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Dr Gérald Kierzek (Medical Director of Doctissimo)
Medical validation:
October 21, 2024
Waking up as surgeons prepared to remove his organs. This is what happened to Anthony Thomas, a 36-year-old young man declared “by mistake” to be brain dead. Dr Gérald Kierzek tells us more about this incident and the measures taken in France to avoid it.
This news story looks like a nightmare. Declared dead in October 2021, Anthony Thomas woke up on the operating table as the medical team was preparing to harvest his organs. How could such an incident happen? Could it have occurred in France? We asked the question to Dr Gérald Kierzek, medical director of Doctissimo.
A trauma for the family and the teams on site
The facts date back to 2021. Anthony Thomas was admitted to the emergency room of Baptist Health hospital in Richmond after having overdosed. He quickly went into cardiac arrest and doctors declared him brain dead.
“On October 26, we were told that he no longer had any reflexes or brain activity“, confirms his sister Donna Rhorer, to the local channel WKYT.
The next day, the family learned that Anthony Thomas was “organ donor“. The young man is therefore disconnected and a battery of tests is carried out. Nothing disrupts the procedure… Except for one detail: the thirty-year-old shows signs of life several times (he opens his eyes and begins to follow looking at his family members) but the medical staff indicates that it is only “normal reflexes. The young man is then taken to the operating room. But in the middle of the intervention, the medical team realizes that the patient is alive.
“He was moving and thrashing on the bed […] Tears were streaming down his face, he was crying.”says a caregiver on American public radio.
The doctors, in shock, canceled the operation. Several of them resigned, traumatized by the incident.
Family protests against medical staff
Following this terrible incident, doctors were pessimistic: they affirmed that Anthony Thomas would only be able to live for a very short time. But three years later, the young man is still alive. An accumulation of errors, which Donna Rhorer deplores on the local television channel WKYT.
“He made several attempts that day to tell us: ‘I’m here’. But we ignored it. They finally stopped the operation because he showed too many signs of life“, she protests.
Today, the thirty-year-old is safe and sound but he still suffers from after-effects (difficulty walking and speaking).
In France, what does the law say?
In France, “the diagnosis of brain death before organ harvesting follows a strict protocol defined by law“, confirms Dr Gérald Kierzek, medical director of Doctissimo.
The diagnosis of brain death is firstly based on a clinical examination which must note:
- 1. The complete absence of consciousness and spontaneous motor activity;
- 2. The abolition of all brain stem reflexes (photomotor, corneal, cilio-spinal, oculovestibular, oculo-cephalic);
- 3. The absence of spontaneous ventilation, verified by a hypercapnia test (apnea test).
“These criteria must be observed in the absence of hypothermia, drug intoxication or sedation. Then, confirmatory paraclinical examinations are carried out“, reveals Dr. Gérald Kierzek.
As such, two options are “legally recognized” In France :
- Electroencephalogram (EEG).
– Two null and unreactive EEGs lasting 30 minutes each, carried out 4 hours apart. – An absence of brain activity greater than 5 μV and an absence of reactivity to stimuli. - Cerebral angiography, showing the absence of cerebral blood flow on the 4 arterial axes.
“Since 2005, cerebral CT angiography has also been recognized as a legal confirmatory examination. It must be carried out according to a standardized protocol: at least 6 hours after clinical diagnosis, in a hemodynamically stable patient (MAP > 65 mmHg) with 4 series of acquisitions, including 3 after injection of contrast product. specifies the doctor.
As for the death report, it must be signed.by two full-time doctors belonging to functional units” Or “services separate from those who will carry out the transplantation“.
“This rigorous protocol aims to guarantee the certainty of the diagnosis of brain death before any organ harvesting in France and therefore the impossibility of “awakening”, concludes the medical director of Doctissimo.