The company stacked brochures in funeral parlors around Sin City. On the cover: a couple clasping hands. Above the image, a promise: “Providing Options in Your Time of Need.”
The company, Southern Nevada Donor Services, offered grieving families a way to eliminate expensive funeral costs: free cremation in exchange for donating a loved one’s body to “advance medical studies.”
Outside Southern Nevada’s suburban warehouse, the circumstances were far from comforting. In the fall of 2015, neighboring tenants began complaining about a mysterious stench and bloody boxes in a Dumpster. That December, local health records show, someone contacted authorities to report odd activity in the courtyard.
Health inspectors found a man in medical scrubs holding a garden hose. He was thawing a frozen human torso in the midday sun.
As the man sprayed the remains, “bits of tissue and blood were washed into the gutters,” a state health report said. The stream weaved past storefronts and pooled across the street near a technical school.
Southern Nevada, the inspectors learned, was a so-called body broker, a company that acquires dead bodies, dissects them and sells the parts for profit to medical researchers, training organizations and other buyers. The torso on the gurney was being prepared for just such a sale.
Each year, thousands of Americans donate their bodies in the belief they are contributing to science. In fact, many are also unwittingly contributing to commerce, their bodies traded as raw material in a largely unregulated national market.
Body brokers are also known as non-transplant tissue banks. They are distinct from the organ and tissue transplant industry, which the U.S. government closely regulates. Selling hearts, kidneys and tendons for transplant is illegal. But no federal law governs the sale of cadavers or body parts for use in research or education. Few state laws provide any oversight whatsoever, and almost anyone, regardless of expertise, can dissect and sell human body parts.
“The current state of affairs is a free-for-all,” said Angela McArthur, who directs the body donation program at the University of Minnesota Medical School and formerly chaired her state’s anatomical donation commission. “We are seeing similar problems to what we saw with grave-robbers centuries ago,” she said, referring to the 19th-century practice of obtaining cadavers in ways that violated the dignity of the dead.
“I don’t know if I can state this strongly enough,” McArthur said. “What they are doing is profiting from the sale of humans.”
The industry’s business model hinges on access to a large supply of free bodies, which often come from the poor. In return for a body, brokers typically cremate a portion of the donor at no charge. By offering free cremation, some deathcare industry veterans say, brokers appeal to low-income families at their most vulnerable. Many have drained their savings paying for a loved one’s medical treatment and can’t afford a traditional funeral.
“People who have financial means get the chance to have the moral, ethical and spiritual debates about which method to choose,” said Dawn Vander Kolk, an Illinois hospice social worker. “But if they don’t have money, they may end up with the option of last resort: body donation.”
Few rules mean few consequences when bodies are mistreated. In the Southern Nevada case, officials found they could do little more than issue a minor pollution citation to one of the workers involved. Southern Nevada operator Joe Collazo, who wasn’t cited, said he regretted the incident. He said the industry would benefit from oversight that offers peace of mind to donors, brokers and researchers.
“To be honest with you, I think there should be regulation,” said Collazo. “There’s too much gray area.”
“BIG MARKET FOR DEAD BODIES”
Donated bodies play an essential role in medical education, training and research. Cadavers and body parts are used to train medical students, doctors, nurses and dentists. Surgeons say no mannequin or computer simulation can replicate the tactile response and emotional experience of practicing on human body parts. Paramedics, for example, use human heads and torsos to learn how to insert breathing tubes.
Researchers rely on donated human body parts to develop new surgical instruments, techniques and implants; and to develop new medicines and treatments for diseases.
“The need for human bodies is absolutely vital,” said Chicago doctor Armand Krikorian, past president of the American Federation for Medical Research. He cited a recent potential cure for Type 1 diabetes developed by studying pancreases from body donors. “It’s a kind of treatment that would have never come to light if we did not have whole-body donation.”
Despite the industry’s critically important role in medicine, no national registry of body brokers exists. Many can operate in near anonymity, quietly making deals to obtain cadavers and sell the parts.
“There is a big market for dead bodies,” said Ray Madoff, a Boston College Law School professor who studies how U.S. laws treat the dead. “We know very little about who is acquiring these bodies and what they are doing with them.”
In most states, anyone can legally purchase body parts. As an upcoming story will detail, a Tennessee broker sold Reuters a cervical spine and two human heads after just a few email exchanges.
Through interviews and public records, Reuters identified Southern Nevada and 33 other body brokers active across America during the past five years. Twenty-five of the 34 body brokers were for-profit corporations; the rest were nonprofits. In three years alone, one for-profit broker earned at least $12.5 million stemming from the body part business, an upcoming Reuters report will show.
Because only four states closely track donations and sales, the breadth of the market for body parts remains unknown. But data obtained under public record laws from those states – New York, Virginia, Oklahoma and Florida – provide a snapshot. Reuters calculated that from 2011 through 2015, private brokers received at least 50,000 bodies and distributed more than 182,000 body parts.
Permits from Florida and Virginia offer a glimpse of how some of those parts were used: A 2013 shipment to a Florida orthopedic training seminar included 27 shoulders. A 2015 shipment to a session on carpal tunnel syndrome in Virginia included five arms.
As with other commodities, prices for bodies and body parts fluctuate with market conditions. Generally, a broker can sell a donated human body for about $3,000 to $5,000, though prices sometime top $10,000. But a broker will typically divide a cadaver into six parts to meet customer needs. Internal documents from seven brokers show a range of prices for body parts: $3,575 for a torso with legs; $500 for a head; $350 for a foot; $300 for a spine.
