Jim Stauffer thought he was doing the right thing.
He had cared for his elderly mother, Doris, throughout her harrowing descent into dementia. In 2013, when she passed away at age 74, he decided to donate her brain to science. He hoped the gift might aid the search for a cure to Alzheimer's disease.
At a nurse's suggestion, the family contacted Biological Resource Center, a local company that brokered the donation of human bodies for research. Within the hour, BRC dispatched a driver to collect Doris. Jim Stauffer signed a form authorizing medical research on his mother's body. He also checked a box prohibiting military, traffic-safety and other non-medical experiments.
Ten days later, Jim received his mother's cremated remains. He wasn't told how her body had been used.
Records reviewed by Reuters show that BRC workers detached one of Doris Stauffer's hands for cremation. After sending those ashes back to her son, the company sold and shipped the rest of Stauffer's body to a taxpayer-funded research project for the U.S. Army.
Her brain never was used for Alzheimer's research. Instead, Stauffer's body became part of an Army experiment to measure damage caused by roadside bombs.
Internal BRC and military records show that at least 20 other bodies were also used in the blast experiments without permission of the donors or their relatives, a violation of U.S. Army policy. BRC sold donated bodies like Stauffer's for $5,893 each.
Army officials involved in the project said they never received the consent forms that donors or their families had signed. Rather, the officials said they relied on assurances from BRC that families had agreed to let the bodies be used in such experiments.
BRC, which sold more than 20,000 parts from some 5,000 human bodies over a decade, is no longer in business. Its former owner, Stephen Gore, pleaded guilty to fraud last year. In a statement to Reuters, Gore said that he always tried to honor the wishes of donors and sent consent forms when researchers requested them.
Jim Stauffer learned of his mother's fate not from BRC or the Army but from a Reuters reporter. When told, Stauffer curled his lip in anger and clutched his wife Lisa's arm.
"We did right," Lisa reassured him. "They just did not honor our wishes."
The story of how an Arizona grandmother's remains came to be used in a Pentagon experiment shines a spotlight on a growing but little-known industry: the trade in human cadavers and body parts.
The body-brokering business is distinct from organ transplantation, in which hearts, livers, eyes and lungs are carefully removed from the dead to extend or enrich the lives of the living. It also is separate from the business of using skin, tendon or bone from cadavers to repair joints or other parts of the body. Those practices are strictly regulated by U.S. law. In contrast, the buying and selling of human bodies not used for transplant receives scant oversight.
No federal law regulates body brokers like BRC, and no U.S. government agency monitors what happens to cadavers pledged for use in medical education and research.
"It is not illegal to sell a whole body or the parts of a body for research or education," said University of Iowa law professor Sheldon F. Kurtz, who helped modify the Uniform Anatomical Gift Act, which has been adopted by 46 states. Although the act was updated in 2006, Kurtz said, "the issue of whole bodies or body parts for research or education never came up during our discussions."
Since then, the body trade has become big business. Only one state, New York, keeps detailed records on the industry. According to the most recent data available, companies that did business in New York shipped at least 100,000 body parts across the country from 2011 to 2014. Reuters obtained the data, which have never been made public, from the state's health department.
The New York figures represent a fraction of the industry: Any company that handles bodies but doesn't do business in New York state is not included. A handful of other states either require companies to register with state health departments or seek approval to ship individual body parts across state lines. Most states compile no such records.
"We are in a complete vacuum," said Michel Anteby, a Boston University business professor who has researched the trade in bodies. "That's a real problem because we are treating bodies as a potential commodity like any other."
Brokers procure virtually all their cadavers for free from donors who believe the remains will be used for science. As a result, brokers can turn a profit of thousands of dollars on each body donated. "It's about $2,500 to $3,000," said John Cover, chief operating officer of Research for Life, a body broker based in Phoenix.
