a third-year medical student and doctoral candidate at the UW who visited Garon in his UWMC hospital room.

“But he had such a strength of conviction that said, ‘I’m going to get through this, and I really want to live,’” Aggarwal said of Garon.

On May 2, a little more than two weeks later, Seattle musician Timothy Garon, 56, died.

After being denied a spot on the liver transplant lists at Harborview Medical Center and the UW Medical Center (UWMC), Garon’s case attracted attention throughout the nation.

The reasons for the denial of Garon’s liver transplant are hazy due to patient privacy laws.

Garon’s liver problems can be traced to his teenage years. He thought he contracted hepatitis C from sharing needles with “speed freaks,” Garon said in an interview with The Associated Press a week before his death.

To relieve the pain and nausea associated with hepatitis C, Garon used medically authorized marijuana.

“I’m not a proponent of medical marijuana,” said Dr. Brad Roter, Garon’s physician and a member of the UW’s medical faculty. “However, in very rare cases, it can be useful. Tim was one of those cases.”

Garon had hepatitis C and was smoking marijuana even before Roter authorized his use of medical marijuana.

“Whether he used it for medical reasons only or for recreational reasons or other reasons, I really don’t know,” Roter said.

Because Garon was already using the substance and the benefits of relieving hepatitis C symptoms outweighed the risks, Roter decided to authorize medical marijuana for Garon.

Roter did not know how long Garon had been using marijuana before he met him.

In December 2007, Garon was arrested in his Mountlake Terrace apartment for growing marijuana, said Douglas Hiatt, his attorney.

While authorized marijuana is legal under Washington state law, it is illegal under federal law. Garon spent several days in prison, where his health noticeably worsened, Aggarwal said.

After his girlfriend posted bail for him, Garon was told he had to move out of his apartment, Aggarwal said.

Garon was denied a place on the transplant list at Harborview Medical Center. After that, Garon and Hiatt went to the UWMC, where he was again denied.

The UWMC said it would reconsider its decision if Garon went through 60 days of drug treatment, Hiatt said. The day before, Garon had been told he had about two weeks to live.

“You tell a dying guy that’s got less than two weeks to live that he’s got to go through 60 days of drug treatment before you reconsider him again?” Hiatt said.

The UWMC cannot speak specifically about Garon’s case due to patient privacy laws, said Tina Mankowski, director of the news and community relations for UW Medicine and Health Sciences.

“I am not sure we can ever predict with accuracy how long a person with a life-threatening disease will live,” she said.

The UWMC reviewed Garon’s case, and it was denied again.

Hiatt said Garon was denied because he used medically authorized marijuana.

However, a statement released by the UWMC claimed medical marijuana “is never the sole determinant in arriving at medical decisions about candidates for organ transplants.”

Because of the scarcity of organs, the transplant committee performs a “very comprehensive … evaluation for every patient,” Mankowski said.

About 98,000 patients are waiting for organs in the United States, and there are only about 6,000 donors, Mankowski said.

The liver transplant committee considers a patient from a medical and psychosocial standpoint and looks at patient history of substance abuse and dependency.

If a history exists, the committee considers the period of abstinence to date, the effort to abstain and substance abuse potential, Mankowski said.

Garon had been abstinent from marijuana for six months. Realizing marijuana could influence his chances of receiving a transplant, Garon stopped smoking it in October 2007, Hiatt said.

“He thought it’d be better to deal with the symptoms of pain and nausea rather than not getting a transplant and dying — which he did anyway,” Aggarwal said.

Garon had also been sober for the past eight years, Roter said.

Six months of marijuana abstinence and eight years of alcohol sobriety should be adequate, Roter said in regards to the UWMC wanting 60 days of drug treatment.

Potential problems could have arisen due to Garon’s arrest and eviction from his apartment in December 2007, Aggarwal said.

Hiatt, who frequently serves as an attorney for medical marijuana patients, said he believes marijuana was the problem in Garon’s trouble getting on the liver transplant list.

In general, marijuana “perhaps would be one of the considerations,” Mankowski said. “However, I think it’s important to note the use of medical marijuana in and of itself would not prevent somebody from being listed.”

[Reach reporter Joy Yagi at news@thedaily.washington.edu.]