Michael Mastromarino made millions illegally selling human organs. Today he faces the court

It was one of those frigid February mornings in northeast Philly, and the wind whipping through the streets turned the whole city into a meat locker as Kevin Vickers and his coworkers eased their big white Suburban through the gate that led to the alley behind the Louis Garzone Funeral Home.

They parked the truck and closed the gate behind them, barring any curious glances from anyone who might be passing by on East Somerset Street. Vickers was almost grateful that it was so cold.

It meant that the body would keep.

When Vickers questioned the brutal way his coworkers seemed to be slashing at the cadaver, he was told, firmly and simply, 'Don't worry about it'After all, there was no telling how long the gurney had been standing there in that seedy alley, Vickers would later recall, though it had obviously been there long enough for a skittish little sparrow to become accustomed to it. It now sat perched near the spot on the body bag that concealed the head of the cadaver inside.

The men, all of them employees of Biomedical Tissue Services, Inc., slipped out of the SUV, toting their tools, saws, scalpels, their hospital greens and their coolers. They slipped inside the funeral home to change, then returned and retrieved the body, wheeling it into a bloodstained tiled room that looked more like an abattoir than an operating room. Vickers had been in rooms like this before, of course, but this one struck Vickers as particularly horrendous, with dried blood and bits of human tissue ground into the floor. Then, as they would do 244 times in Philadelphia alone, the cutters got to work.

With one man on either side of the corpse and a third, usually Richard Bifone, ready to label and ice their work at what they called the "back table," the men set about dismantling the body. Yards of skin, most commonly harvested delicately so that it can be properly labeled and processed and then used by doctors to heal the sick or the maimed, even in some cases to enlarge genitals, was indelicately flayed off. Limbs were lopped off and bones, including entire spinal columns, which normally take up to three hours to properly remove, were hacked out in minutes using a jigsaw. And when they were done, the bloody remains were simply dumped into a plastic bag and wheeled back out to the alley to await cremation, often leaving a trail of gore behind.

This wasn't the way Vickers had been trained to harvest body parts. He wasn't some butcher they found off the street. He was a trained professional who knew what he was doing. In his early years as a harvester at the Rochester Eye and Human Parts Bank, he had been taught to proceed cautiously and carefully, to take great pains to ensure that the tissue he took would not be contaminated. But here, he would later tell investigators, he felt as if he were trapped in a "room plagued with bacteria." His coworkers didn't seem to mind. In fact, when he tried to wash his hands, he was told he didn't need to bother. And when he questioned the brutal way his coworkers seemed to be slashing at the cadaver, he was told, firmly and simply, "Don't worry about it." The body parts they were recovering, he was told, would never find their way into a human being. These were strictly for research, and besides, he was told, the bodies had all been screened for infectious diseases like HIV and hepatitis, so the danger of contamination was slim. Besides, all had the appropriate consent forms signed by the next of kin, so there was, he was told, no need to fret.

***

Eight months later, and 65 miles away, Anthony Vitola was lying in a recovery room at Shore Memorial Hospital in Somers Point, New Jersey, sliding back into the world after spending a few hours under anesthesia and under the knife. It was over. The operation had been a success, and even through his narcotic fog, Vitola could feel the first stirrings of relief.

The 54-year-old middle manager had been terrified about the prospect of undergoing surgery. But by the summer of 2005, the bones in his neck had deteriorated so badly that he had no choice. It was getting to the point where Vitola could no longer control the shaking in his left arm. His right arm was completely numb and he was in almost constant pain. The cocktail of steroids and painkillers his general practitioner had prescribed for him weren't working. Then the doctors discovered the bone spurs, razorlike shards that were growing larger and more dangerous. One fast move, one tumble down the stairs, and those bony blades could slice right through his spinal cord, leaving him a cripple, Vitola had been told. Surgery was his only real choice.

The surgeon had done his best to put Vitola at ease. He was an experienced bone man and he had done this kind of operation countless times before. In theory, it was simple, sort of like putting a new set of struts on an old car. He'd remove the jagged bones in Vitola's neck and replace them. He'd use a three-inch titanium rod as a matrix, and then he'd insert disks made out of the pulverized dust of real human bones. Of course, the bones had been extracted under the most stringent sanitary conditions by trained professionals, always from carefully selected cadavers, and they were then rigorously processed by one of the largest tissue providers in the country. They were sterilized and treated with all manner of compounds that would certainly kill any lingering bacteria or virus. There was no need to fret, Vitola had been told.

The truth was, Vitola hadn't paid much attention to the surgeon's lecture on the provenance of the bones. It was the thought of the surgery itself that frightened him. This wasn't going to be a quick slice job. To reach the deteriorated bones in his neck, the surgeon would have to cut through the front of his throat. He'd have to carefully move his voice box and try not to nick Vitola's vocal cords.