When bodies are subsequently dismembered and sold part by part, the profit margin can be even higher. BRC charged $5,893 for a whole body in 2013; a few years earlier, the company priced spines at $1,900, legs at $1,300 each, and torsos at $3,500, BRC documents show.
Cadavers and donated body parts provide vital tools to teach anatomy and medical students. They also serve as a cornerstone of the medical-device business. Artificial hips, dental crowns and surgical devices are best tested on real human tissue. Surgeons and dentists who implant the devices and use new tools have to be trained.
"There's no way any medical institution could function without the donation of cadavers," said David Morton, a University of Utah School of Medicine professor and a board member of the American Association of Anatomists.
Most medical schools have strict rules for handling bodies, Morton said. Those quality controls and ethical guidelines, however, aren't always followed. This year, The New York Times reported that New York University buried an unknown number of donated bodies in mass graves. The school apologized and said it had changed its policy in 2013 to better protect donor wishes.
The BRC case is not the first time bodies donated to medical schools have been misused in military experiments. In 2004, Tulane University disclosed that bodies donated to the school were shipped to a broker who then provided them to the Army, which used them for landmine experiments. As happened with BRC, these donors had not consented to military use.
Federal authorities began investigating BRC in 2011. That year, a Detroit body broker from a company called International Biological Inc was stopped by U.S. customs agents as he crossed the border from Ontario. He had 10 human heads with him. According to an FBI affidavit, agents traced one of the heads to BRC.
Within a year, investigators had identified at least 250 suspect body parts sold by BRC to the Detroit broker. Records from the Detroit and Phoenix cases show that thousands of bodies donated for research and education were dismembered and then sold or leased, often for commercial purposes.
In January 2016, the Detroit broker and his wife were arrested by the FBI on fraud charges related to their practices at International Biological. The broker, Arthur Rathburn, has pleaded not guilty and is jailed awaiting trial. His wife, Elizabeth Rathburn, pleaded guilty to a single fraud charge but has not been sentenced.
Arthur Rathburn leased human heads, torsos and other body parts for medical and dental training in the United States, Mexico, Canada, Italy, Greece and Israel, authorities said. In 2012, two coolers that contained eight bloody heads and were addressed to Rathburn were seized at the Detroit airport.
Government documents unsealed this year also allege that Arthur Rathburn's inventory included more than 100 body parts infected with hepatitis, HIV, sepsis, meningitis, the life-threatening bacteria MRSA, and the flesh-eating disease necrotizing fasciitis.
Rathburn's lawyer, Byron Pitts, said his client committed no crime. "I think the government has overstepped and I don't think they are going to be able to prove their charges," Pitts said. In a court filing this year, Pitts noted that the Uniform Anatomical Gift Act does not prohibit the sale of body parts and said Rathburn should not be held accountable criminally for paperwork errors or the actions of others, including BRC.
BRC also shipped infected body parts, according to Arizona state investigation summaries reviewed by Reuters.
These included portions of eye and ear tissue infected with Hepatitis B sent to researchers in Tucson; eyes from a body that tested positive for Hepatitis C to Utah for use by a biomedical firm; and a left foot infected with Hepatitis B to a podiatry training center near Atlanta.
In at least one case, BRC notified next of kin about the infections but failed to warn researchers who received the tissue or body parts, the records show.
When a 76-year-old woman died the morning of April 29, 2012, BRC staffers rushed to remove her brain by mid-afternoon and shipped the 13-pound package the same day to the Harvard Brain Tissue Resource Center near Boston. In a standard industry practice, BRC also sent a blood sample from the woman's body to a lab. Three days later, the sample came back positive for Hepatitis C.
BRC promptly notified the woman's son.
"Unfortunately, we received an unfavorable report for infectious disease blood testing," BRC staff wrote in a letter. "These blood tests could not confirm that an infectious disease was present, but did prohibit us from using the body for safety reasons."
BRC, however, did not warn Harvard researchers handling the diseased brain, records show. In fact, the researchers did not learn that the specimen was infected until nearly two years later, when Arizona authorities contacted them.
