bloodrayne
02-08-2007, 06:51 AM
Coroner Kept Man's Heart After Autopsy -- Mom Wasn't Told
San Francisco, California - For Selina Picon, the sudden death of her son Nicholas from an undetected heart defect last fall was the first shock.
The second blow came less than a month after his burial, when she learned that the San Mateo County coroner had kept her son's heart after his autopsy.
She went into action, winning the return of the heart of the sensitive, artistic 23-year-old -- one of 105 organs the San Mateo coroner has kept from about 1,800 autopsies since 2004. And she's fighting a little-known state law that allows authorities to keep body parts after autopsies without notifying relatives.
Coroners' representatives in several other Bay Area counties said they rarely retain more than tissue samples, and some said they don't keep any organs.
This morning, San Mateo County's Board of Supervisors is to vote on calling for a change in state law to require coroners to tell next-of-kin when they retain body parts.
Being buried with some parts missing can violate religious or personal beliefs. And coroners keeping parts without telling family members raises ethical questions. But most states have laws similar to California's, and families across the country have been shocked at discoveries like Picon's.
"My son was a taxpayer. An American. Are you telling me he didn't have rights when he died? I want this exposed," Picon said through tears. "It won't bring my son back, but it will help other mothers, fathers and sisters."
At the Daly City house where Picon and her husband, Joseph, raised their son, who died in October, and their daughter, Raquel, 21, a three-tiered glass case holds mementos of Nicholas: his black baseball cap, his Jimi Hendrix tie and photos of him with his guitar and with his family.
The couple keeps his heart in a polished, inlaid wooden box in their bedroom.
Coroner Robert Foucrault said he retained the 105 organs for further testing to support his staff's findings of the cause and manner of death. Not doing that would have been "negligent," he said.
His office keeps organs for three years before disposing of them as medical waste. As for whether families should be notified, he said autopsy reports -- which are available to next-of-kin by request -- always indicate what has been retained.
"We don't hide anything from them," said Foucrault. "There are people who want to know and people who don't want to know. It's a delicate balance."
Coroners and medical examiners conduct autopsies when a death is suspicious, when they can't immediately determine a medical cause or if a contagious illness is suspected.
State law gives coroners the right to retain "parts ... as necessary or advisable for scientific investigation and training." These provisions are unrelated to organ donation, which requires the express permission of the donor or next-of-kin.
The coroner must notify the family only if he releases the body parts to hospitals or law enforcement agencies or for medical research. In those cases, officials must have the consent of the deceased or seek it from next-of-kin.
Medical ethicists said the law is intended to prevent delays in investigations -- but not to keep families in the dark. And if it is written too loosely, problems can arise, said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.
"No coroner should keep it unless material to the case or held as evidence," Caplan said.
In the Picon case, Foucrault said, his staff planned to send out the heart for further testing to support his findings about the cause and manner of death.
"We do our job, and we do it very well," he said. "We understand what Mrs. Picon is going through, and every step of the way, we've been trying to get a resolution."
Other coroners' offices take a different stance.
"We don't want, don't need and don't have room for body parts," said Sgt. R. Bowers, a sheriff's deputy with the office of the Alameda County coroner, which conducts about 900 autopsies a year.
"The parts are put back in the body," said Sgt. Chris Forsyth, a deputy with the Contra Costa coroner's office.
"I've never known a case or trained one where we kept a whole organ," said Solano County deputy coroner David Curl, whose office performs 250 to 350 autopsies a year. "We retain the exemplar, and then it goes back into the body."
Some coroners also notify families if they keep any body parts.
"We're not very busy, so we keep families informed," said Pam Carter, an investigator with the Marin County coroner, which handles about 250 cases a year.
Mimi Klaiman, an Arizona doctor and lawyer, has proposed national standards requiring family consent, similar to laws passed in Britain and New South Wales, Australia, following controversies there.
"If they can change their laws, there's no reason the U.S. shouldn't," Klaiman said, who wrote about her proposal in the Journal of Legal Medicine.