But now it was over. As he shook off the aftereffects of the anesthesia, the surgeon came in and told him that the operation had been a complete success, and over the next few weeks, Vitola came to believe him. The pain was gone, so was the numbness, and pretty soon, he was itching to get back to work.

Then came the phone call.

It was a Friday night in November and the receptionist from his surgeon's office was on the line, summoning him to an urgent meeting at the surgeon's office. He was told that the doctor was having special office hours, 14 hours on Saturday and another 14 on Sunday. That alone sent a chill down Vitola's brand-new spine. "A neurosurgeon's in the office on a weekend?" Vitola thought to himself.

He pressed the receptionist for more details. All she would tell him was that "it had to do with an implant recall," he says. That night, Vitola tried to convince himself that it was probably just a minor problem with the type of titanium rod the doctor had used. Maybe somebody somewhere had found a loose screw or something.

The next day, he made the 55-mile drive to the surgeon's office. The receptionist looked pretty grim when he walked in. He understood why when the doctor approached him, carrying an official-looking white paper from the federal Food and Drug Administration.

"Tony, I want you to read this," the surgeon said, "and then come into my office."

In cold and bureaucratic language, the FDA paper laid out a terrifying scenario. There was a strong chance, it said, that the bones that had been implanted in Vitola's neck had been illegally harvested by a questionable company called Biomedical Tissue Services, and there was a danger, slight perhaps, but a danger nonetheless, that they were contaminated with HIV, or sepsis, or hepatitis, or syphilis.

Shock set in. It was too late to reverse the operation. Vitola's own tissue had already fused to the new bones, and whatever diseases they might carry were now permanently part of his body.

"I'm going to write you a scrip," the surgeon told Vitola in as reassuring a tone as he could muster under the circumstances. "I want you to get some blood work done. Be tested for syphilis, AIDS, and hepatitis."

He doesn't even remember the drive home. Cars whizzed by him on the New Jersey Turnpike, but all Vitola could think of was the grim litany of potentially deadly diseases for which he would now have to be tested. Syphilis. Hepatitis C. And most chilling of all, HIV.

"Why me?" Vitola asked himself.

Two days later, in a daze, Vitola stumbled into a clinic not far from his home. The nurse who was to extract his blood tried to act nonchalant when he handed her the prescription. Maybe it was pride, maybe it was fear, but Vitola desperately wanted this stranger to know that he wasn't promiscuous; he needed her to know that he was not some closet drug addict. He needed her to understand why he was being tested. He handed her the FDA document, and at first she refused to read it, citing confidentiality requirements. But he insisted. "Oh my God," she said, when she at last read the grim report.

A few days after that, days spent waiting in frigid panic, Vitola got another call at home. It was his surgeon and once again, he tried to sound reassuring. "We'll get you another test at a different lab," the doctor said. But Vitola didn't really hear him. All he had heard was the horrifying bottom line. "The test came back ... positive for HIV."

It was another Friday night a year earlier, and the New York Police Department had almost grudgingly sent out a detective on what everybody figured was going to be a run-of-the-mill fraud complaint.

A funeral parlor in Brooklyn, one of several that had signed up to provide cadavers to a new company from New Jersey called Biomedical Tissue Services, run by a disgraced dentist named Michael Mastromarino, had just changed hands. The new owners stumbled across what they thought were a few questionable bills. It seemed that the previous owners had pocketed some funeral down payments from the bereaved, prosecutors have said.

It was the kind of case that was likely to end up in small claims court, and there is nothing in the record to suggest that Detective Patricia O'Brien was expecting to find anything more when she turned up at the funeral parlor.

She was shocked when she wandered upstairs and found what prosecutors would later describe as a blood-spattered "secret operating room." Though she didn't know it at the time, there was nothing illegal about the room's existence. State and federal law permit body harvesting in funeral parlors and similar establishments when it's done legally, and so, to keep up with the ever-increasing demand for sources of body parts, the tissue recovery industry in recent years has increasingly focused on such places. But it certainly piqued O'Brien's curiosity.

She dug a little deeper. She began sifting through the records, tracking down family members of people whose remains had been dissected, and soon discovered that in more than just a few cases, the grisly work had been done without consent. Soon, O'Brien began to suspect that Mastromarino and BTS had struck a Faustian bargain with a number of funeral directors and crematory operators, paying them as much as $1,000 per corpse in exchange for a steady source of grist for his body-parts mill. The case soon found its way to the city's Major Crimes Unit, and from there to the Brooklyn district attorney's office, which began contacting the relatives of 1,077 people whose bodies BTS had processed.

