Doctors at St. Joseph's Hospital in Syracuse NY were in the process of starting surgery to harvest a dead woman's organs when that woman opened her eyes. She was still alive.
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Colleen S. Burns of North Syracuse, New York, 41, had been admitted to the hospital in October 2009 for a drug overdose.
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The state Health Department investigation of the incident found that when Burns was first admitted, they skipped a recommended treatment that would prevent the drugs she had taken - Xanax, Benadryl and a muscle relaxant - from being absorbed by her stomach and intestines.
They also didn't do enough testing to see if she was free of drugs or perform enough brain scans.
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But the day before the organs were to be removed, a nurse performed a reflex test and found that Burns was still reacting.
She scraped her finger on the bottom of one of Burns' feet and her toes curled downward, a sign that she was still alive.
And that wasn't the only sign of life. As she was being wheeled to the operating room, Burns' nostrils flared and it seemed she was breathing independently from the respirator. Her lips and tongue were moving as well.
But doctor's ignored the nurse's observations which indicated Burns was still alive, and proceeded with the surgery anyway.
Before the procedure, Burns was given an injection of the sedative Ativan, but neither the sedative or the observations of life were recorded in the doctor's notes for the procedure.
Dr. David Mayer, a general vascular surgeon and associate professor of clinical surgery an New York Medical College, said the application of a sedative is quite strange.
'It would sedate her to the point that she could be non-reactive,' Mayer told the Post-Standard. 'If you have to sedate them or give them pain medication, they're not brain dead and you shouldn't be harvesting their organs.'
It wasn't until Burns opened her eyes in the OR that the procedure was called off.
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