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Here is new disturbing case from Duke University where the organ procurement team noticed the patient was still alive.
The case authors rightly recommend that the organ procurement team should have left the room immediately and should have withdrawn from the case. They further rightly recommend that the patient’s death should not have been actively hastened.
During organ procurement the patient’s aortic and renal arteries started pumping and pulsing, and her cardiopulmonary activities were back to unexpected levels. The organ procurement surgery was stopped. The patient was then given Fentanyl and Lorazepam. Subsequently, she was pronounced dead again 18 minutes after she was initially pronounced dead.
After a complete autopsy, the cause of death was determined to be acute Fentanyl toxicity due to a Fentanyl injection in the hospital. The manner of death was determined to be homicide.
While cardiac activity rarely resumes after 4 minutes and it rarely resumes for very long, those are averages. Sometimes, there is meaningful spontaneous resuscitation. This case illustrates that we are willing to accept less than 100% certainty of death determination in order to maximize the quantity and quality of procurable organs.