"We would never knowingly use [a brain sample] with a history of disease," said Harvard brain donation coordinator Joseph Manzo. He said privacy rules restricted him from commenting further on a specific specimen.
In an email exchange with Reuters, Gore apologized for not notifying researchers. "I simply have no excuse," he said.
The risks of infection are real: Records of the Arizona state investigation show that one worker at the Georgia podiatry facility was accidentally stuck by a needle used with the hepatitis-infected foot. The worker had been vaccinated.
In emails to Reuters, Gore said that the troubles at BRC represented only a fraction of the work by the company, which served scores of research and training entities it supplied.
"BRC had an incredibly kind, professional and caring staff on all levels," Gore said.
Because BRC sold bodies and parts to various Army subcontractors - and not directly to the military - Gore said he sometimes received different instructions about what BRC needed to provide. But he said he sent consent forms whenever researchers requested them.
"It is my belief that we did what we could to honor the donors' consent as we understood it," Gore said.
When he was sentenced in 2015 for the charge related to misleading donors and families, Gore presented a letter to the judge explaining what went wrong. He said he created BRC because he had grown bored as an insurance salesman. Though he held no more than a high school degree, Gore had previously spent nine years at a local eye and organ bank, he said, working with donor families and assisting surgeons.
"This was never about financial gain but rather a labor of love," Gore wrote. Instead of hiring a qualified medical director to supervise how bodies and parts should be used, Gore said he relied on books and the Internet.
"This was an industry that had no formal regulations to look to for guidance," Gore wrote in his letter to the judge, "and I believe that many times I was simply overwhelmed and I tried to do the right thing but often did not."
Arizona prosecutors said in their filing that Gore's fraud misled those who had hoped to provide "the most precious gift a person could bestow on society, their own body, to benefit scientific and medical research."
In interviews, family members who signed BRC consent forms said they were focused on saving money and serving society. They said they didn't realize the bodies of their loved ones would be sold or used for commercial purposes.
"I had no money," said Tina Johnson, who gave her husband Kerry's body to BRC when he died of liver failure in 2012. "It was a free cremation."
Mary Hughes, whose 52-year-old son, Grady Hughes Jr, died of cancer in late 2012, recalled that "somebody from hospice gave us a pamphlet."
"It was a good idea," Hughes said. "The cremation was free, and it was donating the body for medical purposes."
Months after the donations, Johnson, Hughes and dozens of others received a vague form letter from BRC listing nine potential medical education and research uses. None cited military experiments.
Some BRC donors willed bodies with the expectation that they would be used for a specific disease. Jim Stauffer, for example, said he hoped his mother's brain would be used to study Alzheimer's.
"It shocks me that the military was involved," he said.
The BRC consent form permitted the broker to sell cadavers and parts to almost any entity, including commercial ventures. Under current law, relatives have no right to learn what happened to their loved ones.
ARMY PROJECT
The Army's human-body experiments were part of a program to protect U.S soldiers from improvised explosive devices, or IEDs.
During wars in Iraq and Afghanistan, the Army scrambled - with limited success - to fortify vehicles. Early this decade, the Army launched a long-term study of the biological impact of an IED blast that thrusts a vehicle into the air. The most vulnerable body parts are those already in contact with the inside surfaces of a vehicle.
"It's your feet, your butt in the seat, and to some extent your back," said Randy Coates, the civilian engineer who directed the Army project, which is based at Aberdeen Proving Ground in Maryland.
To study a blast's effect, the Army considered experimenting with crash-test dummies, the biometric mannequins used by engineers to improve automotive safety. But crash-test dummies have limitations: They enable researchers to collect data only on front, rear and side collisions common in traffic accidents, not from explosions beneath a vehicle.
