Now, in what is believed to be the first such case in the US, prosecutors have charged a transplant surgeon with trying to hasten his death in order to retrieve his organs sooner.

At the heart of the case is the question of whether Dr Hootan Roozrokh was pursuing organs at any cost or had become entangled in a web of misunderstanding about a lesser-used harvesting technique known as 'donation after cardiac death'.

Dr Roozrokh, 34, who is facing three felony counts relating to Mr Navarro's treatment, has pleaded not guilty.

Mr Navarro had been diagnosed at age nine with adrenoleukodystrophy, a genetic disorder which damages the membranes surrounding nerve cells in the brain.

Symptoms include learning disabilities and uncoordinated movement, and progressive dementia.

By his early 20s, Mr Navarro's mental and physical condition had deteriorated to a point where he had to be placed in an assisted-care facility.

In January 2006, he suffered cardiac and respiratory arrest and was rushed to the Sierra Vista Regional Medical Centre.

His brain had been damaged from a lack of oxygen.

Several days later, a decision was made to remove his ventilator and the California Transplant Donor Network - a non-profit organ procurement organisation - called his mother Rosa to ask if she would agree to donate his organs.

Mrs Navarro agreed, saying she did not want her 'boy to suffer too long'.

Late on Feb3, a transplant team, including Dr Roozrokh, arrived at the hospital.

The hospital was subsequently criticised for a series of donor protocol lapses, including allowing a person without clinical privileges - Dr Roozrokh - to prescribe controlled substances.

Cardiac death donations occur after a patient's respirator is removed. The heart slows and then stops, at which time brain function ceases.

Most donor protocols call for a five-minute delay before the patient is declared dead, and transplant teams are not allowed in a prospective donor's room before that time.

According to a police interview with nurse Jennifer Endsley, Dr Roozrokh was in the room during the removal of the respirator and gave orders for medication, something that violates donation protocol.

Ms Endsley, who stayed to watch because she had never seen the procedure, also said that Dr Roozrokh also asked an emergency room nurse to find and administer more 'candy' - meaning drugs - after Mr Navarro did not die after the removal of his respirator.

He died after eight hours of what the coroner would later rule as natural causes.

By then, his organs had deteriorated so much that they were unusable for a transplant.

About 18 people die every day in the US while waiting for transplants.

The case has sent a shudder through the tightly knit field of transplant surgeons. It set donation advocacy groups worrying that organ donors could be frightened away.

'If you think a malpractice lawsuit is scaring surgeons off,' said Dr Goran Klintmalm, the president of the American Society of Transplant Surgeons, 'wait to see what happens when people see a surgeon being charged criminally and going to jail.'

If convicted on all counts, Dr Roozrokh could face eight years in prison.

Mr Navarro's mother has filed a civil suit against him, the donor network and other doctors in the operating room, and has settled a lawsuit against the hospital.

'He didn't deserve to be like that, to go that way,' she said. 'He died without dignity and sympathy and without respect.'

NEW YORK TIMES