The trade in human body parts is a seller's market.
Pharmaceutical companies buy everything from fingernails to tendons to use for research.
Medical instrument firms conduct training seminars for doctors, filling anatomy laboratories -- or hotel event rooms -- with trays of knees or heads that surgeons can use to acquaint themselves with new devices and techniques.
Then there are at least 50 surgical products made from human skin, bones and heart valves that are used in procedures ranging from lip enhancements to fracture repairs.
Bodies also end up as crash-test dummies and are used in other product-safety research.
In all, the human-tissue industry is thought to be worth $500 million a year -- and growing. The trade is supposedly nonprofit, since it is illegal to earn money from the sale of human body parts. But the law allows middlemen to cover their costs by charging "reasonable" fees. Reasonable has become a matter of interpretation. As demand has expanded, so have prices -- and the opportunities for fraud.
The alleged theft of body parts by employees at the UCLA medical school is the latest in a series of local scandals involving cadavers. The willed body program's director, Henry Reid, was arrested Saturday at his home in Anaheim on suspicion of grand theft, but little is known about what transactions occurred.
This much, however, is clear: Reid had easy access to bodies.
There are three main, legitimate sources of bodies and parts.
The first are medical schools. In 1950, UCLA started the world's first willed body program, pioneering the convention of donating one's body to science. There are now 154 such programs nationwide, 10 of them in California.
The vast majority of bodies -- by one report up to 8,000 a year -- are collected this way. The process is straightforward. A donor signs a consent agreement, and upon death, the school arranges to pick up the body. Schools often cover the cost of burial, or more often cremation, when they are finished.
Most cadavers are dissected by first-year medical students. But surplus bodies and parts can be sent to other scientific institutions, including for-profit biomedical corporations. The schools are allowed to charge fees to cover administrative costs, salaries, preservation and storage. Such deals provide an important source of revenue for some anatomy departments.
In principle, all parts that go out must come back -- in order that the ashes from the complete body can eventually be returned to the donor's family.
The second primary legal source of bodies has been more controversial.
Over the last decade, the tissue and organ bank industries have boomed. These institutions are considered nonprofit, and donors envision their parts being used only in altruistic endeavors. But many such banks, closely tied to for-profit companies, essentially sell body parts for commercial research and products.
Only recently, after the Orange County Register produced a series of stories in 2000 detailing the practice, has there been an effort by legislators to force the industry to disclose all the ways a donated body could be used.
The families of donors are not paid.
The final source of bodies is a tiny number of companies that set up their own willed body programs in states that do not restrict such activities to medical schools.
Such firms often work as contractors, setting up surgical training seminars or product tests and providing well-paid experts to prepare the specimens.
Some university anatomists question the recruiting methods of such companies.
"They go in and raid retirement communities with the idea that people are donating their body to science in a humane act," said Arthur Dalley, who heads the anatomy department at Vanderbilt University School of Medicine. "It's turned around and used for profit."
Like stolen cars that are chopped up and sold in pieces, bodies are worth much less than the sum of their parts.
"The prices have been escalating," said Arthur Caplan, a professor of medical ethics at the University of Pennsylvania. "There is more demand."
Vidal Herrera, a former medical technician who runs a forensic services business called 1-800-Autopsy, said: "I get calls all the time from medical researchers, corporations. They want to purchase bodies or they want to purchase tissue."
He said he always refuses such offers.
But as prices have risen, some people who work closely with the dead have been unable to resist the temptation to sell body parts. By some estimates, a single body can be used to make products worth more than $200,000.
At medical schools, the task of procuring bodies, preserving them and keeping records often falls not to professors but to nonacademic technicians who trained as morticians or worked their way up through the ranks.
"We don't keep a count on bodies," said Carmine Clemente, a UCLA professor and longtime editor of the famous anatomy text, Gray's Anatomy. "That's not our responsibility. We are the teachers. They are the technicians. We don't check whether we have all the cadavers, all the arms, all the heads."
Typically the technicians have been at the center of the cadaver scandals, as appears to be the case at UCLA.
At UC Irvine medical school in 1999, Christopher Brown had an impressive title, director of the willed body program. But he earned just $33,000 a year. He was fired after it was discovered during a routine audit that he had charged the university for a trip to Phoenix and sold six spines to a hospital there for $5,000. The check was made out to a company owned by a business associate.
