Missouri doctor halts organ procurement after patient with beating heart is wheeled to OR
Physician intervened as surgeons prepared to remove organs from 22-year-old shooting victim who was not declared brain dead; federal probes into similar practices are under way
A Missouri physician intervened to stop surgeons from removing organs from a critically injured 22-year-old man whose heart was still beating and who had not been declared brain dead, according to interviews and medical records reviewed by KFF Health News.
Larry Black was shot in the head on March 24, 2019, and was taken to SSM Health Saint Louis University Hospital. About a week after the shooting, hospital staff prepared to remove his organs, but Zohny Zohny — the trauma surgeon who had been treating Black and had not pronounced him dead — entered the operating room and ordered the procedure stopped, saying the patient was still his and had not been declared legally dead.
Zohny told KFF Health News that he saw Black’s chest rising and falling and that the patient’s heart was beating. He said he confronted the surgical team, telling them, "This is my patient. Get him off the table," and insisting he had not spoken to the family or agreed that procurement should proceed. Hospital records and contemporaneous accounts indicate Black was returned to the intensive care unit and regained consciousness two days later.
Family members told reporters they had been approached in the ICU about organ donation before physicians completed a final evaluation. Black’s sister, Macquel Payne, said a hospital worker handed her brochures and urged the family to consent, telling them multiple lives could be saved. Payne and other relatives said they later felt pressured to agree and believed staff treated them differently after they signed consent forms.
Black and his relatives say he showed signs of awareness while in the ICU, including tapping the side of his bed and blinking in response to questions. Video of Black being wheeled down a hospital corridor was later reviewed by KFF; his eyes appear half open in the footage. A hospital worker who later helped return Black to the ICU told Zohny they had observed the patient’s eyes open during the transfer.
Black woke from his coma days after the aborted procurement and was speaking within days and walking within a week. He spent 21 days in the hospital and required rehabilitation to re-learn basic functions. He has since changed his organ-donor status, has three children and is pursuing a music career.
Mid-America Transplant, the federally designated organ procurement organization serving the St. Louis region, said in a statement that hospital medical teams must declare a patient legally dead before organ procurement begins. Kevin Lee, the organization’s chief executive, wrote that legal death can be determined either when the heart stops beating or when brain function has ceased, and that neither condition applied to Black.
SSM Health Saint Louis University Hospital declined to comment on the specifics of Black’s case.
The incident has drawn renewed attention amid federal findings of improper practices at an organ donation nonprofit in Kentucky. A federal investigation determined that over a four-year period medical providers procured organs from 73 patients despite signs of neurological activity, findings that Health and Human Services Secretary Robert F. Kennedy Jr. described as "horrifying." Kennedy said the system must be fixed to ensure that every potential donor’s life is treated with sanctity.
Independent reviewers, including KFF and a former trauma surgeon who was not involved in Black’s care, examined the patient’s chart but could not identify why procurement was allowed to begin. LJ Punch, a former trauma surgeon, suggested systemic factors may contribute to how cases involving young Black men and traumatic injury are handled and warned against attributing the outcome to a single clinician.
Black’s family members and Zohny have said that if they had known his true clinical status, they would not have consented to donation. Payne told reporters that she believed hospital staff had conveyed to the family that Black’s prognosis was poor before they agreed to donation.
Federal rules require that hospitals determine legal death under established medical standards before organ procurement, but the Kentucky investigation and cases like Black’s have prompted calls from clinicians and lawmakers for clearer enforcement and oversight. Mid-America Transplant reiterated that declaration of legal death by the hospital team is nonnegotiable and emphasized that organ donation should proceed only when legal and ethical criteria are met.
Black’s case underscores tensions that can arise at the intersection of end-of-life care, organ donation and pressure on families making rapid decisions in intensive care settings. It also comes as policymakers and health officials consider measures to improve safeguards to ensure organ procurement never begins until a patient is unequivocally declared dead by responsible clinicians.
Black and his family said they hope his experience leads to stronger protections so other patients do not face similar risks. Zohny, who left the hospital shortly after the incident, called Black’s recovery "a miracle despite flawed policy," and urged reforms to prevent premature or improper procurement.
Federal officials have not linked the Missouri incident to the Kentucky investigation. Investigations and reviews of organ procurement practices are ongoing in multiple jurisdictions, and advocates and clinicians continue to push for clearer protocols, transparency and accountability in how hospitals and transplant organizations coordinate end-of-life determinations and organ donation.