Mastromarino and BTS struck a Faustian bargain with a number of funeral directors, paying them as much as $1,000 per corpse in exchange for a steady source of grist for his body-parts millAuthorities now say that of those cases, only one family had given consent. Over the next 15 months, the NYPD and the Brooklyn DA's office launched a massive investigation, including the exhumation of bodies from graves. Investigators found what Brooklyn assistant DA Michael Vecchione would later call "nothing short of medical terrorism." In some cases, bones of dead people had been hacked out hours before their funerals and replaced with PVC pipe—a common replacement for missing bones in the mortuary industry. The bodies were stitched back up to prevent family members from discovering the theft, prosecutors contend. In other cases, bodies that were to be cremated were unceremoniously dismantled and the remains treated almost like medical waste, authorities say. In scores of cases, authorities allege, medical records were forged, often misrepresenting the deceased's age and medical condition. Blood tests—crucial in determining whether a person is a fit donor—were falsified as well, prosecutors allege. The names of doctors who treated the deceased were sometimes made up, and in other cases, fictitious relatives were invented to give consent to the harvesting, officials say.

What had started out as an investigation into a run-of-the-mill business dispute had become, as New York City police commissioner Ray Kelly put it at the time, "the first chapter in a horror story that would shake the funeral industry to its core."

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As you're reading this, somebody, somewhere, is lying on an operating table. Maybe a failing heart or a liver or a kidney is being replaced and a life will be saved. Elsewhere, perhaps, a patient whose bones have been weakened by disease or shattered by trauma is being rebuilt with parts made from the recycled remains of someone who died, while in a recovery room somewhere, a patient may open her eyes and be able to see because she was lucky enough to receive a cornea transplant. In specialized trauma centers across the country, the oozing wounds of burn victims are being covered with processed flesh, giving their own ravaged skin the critical time they need to heal. The U.S. military uses grafts made from recycled skin to heal wounded soldiers.

Try as it might, science has not yet been able to duplicate the strength and durability, the subtleness and resilience, of real human tissue, says Dr. Michael Ciccotti, the orthopedic surgeon to whom the Philadelphia Phillies turn when one of their million-dollar players needs repair. "We can develop a synthetic that's strong enough to lift a boat off the ground ... but ... we haven't figured out how to make these tissues as good as God."

And so, in operating rooms across the country, the blind are being made to see, the lame are being to walk, and the wounded are being made whole with pieces of the dead. It is a medical miracle and it happens a million times a year in the United States, says Bob Rigney, the chief executive officer of the American Association of Tissue Banks, the trade organization that represents the recycled body-parts industry.

It is also a billion-dollar-a-year industry dominated by a handful of key players with names like Regeneration Technologies, Tutegen, and LifeCell, and it's growing by leaps and bounds, Rigney says. Although demand is high, the competition for body parts is stiff and the pool of potential donors is comparatively small—about half a million people donate their bodies to science or medicine, and of those, only about 50,000 actually make it through the industry's screening and certification processes. There is a great deal of money to be made by everybody in the system—except the donors, who are barred by law from gleaning any profit from their own earthly remains or those of their loved ones.

Rigney insists that industry is well-policed.

Maybe.

The investigation into Mastromarino's alleged body-snatching is still far from over. In a plea agreement announced yesterday, Mastromarino has admitted to the charges in Brooklyn, and is expected to do the same in Philadelphia. Both have also agreed to work with investigators probing possible misconduct by tissue processors.

Meanwhile, a least one other criminal case is still proceeding. Last spring, authorities in Rochester, New York, charged Vickers, along with three other BTS employees—Darlene Deats, Nicholas Sloyer, and Kirrsy Knapp—and three area funeral directors, with forgery, fraud, body-stealing, unlawful dissection, and, in a particularly Dickensian twist, grave-opening. In October, Philadelphia district attorney Lynn Abraham announced the indictment of Mastromarino, Crucetta, and three funeral directors, James McCaffrey and brothers Louis and Gerald Garzone, charging them with literally thousands of counts, everything from racketeering to theft of body parts for their role in a scheme that authorities say netted BTS millions of dollars—up to $7,000 per corpse—during the three years the company was in business.

Vickers, who still insists that he just did what he was told, was granted immunity in Philadelphia after he agreed to tell the grand jury all he knew about the operation.

But according to prosecutors in Philadelphia, Brooklyn, and Rochester, for two years the company that Kevin Vickers was working for when he harvested human tissue under ghastly conditions in that Philadelphia funeral home managed to flood the system with illegally harvested and potentially contaminated tissue without being detected.

More than a thousand times, prosecutors contend, BTS cutters, acting on orders from their boss, Mastromarino, carried out their grisly vivisections without consent, often using forged death certificates and in some cases falsified medical records that hid the potentially deadly and transmittable diseases that Vickers said he had been told were not a threat.

