Missouri doctor says surgeon nearly began organ removal from living patient; physician intervened
A treating physician stopped an operating-room procedure after he said a 22-year-old gunshot victim had not been declared brain dead, and the patient later recovered.
A hospital physician in St. Louis says he stopped surgeons from removing organs from a patient who was still alive after being shot in the head in March 2019.
Larry Black, then 22, was walking to his sister’s apartment on March 24, 2019, when he was shot in the head, according to interviews and medical records reviewed by KFF Health News. About a week later, hospital staff at SSM Health Saint Louis University Hospital prepared to take his organs for transplant, even though the patient's heart was still beating and his attending physician, Zohny Zohny, had not declared him brain dead, Zohny told KFF.
Zohny, then a first-year physician at the hospital, said he burst into the operating room and told the surgeon to stop. "This is my patient. Get him off the table," Zohny recalled telling the team. "I don’t care if we have consent [from his family]. I haven’t spoken to the family, and I don’t agree with this. Get him off the table."
Black was returned to an intensive care unit. He regained consciousness days later, spoke almost immediately and was walking within a week, according to interviews with Black and his family and the medical records reviewed by KFF. He remained hospitalized for 21 days. Black later told KFF he had been a registered organ donor but has since changed that status.
Black’s relatives described being approached soon after his arrival at the hospital by someone offering organ donation information and said they felt pressure to consent. His sister, Macquel Payne, told KFF that when she and the family agreed to donate, some staff became standoffish. She said she watched her brother tap the side of his bed and asked clinicians to check him again just before he was wheeled into the operating room. Hospital staff told her those movements were involuntary, she said. Chilling video reviewed by KFF showed Black being moved down the hallway with his eyes partly open.
Mid-America Transplant, the federally designated organ procurement organization that serves the St. Louis region, said in a blog post that patients must be declared legally dead by the hospital’s medical team before organ procurement begins. "In every case, the patient must be declared legally dead by the hospital’s medical team before organ procurement begins. This is not negotiable," Mid-America Transplant President and CEO Kevin Lee wrote in August.
KFF, Zohny and a former trauma surgeon who was not involved in the case, LJ Punch, reviewed Black’s records and said they could not identify why the hospital had begun to prepare the patient for organ removal. Punch suggested the circumstances of the case — a young Black man with a traumatic injury — may have shaped how clinicians and administrators handled the situation and cited structural neglect of Black men’s bodies as a possible contributing factor.
SSM Health Saint Louis University Hospital declined to comment on details of Black’s case. Zohny, who left the hospital shortly after the incident, said the episode demonstrated what he called flawed policy and the need for clearer adherence to the legal standards for declaring death.
The case has drawn renewed attention as federal authorities investigate organ procurement practices elsewhere. A recent federal review of a Kentucky organ donation nonprofit concluded that medical providers harvested organs from 73 patients over four years despite signs of neurological activity. Health and Human Services Secretary Robert F. Kennedy Jr. described those findings as "horrifying" and called for changes to ensure that "every potential donor’s life is treated with the sanctity it deserves," according to a department statement.
Medical and legal standards recognize two ways to declare death: circulatory death, when a patient’s heart stops and breathing ceases, and brain death, when all brain functions have irreversibly ceased. Mid-America Transplant reiterated that neither condition applied to Black when he was being prepared for organ procurement, according to the records reviewed and the organization’s public statement.
Family members said the experience left them shaken. Black’s sister said the family would not have consented to organ donation had they understood his condition, and Zohny said families generally do not agree to donation unless they are given the impression that a loved one has a very poor prognosis.
Black has since rebuilt his life. He is a father of three and said he is pursuing a music career. He told KFF that he had to relearn basic skills and identity details after the injury but described his recovery as a "miracle." The case and the larger federal review have prompted calls from some clinicians and officials for tighter safeguards and clearer procedures to ensure that organ procurement does not begin until legal death has been established and documented.
Officials at the Department of Health and Human Services and leaders at organ procurement organizations have said the system must ensure both that organs are available for patients in need and that donors and their families are protected by rigorous, legally grounded protocols. The hospital at the center of the St. Louis case declined to comment, and state or federal investigations into the specific 2019 incident have not been publicly disclosed.