America Letter: A ghoulish scandal over stolen body parts took a new twist this week when seven New York funeral home directors admitted their role in supplying corpses to bone and tissue harvesters without relatives' permission. They included the director of a funeral home that took parts from the body of BBC journalist Alistair Cooke when he died in 2004.
Four people have already been charged with stealing and carving up more than 1,100 corpses without the consent of next of kin. Prosecutors claim that former dental surgeon Michael Mastromarino, the alleged ringleader, made millions by selling the stolen body parts to tissue banks.
The bodysnatching scandal, with its eerie details of midnight carve-ups at funeral parlours, has a whiff of the 19th century about it and most US reports describe the story as "Dickensian".
It is also a very modern story, however, driven by scientific advances that have made almost every part of the human corpse useful to doctors and highly lucrative to others. Grave- robbing went out of vogue more than a century ago when doctors found legitimate sources for experimentation and other uses. Today, however, transplant technology has become so advanced that the demand for corpses far outstrips supply.
Apart from heart, liver and kidney transplants, doctors are using human tissues for regenerative surgery, harvesting bone to repair fractures, veins for heart surgery and membranes, skin and collagen for everything from skin grafts to facelifts.
The tissue shortage is acute in the US, where doctors perform more than a million tissue transplants every year with only some 25,000 donors.
Tissue must be harvested within a day or two of death and many states require the permission of next of kin, even if donors have themselves signed a consent form. Many relatives are willing to consider heart, liver and kidney transplants, which can save lives immediately, but persuading families to give up their dead for collagen implants is more difficult.
Prosecutors say that Mastromarino and his accomplices got around the problem by forging consent forms and often changed the dead person's age and medical history on death certificates to make the tissue more marketable. Funeral homes received $1,000 (€793) for each corpse - a small price given that the body parts could fetch up to $250,000.
The harvesting operation was swift and efficient, requiring just one hour to strip a corpse of its most valuable parts before sewing it back up in time for the funeral. Most of the operations were conducted in funeral homes, often in the middle of the night.
"We wore surgical gowns and caps. We worked on embalming tables; some were stainless steel, others were the old porcelain. It would take 45 minutes to take out the bones, then another 15 minutes for the skin, the upper arm, lower arm, thigh, abdominal area and more," Lee Cruceta, one of Mastromarino's alleged accomplices, told the New York Daily News this week.
Skin was stuffed into jars and other tissues were put into drinks coolers packed with ice. Crucetta said he and his colleagues were so busy they sometimes ate lunch in the cutting room. After the bones and large veins were removed, they would be replaced by PVC pipes as legs were sewn up so that, even if the casket was open for the funeral, relatives would not suspect what had happened.
If bodies were due to be cremated, they were simply butchered with no care for their final appearance.
Mastromarino, Cruceta and two others have pleaded not guilty to all charges and Mastromarino maintains he ran a legitimate business.
Although Cruceta admits carving up the corpses, his lawyer insists that the former nurse did nothing wrong.
"My client is 100 per cent innocent. In retrospect, was my client naive? Yes. Was he dumb? Probably," he said.