When cadaver experiments confirmed that a crash-test dummy couldn't replicate battlefield wounds, the Army set out to create a mannequin that could show the effects of explosions. The project required experiments involving more than a hundred cadavers and included researchers from nine universities.
In addition to building the blast mannequin, the Army is using cadavers to obtain data to develop a virtual dummy for computer simulations.
Donated bodies are not obliterated in explosions, Coates said. But the blasts do break bones and snap spines. In an experiment witnessed by a Reuters reporter this year, two bodies wired to 100 biosensors flailed violently during an explosion and came to rest slumped, but intact.
Army policy requires that body donors or next of kin consent to the blast experiments. But records reviewed by Reuters show that the bodies or body parts of 34 people were shipped to the military without donor permission.
In 18 of the 34 cases, the donor consent forms neither mentioned nor offered any warning language about potential military experiments.
In the remaining 16 instances, the consent form presented an option to allow military and other violent experiments. Twelve of the 16 families explicitly rejected violent experiments. Four made no choice. All 16 were shipped to the Army anyway.
Among those shipped to the military were Nancy Culver's son and Marla Yale's grandfather.
"Oh, no. Oh, no," Culver said when a Reuters reporter told her that the right arm of her son, Timothy Smith, was detached and used for a military experiment against her wishes. She donated his body two days after he took his own life in late 2012. "I wanted something good to come of this," she said.
Marla Yale recalled watching grandfather Kurt Hollstein sign a donor form two months before he died of cancer in 2013. Hollstein, an Army veteran, was so angry about the health care he was provided by the U.S. Department of Veterans Affairs, she said, that on the consent form he checked "No" to military experimentation.
Yale learned what really happened to her grandfather from Reuters.
"This is almost beyond belief that his entire body went somewhere else without his permission, and especially to a place that he absolutely did not want to be," she said. "To go to the Department of Defense is absolutely mind-boggling."
According to Army policy, "If it is clear that a donor prohibited the contemplated use, then the donor's cadaver will not be used." The policy requires that authorization forms must explicitly state that donors or next-of-kin agree that their bodies may be used in explosions.
But the consent forms the Army examines are not necessarily the same ones signed by donors. In the BRC case, the Army said, the military reviewed "heavily redacted forms or forms signed by an agent of BRC that indicated consent."
Army officials said their first indication that something was amiss came in January 2014, after law enforcement authorities searched BRC. Coates, who oversaw the military project, said experiments were halted immediately. An Army safety officer then traveled to Arizona to compare the documents the military reviewed with those kept by BRC. In at least 34 cases, the forms did not match, records show.
Coates said that the Army acted in good faith because it believed the consent forms it received were valid. "The Army was a victim of BRC business practices," he said.
Even so, the Army said in a statement that it still relies on brokers to accurately represent the wishes of donors and does not review the original consent forms before experiments begin.
BRC records also show that in at least two cases, consent forms were amended after the donor died.
In each case, records show, an elderly widow agreed to countermand a husband's written instructions that his body not be subjected to explosive military experiments. Both widows made the change after being contacted by BRC, donor case files show.
In an interview with Reuters, one of the widows, Dona Patrick, said she didn't fully grasp what she had agreed to: that husband Conrad's head and spine would be severed and shipped to one of the universities conducting the military experiments, his case file shows. The call from BRC came less than 48 hours after her husband died, "at a time when you are susceptible to anything just to get it out of your mind," she said.
Patrick said yes to the BRC caller because Conrad's "soul was already gone, and the body was nothing," she said. "Probably now if they would have called me, I would have said 'no.' But then, I didn't know what to do."
BRC recorded the conversation for legal reasons and quality assurance.
On the call, the BRC employee asked: As next of kin, do you agree to amend the consent form to allow "special non-medical projects that could involve exposures to destructive forces - for example, impacts, crashes, ballistic injuries and blasts" involving "agencies such as the military"?
Patrick, her voice quavering, said, "Yes, I do."
"Excellent," the body broker replied. "That takes care of everything."