Families across the country have already fought back.
In Massachusetts, one couple sued when they learned a medical examiner had removed their baby son's heart, liver, kidneys and other organs. A jury found the hospital had acted within its rights, but in response to the case, the state in 2004 required hospitals to notify families when organs were to be retained after an autopsy. Arizona tightened rules on consent the same year after a woman complained that her father's bones and tissues were removed without her permission. In many cultures and religions, separating organs from the rest of a body after death is problematic.
Muslim belief dictates that a body be returned to the earth intact, as do Jewish precepts and Chinese tradition.
The Picons were raised as Catholics, though Selina took the children to an evangelical church. When she later told them she wanted to be an organ donor, Nicholas said he wanted to be buried whole.
Selina Picon, who grew up in San Francisco's Noe Valley, said she spoiled "Nicky" as a child. He spent hours caring for hamsters, rats, birds and other pets (which he buried with full funeral rites in the backyard). And he filled sketch pads with drawings of animals and dragons.
He also played guitar -- he had five -- and Hendrix, his favorite musician, showed up in posters in his room and in an image on a necktie.
Around 11 a.m. on Oct. 25, Joe Picon woke Nicholas -- a night owl who usually slept in -- and told him to get up and finish some chores while the rest of the family was out. That afternoon, a family member found him dead in the bathroom.
At his funeral, which drew about 400 people, his parents were amazed to see his many different circles of friends, from goths to punk rockers to old union men he'd met through his work setting up trade shows.
In the painful days after the funeral, Selina Picon stumbled across a Web posting by another mother writing about her daughter's organs missing after autopsy. Picon had to know if this had happened to her son, and she soon learned the truth.
After the Picons called her for help, San Mateo County Supervisor Adrienne Tissier proposed the resolution under consideration today, though the Picons don't think the proposal goes far enough. They want the law to require consent from relatives.
"He should have been buried whole," said Selina Picon. "I have no closure. I haven't been able to grieve. I have to keep fighting."
San Francisco, California - For Selina Picon, the sudden death of her son Nicholas from an undetected heart defect last fall was the first shock.
The second blow came less than a month after his burial, when she learned that the San Mateo County coroner had kept her son's heart after his autopsy.
She went into action, winning the return of the heart of the sensitive, artistic 23-year-old -- one of 105 organs the San Mateo coroner has kept from about 1,800 autopsies since 2004. And she's fighting a little-known state law that allows authorities to keep body parts after autopsies without notifying relatives.
Coroners' representatives in several other Bay Area counties said they rarely retain more than tissue samples, and some said they don't keep any organs.
This morning, San Mateo County's Board of Supervisors is to vote on calling for a change in state law to require coroners to tell next-of-kin when they retain body parts.
Being buried with some parts missing can violate religious or personal beliefs. And coroners keeping parts without telling family members raises ethical questions. But most states have laws similar to California's, and families across the country have been shocked at discoveries like Picon's.
"My son was a taxpayer. An American. Are you telling me he didn't have rights when he died? I want this exposed," Picon said through tears. "It won't bring my son back, but it will help other mothers, fathers and sisters."
At the Daly City house where Picon and her husband, Joseph, raised their son, who died in October, and their daughter, Raquel, 21, a three-tiered glass case holds mementos of Nicholas: his black baseball cap, his Jimi Hendrix tie and photos of him with his guitar and with his family.
The couple keeps his heart in a polished, inlaid wooden box in their bedroom.
Coroner Robert Foucrault said he retained the 105 organs for further testing to support his staff's findings of the cause and manner of death. Not doing that would have been "negligent," he said.
His office keeps organs for three years before disposing of them as medical waste. As for whether families should be notified, he said autopsy reports -- which are available to next-of-kin by request -- always indicate what has been retained.
"We don't hide anything from them," said Foucrault. "There are people who want to know and people who don't want to know. It's a delicate balance."
