It was revealed last week that 46 Australian patients received tissue implants from Biomedical Tissue Services (BTS), a company under investigation and now shut down by the United States Food and Drug Administration for illegally obtaining body parts from cadavers (many of which were diseased) and placing them in the stream of commerce.
A tragic scandal now has repercussions beyond the New Jersey shores where BTS is located. Patients who received body parts from BTS have filed lawsuits claiming to have contracted syphilis, hepatitis and other diseases from the bones and tissues they received from pillaged cadavers. The emptied corpses were sent to funeral homes in New York to prepare for burial. Yet, Michael Mastromarino, the CEO of BTS, and his colleagues had other macabre business objectives in mind, including looting the corpses for profit.
Prosecutors in New Jersey and New York are investigating over a dozen funeral homes complicit in the tissue and bone-robbing scheme that led to Mastromarino, a former dentist, profiting handsomely from desecrating bodies and selling them on the black market. Mastromarino is alleged to have stolen tendons, bones, skin and other body parts from corpses and then selling them through his tissue bank.
Each corpse can be worth more than US$200,000 in profit. With the dramatic rise in demand for human body parts, the industry is estimated to profit more than $1 billion dollars a year.
Rest assured, however, Australia is not alone: diseased human tissues have entered the international stream of commerce, reaching nearly all continents. But this is not the first time that the clandestine nature of the industry has been exposed, and it may not be the last.
Two years ago, an executive at UCLA’s medical school (a prestigious American university) was caught selling body parts donated to the medical school to a body broker, who sold to prominent tissue bank clients. Each profited several hundred thousand dollars before their criminal ring was exposed.
The market in human body parts is ubiquitous and robust, spreading human tissue throughout the world for a range of treatments, including cornea transplants and cosmetic surgeries, or used for procedures to enhance sexual function or to provide a new life for burn victims. Because the industry generates more than $1 billion dollars in revenue each year, it is unlikely to turn around any time soon. Many tissue banks are publicly-listed companies - they are a part of the global economy.
The problem is that consent is an illusory prospect in the tissue marketplace. Most people have no idea that their late relatives could become pieces of commerce: chopped, packaged and shipped thousands of kilometres away or sold across town to a local hospital. The National Organ Transplantation Act (NOTA) in the United States prohibits the buying and selling of body parts. Indeed, violation of the statute is punishable by a US$50,000 fine and five-year prison term. Yet the law is flouted regularly.
Hundreds of tissue banks skirt the law’s intent by providing incredibly generous processing fees (which are legal) to organ procurement organisations and medical schools, which legally obtain body parts - although not for these purposes. Other companies like Biomedical Tissue Services flat-out violate the law by going to funeral homes and working with mortuary staff to retrieve body parts. They implant plumbing piping to hide the disfigurement of the bodies.
The issues are not at all simple. Demand for plastic surgeries, elective orthopaedic operations and the rapid growth of biotechnology spurs the demand for tissues. Nearly a million allograft surgeries will occur this year. The human device industry, however, lacks a real incentive to develop other technologies to satisfy the demand. Why move to plastics or metal when obtaining parts virtually free brings so much profit when the parts are sold?
Tissue banks are often for-profit and some even boast on their websites about the hundreds of thousands that can be profited through the reprocessing of one cadaver. Thus, there is a disincentive for tissue banks to acquire consent from relatives.
The pressing questions have to do with supply, demand and safety. It is clear that the demand for life-saving and or elective surgeries will not dissipate in the near future. Human tissues are used in tendon implants for knees, plastic surgeries, dental procedures and a host of other operations. Many patients believe these operations enhance their quality of life. The problem is that they do not know how or where the tissues are obtained. After discovering the origin of transplanted organs and tissues, patients are terrified not only for their own safety, but because of the undignified pillaging of bodies without the consent of relatives.
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