SAN LUIS OBISPO, CALIF. - On a winter night in 2006, a disabled and brain-damaged man named Ruben Navarro was wheeled into an operating room at a hospital here. By most accounts, Navarro, 25, was very near death, and doctors hoped that he might sustain other lives by donating his kidneys and liver.

But what happened to Navarro quickly went from the potentially life-saving to what law enforcement officials say was criminal. In what is thought to be the first such case in the country, prosecutors have charged the transplant surgeon, Dr. Hootan C. Roozrokh, with trying to hasten Navarro's death to retrieve his organs sooner.

A preliminary hearing will begin today in San Luis Obispo, with Roozrokh facing three felony counts relating to Navarro's treatment as a donor. At the heart of the case is the question of whether Roozrokh, who studied at a transplant fellowship program at the prestigious Stanford University School of Medicine, 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."

Roozrokh has pleaded not guilty, and his attorney said the charges were brought by overzealous prosecutors. But the case has already sent a shudder through the tight-knit field of transplant surgeons -- if convicted on all counts, Roozrokh could face eight years in prison -- while also worrying donation advocacy groups 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."

David Fleming, the executive director of Donate Life America, a nonprofit group that promotes donations, said the case has "given some support to the myths and misperceptions we spend an inordinate amount of time telling people won't happen."

Cardiac-death donations began to go out of vogue in the late 1960s after medical advances such as life support and subsequent changes in the legal definition of death made brain-death donations more appealing. But the procedure has been encouraged by health officials in recent years.

There were a decade-high 670 cardiac-death donations through the first nine months of 2007, according to the United Network for Organ Sharing, which oversees organ allocation. In all, there were 13,223 organ donations over the same period, the vast majority with brain-dead donors

The two techniques

In brain-death donations, the donor is legally dead, but the organs are kept viable by machines.

In cardiac-death procedures, after the patient's respirator is removed, the heart slows. Once the heart stops, brain function ceases. Most protocols call for a five-minute delay before the patient is declared dead. Transplant teams are not let into a prospective donor's room before that.

Several days after Navarro was hospitalized at the Sierra Vista Regional Medical Center, a decision was made to remove the respirator. According to the criminal complaint, Roozrokh ordered excessive doses of morphine and Ativan, an anti-anxiety medicine, both of which are commonly used as comfort medicines for dying patients. He also ordered the introduction of Betadine, an antiseptic usually used after death to clean organs for transplantation, the criminal complaint says.

Navarro died about eight hours later of what the coroner would later rule as natural causes. In the end, because the death was not more immediate, his organs had deteriorated so much that they were unusable for a transplant.

Prosecutors have charged Roozrokh with felony counts of dependent adult abuse, mingling a harmful substance and unlawful controlled substance prescription.