Coroners and medical examiners conduct autopsies when a death is suspicious, when they can't immediately determine a medical cause or if a contagious illness is suspected.
State law gives coroners the right to retain "parts ... as necessary or advisable for scientific investigation and training." These provisions are unrelated to organ donation, which requires the express permission of the donor or next-of-kin.
The coroner must notify the family only if he releases the body parts to hospitals or law enforcement agencies or for medical research. In those cases, officials must have the consent of the deceased or seek it from next-of-kin.
Medical ethicists said the law is intended to prevent delays in investigations -- but not to keep families in the dark. And if it is written too loosely, problems can arise, said Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania.
"No coroner should keep it unless material to the case or held as evidence," Caplan said.
In the Picon case, Foucrault said, his staff planned to send out the heart for further testing to support his findings about the cause and manner of death.
"We do our job, and we do it very well," he said. "We understand what Mrs. Picon is going through, and every step of the way, we've been trying to get a resolution."
Other coroners' offices take a different stance.
"We don't want, don't need and don't have room for body parts," said Sgt. R. Bowers, a sheriff's deputy with the office of the Alameda County coroner, which conducts about 900 autopsies a year.
"The parts are put back in the body," said Sgt. Chris Forsyth, a deputy with the Contra Costa coroner's office.
"I've never known a case or trained one where we kept a whole organ," said Solano County deputy coroner David Curl, whose office performs 250 to 350 autopsies a year. "We retain the exemplar, and then it goes back into the body."
Some coroners also notify families if they keep any body parts.
"We're not very busy, so we keep families informed," said Pam Carter, an investigator with the Marin County coroner, which handles about 250 cases a year.
Mimi Klaiman, an Arizona doctor and lawyer, has proposed national standards requiring family consent, similar to laws passed in Britain and New South Wales, Australia, following controversies there.
"If they can change their laws, there's no reason the U.S. shouldn't," Klaiman said, who wrote about her proposal in the Journal of Legal Medicine.
Families across the country have already fought back.
In Massachusetts, one couple sued when they learned a medical examiner had removed their baby son's heart, liver, kidneys and other organs. A jury found the hospital had acted within its rights, but in response to the case, the state in 2004 required hospitals to notify families when organs were to be retained after an autopsy. Arizona tightened rules on consent the same year after a woman complained that her father's bones and tissues were removed without her permission. In many cultures and religions, separating organs from the rest of a body after death is problematic.
Muslim belief dictates that a body be returned to the earth intact, as do Jewish precepts and Chinese tradition.
The Picons were raised as Catholics, though Selina took the children to an evangelical church. When she later told them she wanted to be an organ donor, Nicholas said he wanted to be buried whole.
Selina Picon, who grew up in San Francisco's Noe Valley, said she spoiled "Nicky" as a child. He spent hours caring for hamsters, rats, birds and other pets (which he buried with full funeral rites in the backyard). And he filled sketch pads with drawings of animals and dragons.
He also played guitar -- he had five -- and Hendrix, his favorite musician, showed up in posters in his room and in an image on a necktie.
Around 11 a.m. on Oct. 25, Joe Picon woke Nicholas -- a night owl who usually slept in -- and told him to get up and finish some chores while the rest of the family was out. That afternoon, a family member found him dead in the bathroom.
At his funeral, which drew about 400 people, his parents were amazed to see his many different circles of friends, from goths to punk rockers to old union men he'd met through his work setting up trade shows.
In the painful days after the funeral, Selina Picon stumbled across a Web posting by another mother writing about her daughter's organs missing after autopsy. Picon had to know if this had happened to her son, and she soon learned the truth.
After the Picons called her for help, San Mateo County Supervisor Adrienne Tissier proposed the resolution under consideration today, though the Picons don't think the proposal goes far enough. They want the law to require consent from relatives.
"He should have been buried whole," said Selina Picon. "I have no closure. I haven't been able to grieve. I have to keep fighting."