UCI auditors could account for only 121 of the 441 cadavers donated to the Willed Body Program for medical and scientific research from 1995 through 1999, indicating that there were record-keeping problems before Brown became head of the program. UCI could not identify four cadavers in its morgue.
In addition, families may have received the wrong remains or been improperly billed for the return of their relatives' ashes.
About 20 lawsuits against UCI are pending, but Brown was never prosecuted.
Neither was Allen Tyler, who headed the cadaver program at the University of Texas Medical Branch at Galveston. He lost his job in 2002 and was suspected of selling bodies. In a single transaction, he made more than $4,000 selling 232 fingernails and 35 toenails to a pharmaceutical company in Salt Lake City.
The scandal was still being investigated when he died of cancer in January.
Besides his duties at the medical school, Tyler also freelanced in the tissue industry. He would help companies across the nation procure body parts, prepare specimens for seminars or, in the case of one client in Lake Elsinore, Michael Francis Brown, cut up bodies to be sold in pieces.
Brown had achieved synergy in the illegal body parts trade. He ran three businesses: a funeral home, a crematory and a biotech company. Instead of cremating corpses -- delivered from funeral homes and a Riverside County contract to cremate local indigents -- he sold their heads, torsos and other parts.
In 2002, he pleaded guilty to 66 counts of unlawful mutilation. Prosecutors estimated that he stole parts from 133 bodies, earning $465,000 between 1999 and 2001.
Brown was later sentenced to 20 years in prison.
Some loved ones are still waiting for closure.
In February 2001, Ruth Storr, a post office clerk in San Diego, lost her 82-year-old mother. A local funeral home sent the body to Brown for cremation. An urn was returned.
"I said goodbye to my mom," Storr said. "I thought everything was OK."
But more than two years later, Storr found out that her mother's body had been used for parts. She is still trying to get everything back.
"I have no idea what's in my mother's urn," she said. "It could be a dead dog, cigarette ashes, burnt newspaper. Who knows? I can't throw it away. Whoever got part of my mom's ashes, I wouldn't want her thrown away."
Such scandals spurred calls for better oversight.
UCI, for one, tightened its written procedures and policies, established an advisory group, created a system for tracking body parts, increased supervision and upped the pay for a new director.
Then-Gov. Gray Davis signed a bill in 2000 calling for better documentation of willed bodies and made it a crime to knowingly return the wrong cremains to family members. It says that after body parts are used for medical research, the parts or their ashes are to be returned to relatives at no charge.
The law also requires coroners to receive consent from a representative of a dead person before releasing a body or body part for scientific purposes.
Another law that went into effect this year requires hospitals, organ-procurement organizations and tissue banks to advise donors of their right to prohibit their tissues from going to for-profit companies.
Yet some aspects of the body parts industry remain loosely regulated.
It is illegal to sell body parts for profit. But tissue brokers have found ways to make money.
"You can be paid money for handling fees, sterilizations, shaping the material," Caplan said, adding that those prices can amount to "gouging."
After scandals in the 1980s involving organs sold for transplantation, laws reduced the black market trade in organs such as kidneys and corneas.
But the market for tissues -- legal and illegal -- has been growing.
Unlike organs, which must be harvested within hours, tissues such as bone and skin remain viable for up to a day. "You have people who can get tissues who might be at the funeral home," Caplan said. "They could be coroners."
Duke Kasprisin, president of the American Assn. of Tissue Banks, said advances in surgery are driving up demand for tissue. But he said most companies would be unlikely to seek bone and tendons on the black market, out of concerns for disease and a commitment to obtaining consent from donors.
Perhaps the least regulated use of bodies is in research and training. Doctors learning new procedures need to practice. Preserved parts are still useful for years after a person's death. But many doctors favor fresh body parts. In the opening scene of her 2003 nonfiction book, "Stiff: The Curious Lives of Human Cadavers," author Mary Roach describes a training course for 20 plastic surgeons who have paid $500 each to practice face-lifts at a Southern university. Each surgeon got two severed heads, each in its own aluminum roasting pan. The doctors were not squeamish.
"The 40 heads are from people who have died in the past few days and, as such, still look very much the way they looked while those people were alive."
Times staff writer Jeff Gottlieb contributed to this report.