Body brokers also have become intertwined with the American funeral industry. Reuters identified 62 funeral operators that have struck mutually beneficial business arrangements with brokers. The funeral homes provide brokers access to potential donors. In return, the brokers pay morticians referral fees, ranging from $300 to $1,430, according to broker ledgers and court records.
These payments generate income for morticians from families who might not be able to otherwise afford even simple cremation. But such relationships raise potential conflicts of interest by creating an incentive for funeral homes to encourage grieving relatives to consider body donation, sometimes without fully understanding what might happen to the remains.
“Some funeral home directors are saying, ‘Cremation isn’t paying the bills anymore, so let me see if I can help people harvest body parts,’” said Steve Palmer, an Arizona mortician who serves on the National Funeral Directors Association’s policy board. “I just think families who donate loved ones would have second thoughts if they knew that.”
Some morticians have made body donation part of their own businesses. In Oklahoma, two funeral home owners invested $650,000 in a startup body broker firm. In Colorado, a family operating a funeral home ran a company that dissected and distributed body parts from the same building.
When a body is donated, few states provide rules governing dismemberment or use, or offer any rights to a donor’s next of kin. Bodies and parts can be bought, sold and leased, again and again. As a result, it can be difficult to track what becomes of the bodies of donors, let alone ensure that they are handled with dignity.
In 2004, a federal health panel unsuccessfully called on the U.S. government to regulate the industry. Since then, more than 2,357 body parts obtained by brokers from at least 1,638 people have been misused, abused or desecrated across America, Reuters found.
The count, based on a review of court, police, bankruptcy and internal broker records, is almost certainly understated, given the lack of oversight. It includes instances in which bodies were used without donor or next-of-kin consent; donors were misled about how bodies would be used; bodies were dismembered by chainsaws instead of medical instruments; body parts were stored in such unsanitary conditions that they decomposed; or bodies were discarded in medical waste incinerators instead of being properly cremated.
Most brokers employ a distinctive language to describe what they do and how they make money. They call human remains “tissue,” not body parts, for example. And they detest the term “body brokers.” They prefer to be known as “non-transplant tissue banks.”
Most also insist they don’t “sell” body parts but instead only charge “fees” for services. Such characterizations, however, are contradicted by other documents Reuters reviewed, including court filings in which brokers clearly attach monetary value to donated remains.
A lien filed by one body broker against another cited as collateral “all tissue inventory owned by or in the possession of debtor.” In bankruptcy filings, brokers have claimed body parts as assets. One debtor included as property not only cabinets, desks and computers, but also spines, heads and other body parts. The bankrupt broker valued the human remains at $160,900.
“There are no real rules,” said Thomas Champney, a University of Miami anatomy professor who teaches bioethics. “This is the ultimate gift people have given, and we really need to respect that.”
Given the number of body brokers that currently operate in America, academics and others familiar with the industry say regular inspections of facilities and reviews of donor consent forms wouldn’t place a big burden on government.
“This isn’t reinventing the wheel,” said Christina Strong, a New Jersey lawyer who co-wrote a set of standards that most states largely adopted for the organ transplant industry. “It would not be a stretch to envision a uniform state law which requires that those who recover, distribute and use human bodies adhere to uniform standards of transparency, traceability and authorization.”
But without consistent laws or a clear oversight authority – local, state or national – “nobody is accounting for anything,” said Todd Olson, an anatomy and structural biology professor at Yeshiva University’s Albert Einstein College of Medicine. “Nobody is watching. We regulate heads of lettuce in this country more than we regulate heads of bodies.”
“RAW MATERIALS FOR FREE”
Body brokers range in size from small, family-operated endeavors to national firms with offices in several states. Brokers also vary in expertise.
Garland Shreves, who founded Phoenix broker Research for Life in 2009, said he invested more than $2 million in quality-control procedures and medical equipment, including $265,000 on an X-ray machine to scan cadavers for surgical implants.
But other brokers have launched their businesses for less than $100,000, internal corporate records and interviews show. Often, the largest capital expenses are a cargo van and a set of freezers. Some brokers have saved money by using chainsaws to carve up the dead instead of more expensive surgical saws.
“You have people who want to do it in a pretty half-assed way,” Shreves said. “I have really grown to dislike the business.”
Brokers can also reduce expenses by forgoing the meticulous quality control procedures and sophisticated training called for by a national accreditation organization, the American Association of Tissue Banks.
In Honolulu, police were called twice to storage facilities leased by body broker Bryan Avery in 2011 and 2012. Each time, they found decomposing human remains. Both times, police concluded that Avery committed no crimes because no state law applied.
Steven Labrash, who directs University of Hawaii’s body donation program, said the Avery case illustrates the need for laws to protect donors.
“Everybody knows that what he did was unethical and wrong,” Labrash said of Avery. “But did he break any laws? Not the way they are written today.”
Avery defended how he ran his business and said the incidents were the result of misunderstandings. He said he is now raising capital for a new company, Hawaii BioSkills, which he said will use body parts to train surgeons.
“I’m all for oversight, and companies that are doing this need to be transparent,” Avery said. “As long as it doesn’t infringe upon the flow of business, that’s fine.”
Walt Mitchell, a Phoenix businessman involved in the startup of three brokers, said one reason the industry attracts entrepreneurs is that businesses can profit handsomely from selling a donated product.
“If you can’t make a business when you’re getting raw materials for free,” Mitchell said, “you’re dumb as a box of rocks.”