Case of Anthony Thomas ‘TJ’ Hoover II is under investigation by state and federal government officials

Case of Anthony Thomas ‘TJ’ Hoover II is under investigation by state and federal government officials

A man who had gone into cardiac arrest and been declared brain dead woke up as surgeons in his home state of Kentucky were in the middle of harvesting his organs for donation, his family has told media outlets.

As reported Thursday by both National Public Radio and the Kentucky news station WKYT, the case of Anthony Thomas “TJ” Hoover II is under investigation by state and federal government officials. Officials within the US’s organ-procurement system insist there are safeguards in place to prevent such episodes, though his family told the outlets their experience highlights a need for at least some reform.

…

WKYT reported that Rhorer only learned the full details of her brother’s surgery at the hands of Baptist and the Kentucky Organ Donor Affiliates (Koda) in January. That’s when a former employee of Koda contacted her before sending a letter to a congressional committee that in September held a hearing scrutinizing organ-procurement organizations, NPR reported.

The letter’s author said she saw Hoover begin “thrashing” around on the operating table as well as start “crying visibly”, according to NPR.

  • BlameThePeacock@lemmy.caEnglish
    2464·
    2 years ago

    Just to be clear, they had not actually started harvesting anything.

    The nurses and doctors noticed as he was wheeled into the operating room and called it off, a bunch of them ended up in therapy over the situation.

    Someone fucked up by declaring him brain dead clearly. He does however have significant brain damage from the drug overdose that initiated the whole situation.

    • TachyonTele@lemm.ee
      434·
      2 years ago

      This article says he was considered brain dead for three years. Where are you getting your extra info from?

      This is scary either way.

      • FlowVoid@lemmy.worldEnglish
        363·
        2 years ago

        She was caring for him for three years.

        You cannot be brain dead for three years. Brain death is legal death. Once you are declared brain dead, you are officially a cadaver and won’t be going home. You are going to the morgue that day, with possibly a brief initial stop in the operating room if you’re an organ donor.

        • Lichtblitz@discuss.tchncs.de
          172·
          2 years ago

          That’s not the case (at least in Germany). Being brain dead does not replace the conscious decision on when to disable life support.

        • bradorsomething@ttrpg.network
          4·
          2 years ago

          That’s not correct. When a person is declared dead but is maintained for organ harvesting, a tech is brought in to keep the body stable to best preserve all organs being taken. Think ICU, but focused on saving the organs with not much concern for the brain. Breathing, BP, and heart rate are optimized for organ survival until a surgical team can be set up for harvesting. A colleague did it for a while, and said it was depressing and a lot of sitting around watching the monitor and tweaking drips until they could arrange surgery. When my brother died, we donated what we could, but a lot of his organs were non-viable due to his illness… still, every little bit helps.

          I’d like to lighten up the mood by commenting the guy is lucky this happened in Kentucky… everyone knows the standard for being brain dead is much lower there. :)

      • BlameThePeacock@lemmy.caEnglish
        11·
        2 years ago

        If you think google his name you can see a picture of him riding in a car with his sister in 2023 so he’s clearly not braindead.

    • Rookwood@lemmy.world
      940·
      2 years ago

      Seems like they must have fucked up multiple times. I’m thinking it was probably the nurses that blew the whistle on this and stopped the whole thing.

  • peopleproblems@lemmy.world
    898·
    2 years ago

    “Were in the middle of harvesting his organs…” He’d be dead by that point.

    They can probably remove the corneas before incisions are made for the major organs, but once they make that first incision, those organs come out in a matter of minutes to be placed in sterile containers.

    “Had gone into cardiac arrest” meaning his heart stopped. From a drug overdose. Anyone here wanna guess what that means? You got it - CPR. Anyone who knows how to actually do CPR knows that if you do it correctly you are breaking ribs. That’s going to hurt like fuck when you wake back up.

    When they harvest organs, they aren’t just specialized butchers in there. These are surgeons, specifically specializing in organ transplant. The room for error in this specialty is 0. Every modern surgery, regardless of it is organ harvesting or not, will ultimately have a “pause” where everyone goes down the list to make sure everything that needs to be checked is checked.

    He likely didn’t get to the pause, he probably woke up before that. He was probably being evaluated by the team, and one individual caught something that had been overlooked. The rest of the team spent time to verify, then determined they could actually revive him. This is not a pleasant experience. He would not have been given pain medication beforehand, as he was in for a drug overdose, I could predict it probably wouldn’t work anyway.

    Whoever went public with this will cause many deaths because of the increase in fear of organ donation.

    • Maggoty@lemmy.world
      44·
      2 years ago

      It depends on how you define, “in the middle”. According to NPR he had woken up during his heart catheter to check it’s health for donation and they just sedated him back down. It was when he went into the final operating room that they refused to do the organ removal. That’s past all the checks that are supposed to be done. If he wasn’t visibly writhing on the table and crying he’d be dead.

