Organ donation process may not be what you think

LOS ANGELES – When 69-year-old Marietta Jinde died in 2016, police had already been called to her home several times because of reports of possible abuse. She was so emaciated and frail that the hospital asked investigators to look into her death.

Yet by the time a coroner's investigator was able to examine Jinde's 70-pound body, the bones from her legs and arms were gone. Also missing were large patches of skin from her back. With permission from county officials and saying they did not know of the abuse allegations, employees from OneLegacy, a human tissue procurement company, had gained access to the body, taking parts that could have provided crucial evidence.

Coroner officials said they were able to complete their investigation by using the autopsy exam, hospital records and photos, and determined that she died of natural causes.

After reviewing the report, Cyril Wecht, a nationally known forensic pathologist, questioned the coroner's ability to make that determination when the bones and skin had been removed. "We can't be sure the bones weren't fractured," he said. "This could have been a manslaughter case."

The case is one of dozens of death investigations across the country that the Los Angeles Times found were complicated or upended when transplantable body parts were taken before a coroner's autopsy was performed.

In multiple cases, coroners had to guess at the cause of death. Wrongful death and medical malpractice lawsuits have been thwarted by early tissue harvesting. A death after a fight with police remains unsettled. The procurement process caused changes to bodies that medical examiners mistook as injuries or abuse. In at least one case, a murder charge was dropped.

Organ procurement before an investigation is legal. Over the past decade, some states passed laws requiring coroners and medical examiners to "cooperate" with the companies to "maximize" transplantable organs and tissues. In a handful of states the laws even give the companies the power to force coroners to delay autopsies until they have harvested the body parts.

Procurement companies' lobbyists helped to write and then push those requirements into law. As a consequence, the number of deaths in which body parts are harvested has risen. The laws have helped companies delay autopsies to harvest organs intended to extend the lives of waiting patients.

But in the vast majority of cases nationwide, the companies harvested skin, bone, fat, ligaments and other tissues that are generally not used for life-threatening conditions. Those body parts fuel a booming biotech market in which a half-teaspoon of ground-up human skin is priced at $434. That product is one of those used in cosmetic surgery to plump lips and posteriors, fill cellulite dimples and enhance penises. A single body can supply raw materials for products that sell for hundreds of thousands of dollars.

In lobbying for the laws, the companies pointed to papers published in professional journals stating that there has never been a documented instance of organ or tissue procurement interfering with a death investigation.

But the papers' authors included procurement company executives and others with undisclosed industry ties. And the source of the claim was a short article in a 1994 American Bar Association newsletter.

The reach of the procurement industry has troubled some investigators. Melissa Baker, a former investigator in the medical examiner's office in Pierce County, Wash., filed a whistleblower complaint in 2015 after three procurement companies moved into the morgue to access cadavers — a growing practice nationwide.

Morgue officials often give the corporate employees key cards so they can come and go, any hour of the day or night. The companies rent rooms inside the morgues, including suites where surgical teams harvest donors' tissues.

"One of my biggest concerns was the mere fact that someone could potentially get away with murder because evidence has been bungled, lost or not collected," she said.

A review found evidence was lost in a homicide case when the procurement team washed the victim's hands. Yet it said Thomas Clark, the medical examiner, was following state law by cooperating with the procurement companies. "No death investigation system is perfect," he said.

Executives at OneLegacy said they had followed the law.

OneLegacy's contract does contain restrictions. In L.A. county, procurements from victims of suspected child abuse and officer-involved homicides must be approved by a senior morgue official.

Another exception: Donation is "generally unsuitable" in cases of media interest, including celebrity deaths.

But there was no exception that applied when Mark Flath of Agua Dulce, Calif., pleaded with OneLegacy not to take tissues from the body of his 18-year-old son before the coroner had performed an autopsy. Jonn Flath, who had been a varsity athlete in high school, sat down and died in 2011 while working out during the Army's ROTC program.

Because the teenager had signed up to be an organ and tissue donor, the family could not stop the procurement. OneLegacy took bones and other tissues, including his heart for its valves. The coroner later could not determine why the teenager had died.

"You can't begin to imagine what it's like to learn that they can't complete the autopsy because they took your son's heart," Mark Flath said.