Records Lost, UCI Can’t Use Willed Bodies

Missing records at UC Irvine’s medical school mean officials cannot tell if cadavers set aside for students and researchers to dissect are free of infectious disease, medical school Dean Thomas C. Cesario said Friday.

As a result, the cadavers likely will be cremated and officials are scrambling to replace them before dissection labs for first-year students begin Nov. 5, he said.

The tentative decision to not use the cadavers was made this week by Cesario, whose career as a doctor has been in infectious diseases. Cesario said he is uncomfortable asking students and researchers to use cadavers that carry an increased risk of infection, no matter how small.

“Those cadavers may be good, but I have this problem and I can’t be sure,” he said. “I am not going to compromise.”

There are about 14 cadavers in the laboratory, he said.

The decision follows the shutdown last month of the school’s Willed Body Program, whose director was fired amid allegations he profited from the sale of body parts and steered work to friends and relatives.

In auditing the program, UCI officials discovered that a computer virus had destroyed most program records and they were unable to find proof that the bodies on hand had been tested for infectious diseases.

The practice of testing cadavers prior to use varies widely among medical schools. UCI policy has been to cremate any bodies that come in if they test positive for HIV or hepatitis B or C.

The same is true at UCLA, said spokesman David Langness. That is not the case everywhere, however.

At the University of Washington, for instance, cadavers that are being embalmed are not tested because it is generally believed that the preserving chemicals will destroy infectious agents during the year that the bodies are left to cure.

Bodies that are to be used fresh, however, do get checked, said Daniel Graney, associate professor and head of the Willed Body Program at the school of medicine in Seattle.

How UCI will supply cadavers for its anatomy classes is complicated further because the school decided to stop accepting new cadavers last month while it overhauled the Willed Body Program.

Dr. Peter Lawrence, associate dean and the man charged with reconstituting the program, said he had contacted a number of other schools’ willed body programs to obtain bodies for next month’s class. UCI needs at least 14 to run that session and another 14 for the class in the spring, he said.

“We have an obligation to our students,” Cesario said.

In addition, the school is considering revising the way it teaches anatomy so that fewer bodies are needed. Gross anatomy classes, where students in groups of four to eight dissect their own cadavers, have been a tradition of the medical students’ first year of school.

“It doesn’t mean we eliminate cadavers but we may decide we will reduce the number we use” by having students observe dissections rather than having them do it themselves, Cesario said.

Cesario said many colleagues have told him he is overly cautious about the infection potential. Most people believe that embalming sterilizes the cadavers. He was also told that testing is not accurate on embalmed cadavers.

Despite assurances from the fired embalmer, Christopher S. Brown, that the bodies were tested and the infectious ones destroyed, Cesario remained adamant that his staff prove it to him.

“Nobody could do it,” he said. “I have spent all my life doing infectious disease work. I am vitally concerned with this. I would want to be sure these cadavers were tested for HIV, hepatitis B and C if my kid or somebody else were working on them.”

Families of the donors will have to be notified of the change in use, he said.

The problems at UCI have caused concern among medical schools nationwide because they have made public gruesome details of what happens to donated bodies. Complete dissection can include the severing of arms, legs and even the head for detailed study, officials say.

There also is the problem of tracking body parts as they are used at a school and sometimes at different institutions. Lawrence acknowledged that there are times when “it would be impractical to bring everything back together and cremate it.”

He also said that during cremation there likely was some commingling of smaller body parts that might have been removed during dissection, such as a part of a brain or liver. Bodies generally are cremated separately, but small parts from different bodies are routinely cremated together.

This happens at “virtually all willed body programs,” he said, adding that when it comes to large parts of the body like arms or legs, “an attempt is made to bring it back to the larger body part. The majority of the intact body would then be cremated and returned but the removed parts would be disposed of separately.”

Cesario said the school will advertise for a new embalmer next week, raising the salary from $33,000 paid Brown to between $40,000 and $50,000, which is closer to what other universities pay.

“We will try to upgrade this,” he said. “We don’t want to go through this again.”