    • Sunoiki@lemmy.worldEnglish
      39·
      2 years ago

      Your mixing organ procurement after cardiac death with brain death. It’s the cardiac death donations where they have to move very fast to reduce the warm ischemia time.

      For brain death they can be systematic, corneas sure, but for major organs usually kidneys first, bowel, liver, pancreas if usable (usually with bickering about which team gets more vena cava and aorta). Heart and lungs are functioning throughout the abdominal portion to keep them well perfused, then each is flushed and chilled as it’s passed off. So there is a period of time of ongoing surgery for this to occur.

      But you’re right, the process to declare brain death is lengthy and very formalized. Then while someone from anesthesia is in the room to maintain the body, they are not giving anesthesia. And definitely right about the last point, but it’s a big fuck up.

  • Melatonin@lemmy.dbzer0.com
    68·
    2 years ago

    “…cases like Hoovers are one-offs…”

    Ummm, CASES LIKE THIS??? THERE’S MORE???

    The letter’s author said she saw Hoover begin “thrashing” around on the operating table as well as start “crying visibly”, according to NPR.

    Fucking horror show.

  • Ranvier@sopuli.xyz
    38·
    2 years ago

    Really want to know exactly who declared brain death? For instance in the article the family talks about seeing eye movements and being told they’re "just reflexes."Yeah that may be, but reflexes involving the eyes are cranial nerve reflexes, they go through the brain. There can’t be brain death if they are there. That’s a brain function. Testing to make sure all cranial nerve reflexes are absent (gag, apnea, vestibular, etc) is one of the basic pieces of brain death testing.

    There’s a lot of confusion in popular media between brain death and persistent vegetative state. In a persistent vegetative state there’s still many brain functions going, but troubles maintaining consciousness. Brain death testing when properly done there is extensive testing done by a neurologist or someone with a similar background to show no brain function at all remains before it can be declared brain death, no matter how basic, even the simplest of brain reflexes. It’s not just one test but a whole series of testing with different modalities.

    Would really like to know what happened here to cause such a colossal mess. Or nearly did, the doctors stopped before doing anything at least.

    • peopleproblems@lemmy.world
      15·
      2 years ago

      I suspect that when they declared him brain dead, it was too early in recovering from the overdose that his reflexes weren’t normal yet.

      Drug interactions and drug metabolism are complete unknowns, as I strongly suspect this guy did not have genomic testing done before they administered narcan or whatever antidotes they needed to push.

      • Ranvier@sopuli.xyz
        8·
        2 years ago

        This isn’t something that gets done like after a few hours or a day or something. It takes quite some time to get through cooling protocols, warming again, complete all the testing, geting everything stable. Talking like a week plus at the quickest. And cranial nerve reflexes are just one thing of many different tests done. And to boot, it sounds like from the article they knew he had cranial nerve reflexes, which anyone halfway competent should know, means there is certainly not brain death. Really want to know what this hospital was doing that they messed up so badly.

    • nutsack@lemmy.world
      48·
      2 years ago

      We had actually opened the patient and were in the process of sort of preparing their organs, at which point the ventilator triggered and so the anesthesiologist at the head of the table spoke up and said, ‘Hey, I think this patient might have just breathed,’” Cannon later told NPR in an interview. “If the patient breathes, that means they’re not brain dead.”

      Nevertheless, a representative from the OPO wanted to proceed anyway, Cannon says.

      interesting

    • FundMECFS@lemmy.blahaj.zone
      12·
      2 years ago

      What a shitshow.

      This kind of shit is going to hurt people needing organs a lot. We need better organ donor safeguards so these kind of scandals dont happen.

      Though honestly, it sounds more like some of the speciliasts fucked up than the procedure being bad.

    • superkret@feddit.org
      132·
      2 years ago

      Going public is pretty much always the correct decision.
      I don’t want a healthcare system where fuck-ups are covered up in order to influence decisions of the patients.
      That’s not a slippery slope, that’s a greased fireman’s pole to corruption.

    • catloaf@lemm.eeEnglish
      3·
      2 years ago

      I would assume they’d sedate the person, even if brain dead, to guard against this exact scenario (which means they’d be harvesting a not-actually-braindead person, but that’s a separate issue). Do they not do this? Or did they just not sedate enough or something? I don’t know how sedation is measured, does being braindead make it harder to measure because some metric already looks like it does while sedated?

      • ArmyTiger@lemmy.world
        8·
        2 years ago

        No, if a patient is declared brain dead, there is usually no sedation given. It shouldn’t be necessary, as the neurons responsible for sensing pain aren’t alive and processing signals, and extra medication like sedation comes with the risk of hemodynamic instability, which is already kind of a headache in brain dead patients as the brain is no longer meditating that (extremely oversimplified). Yes, sedation can be measured (sorta) with a BIS probe, a spectral imaging probe on the forehead that acts like an EEG with fewer probes, but it’s not very useful in brain death as it’s ultimately looking at blood flow, and in brain death, we don’t expect to see blood flow to the brain.

