How organ and tissue donation companies worked their way into the county morgue

LOS ANGELES - As the sun set over the Nevada desert, coroners from across the country mingled with business executives, sipping icy margaritas and Tanqueray and tonics by a pool.

The private party, held on the terrace of Las Vegas' Golden Nugget hotel on a summer night in 2017, was a gift from Cryolife, a biotech company that sells valves sliced from human hearts to be used as medical devices. The festivities reflected the cozy relationship that has grown in recent years between the nation's coroners and the industry that trades in tissues from human cadavers.

The relationship wasn't always so warm. Only a decade before, coroners and medical examiners complained they were shut out as the companies helped rewrite the Uniform Anatomical Gift Act. Within three years and with a push from the company's lobbyists, a version of this new model law had been passed by 46 states.

The act makes it much easier for body parts to be harvested quickly - even in cases in which coroners believe it interferes with their ability to determine the cause of death.

Mary Ann Sens, the acting state forensic examiner in North Dakota, had warned state legislators the law "revokes the historic responsibility" of the coroner and gives the procurement companies "equal or greater priority." Despite the concerns of Sens, North Dakota adopted the proposed law almost verbatim.

As the Los Angeles Times has reported, dozens of death investigations across the country were complicated or upended when body parts were harvested before an autopsy.

There's no denying that organs can extend lives, and tissue is sometimes life-enhancing. Corneas can save sight in those going blind. Tendons are used to repair sports injuries. But, in convincing people to become donors, companies rarely mention that a growing part of the multibillion-dollar body parts industry is cosmetic surgery - or that unlike organs, tissues are rarely of immediate need. Distributors employ salespeople whose job it is to persuade surgeons to use body parts rather than materials produced in a lab.

REWRITING THE LAW

Even before the new laws passed, coroners rarely said no when companies asked to procure hearts, kidneys or other vital organs. But coroners often rejected requests to harvest tissues such as skin and bone when they thought it would upend a death investigation.

In July 2003, the companies set out to change state laws across the country to force coroners to cooperate. That month, the trade and lobbying group representing U.S. procurement companies penned a letter to an obscure but powerful organization now