        All of this, of course, assumes that he was declared brain dead, which is a very specific legal term with very specific parameters that vary slightly state by state, which seems unlikely in this situation. He may have been deemed to have a severe neurologic injury with an unlikely prognosis of meaningful recovery, and thus be a planned DCD (declared cardiac death) donation, meaning placed on a minimally assistive ventilatory support and allowed to die once his respiratory drive was so low he died of hypoxic respiratory failure. But the article is long on anecdotes and short on the technical terms physicians would use, so it’s hard to say.

    • thesohoriots@lemmy.worldEnglish
      32·
      2 years ago

      Maybe I’m an optimist, but perhaps this will simultaneously scare off the conspiracy paranoids/lead paint crowd and ensure quality organs go to deserving and rational patients.

    • MataVatnik@lemmy.world
      76·
      2 years ago

      I opted out as an organ donor a few years ago and it was after reading comments like yours where people described the process of organ harvesting. I find it to be pretty dehumanizing. I think there is a lot of pressure to do it without much education on the subject. Additionally I wish I could control where my organs went, I wish I could consent right before I died and I wish there wasn’t a giant Rube Goldberg machine of financial incentives (that can be cheated to benefit the wealthy) driving the entire enterprise, but we don’t live in a perfect world. I hope if I’m ever I situation where I would need a transplant I will not be a hypocrite and let myself die or just survive on life support. This article is just a drop in the bucket, and to me, your comment and this case only highlight sentiments that were already there. We are not animals we can’t put blinders on people in the hopes that more of them sign up to have their organs harvested after death using a system that is arguably kinda fucked up. There is this attitude and arrogance that come from the medical profession where people think because they know best and want to keep patients in the dark in matters of life and death (CDC lying about masks, to absolute catastrophes like the case of Memorial Medical Center after hurricane Katrina)

      • TheRealKuni@lemmy.worldEnglish
        72·
        2 years ago

        I opted out as an organ donor a few years ago and it was after reading comments like yours where people described the process of organ harvesting. I find it to be pretty dehumanizing.

        You opted out of potentially saving lives because you feel like the necessary process of rapidly removing and preserving quickly decaying organs doesn’t treat the cadaver with proper respect?

        That’s a really strange stance.

        Additionally I wish I could control where my organs went

        I’m glad you can’t. I realize the system isn’t perfect, but it’s better than the absurd complexity of letting the flawed and uneducated person dying decide who gets them. Imagine, for example, bigots demanding no black person or gay person gets their organs. Screw that. Continue to improve the system, but a system needs to be in place.

        • MataVatnik@lemmy.world
          11·
          2 years ago

          See, this is what I mean 👆 “iT sAvEs liVess, wHat arE yOu a PieCe of ShiT?” Using social pressure to shame others into a system, which if they were educated on it, they probably wouldn’t agree to it.

          More than 60% of the people that receive organ transplants are 50 or older. To tell you the truth, no I don’t care about being their hero. And as I mentioned there is a for profit incentive system in place which I’m not comfortable with (in the US at least) And just as a bigot wouldn’t want their organ going to a certain portion of the population, I wouldn’t want my organs going to a bigot or some wealthy asshole that can afford the procedure while others die. Also I wouldn’t want to find myself at deaths door surrounded by a transplant team circling my dying body like vultures treating my body like a commodity.

          • TheRealKuni@lemmy.worldEnglish
            1·
            2 years ago

            See, this is what I mean 👆 “iT sAvEs liVess, wHat arE yOu a PieCe of ShiT?”

            Those were not my words.

            I think it’s wild that you care about what happens to your organs after you die. I do think it’s a selfish position, personally, but you do you. I just doubt you’ll feel as strongly opposed to organ donation if you ever find yourself needing one.

  • IMALlama@lemmy.world
    155·
    2 years ago

    This whole thing is nuts to me. From the way the article reads, the patient was likely still breathing and had a heartbeat. I get wanting to keep organs fresh, but this seems… non ideal

      • LadyAutumn@lemmy.blahaj.zoneEnglish
        3·
        2 years ago

        True, but for an organ harvest… would you not want the cadaver to be, well, dead dead? Like, would you start taking organs out while the cadaver still has a beating heart?

        • FlowVoid@lemmy.worldEnglish
          6·
          2 years ago

          Once the heart stops beating, the organs fail. Including the heart itself.

          That’s kind of the point of defining brain death. Normally death is declared after the heart stops beating. In brain death, the heart is beating but the brain is not receiving any blood.

      • rhombus@sh.itjust.works
        2·
        2 years ago

        Heartbeat, yes. Breathing, no. Once the brain is completely dead the body can’t breathe on its own, it has to be kept on a ventilator to keep the organs alive.

    • bdonvr@thelemmy.club
      11·
      2 years ago

      Nah that’s not unusual. Brain trauma or degradation can and often does leave someone with a beating heart but little to no hope of ever being conscious again - hence the term brain death.