In one of the most high-profile cases, the body of BBC commentator and Masterpiece Theater host Alistair Cooke, who died at 95 of lung cancer, was chopped up without his family's knowledge and sold to tissue banks as the remains of a person 10 years younger who had died of heart failure.

On a number of occasions, bodies targeted for harvesting were left out—unrefrigerated—for days. In one case, according to prosecutors in Philadelphia, a body sat out for nearly five days before it was dissected, despite industry and FDA regulations that require tissue be recovered within 15 hours of death, 24 if the body is chilled. In another case, a body was left out for 100 hours.

The harvested tissue, taken in some cases from cadavers riddled with cancer or sepsis, even HIV—conditions that should have excluded them—was shipped off to tissue-processing companies, and the FDA estimates that at least 8,000 times and perhaps as many as 13,000 times, it was implanted into unwitting patients.

The gruesome scandal has sparked a blizzard of lawsuits across the country, 200 of them in the U.S. District Court in Newark alone. Some have been filed by those who had potentially tainted body parts implanted, others by people whose loved ones were allegedly savaged after death by BTS cutters without their consent, says Philadelphia lawyer Larry Cohan, whose office is representing 130 such clients, including Anthony Vitola. Hundreds, maybe thousands more lawsuits could be on the horizon, Cohan says.

More important, it shows just how vulnerable the system is. It is a system that operates in a kind of shadowy netherworld, critics say. Perhaps because our culture is so uncomfortable with the thought of death and all things related to it, we delegate the responsibility for it to what Todd Olson, a professor of anatomy and biology at Albert Einstein School of Medicine, calls "the Profit From Death industry." And then we look away.

There is little regulation and oversight, according to Olson and other critics. The lure of riches is great—a single body in some cases can generate up to $250,000—and yet the people who donate their bodies get nothing from it, other than perhaps a vague sense of having done something noble. It is, he says, a system stitched together like Frankenstein's monster from chunks of high-minded altruism and rank commercialism. And the system is not working, he says. Maybe the time has come, he says, to place limits on the amount of money that can be made from harvesting a cadaver, or instead to allow people to profit from their own bodies with the assumption that a competitive market would better regulate itself. As it stands now, "You have people who are gathering this material under the guise of it being a generous offer to benefit society and mankind," says Olson. "They turn around and they're selling it for huge amounts of money, and the only people who are getting screwed are the people who are giving the tissue."

Because the trade currently exists in that gray area, it is vulnerable to the kind of fraudulent exploitation that Mastromarino and his cutters allegedly engaged in, Olson says.

And the fact that Mastromarino and BTS allegedly managed to carry out their bizarre dissections for so long and in so many places without arousing suspicion raises troubling questions about just how widespread such practices may be. "The characterization of what is happening here by the apologists of the Profit From Death industry as 'you can't indict an entire business and profession by a few rotten apples' is a totally false image to put out there," Olson says. "Excuse me. With all of these people, this is not 'a few.' This is not 'a few.'"

This much is clear: "They weren't doing this for a couple of months and then got caught," says Melissa Hague, one of Cohan's associates, who is handling Vitola's case. "This was going on for years. Somebody dropped the ball."

The way she sees it, the industry, the FDA, and the New York State Department of Health all had oversight responsibilities for Michael Mastromarino and Biomedical Tissue Services, and all failed to stop them.

Yes, inspectors visited Mastromarino's office and they did pore over his paperwork. They even cited him for sloppy record-keeping on at least one occasion. But understaffed, undermanned, and with little real legal authority, they didn't do much to pull back the shroud, and when Mastromarino assured them that he had corrected the glitches in his paperwork, according to court records, they took his word for it.

Nor did the tissue-processing companies that paid Mastromarino catch the alleged deceit. Perhaps, as Rigney says, it simply never dawned on the companies that anyone would dream of cutting corners to make an easy buck. "What you had here, and it was something that was unthinkable to us, was that they were in fact forging this information," Rigney says. "It's something that had never happened in 30 years of tissue banking," Rigney told Radar. However, when pressed, he adds, "I guess over 10 to 20 million ... grafts over 20 or 30 years, I can't say as a matter of metaphysical certainty that somebody hasn't falsified something on a donor record before."

That's cold comfort to Vitola.

Since he first learned the terrifying truth about the potentially contaminated tissue that had been inserted into his body, Vitola says he's lived from one blood test to the next—18 of them so far, the last one just a few weeks ago. There has been some good news. That first test indicating that he had been exposed to the AIDS virus turned out to be wrong, he says. But the incubation period for some of the diseases to which he might have been exposed can be years, in some cases decades. And so, every six months for the rest of his life, Vitola and thousands of others who may have received tainted body parts must be tested again, at their own expense. Between the tests, he battles the fear with antidepressants.

He takes little comfort in the fact that, so far, the federal Centers for Disease Control and Prevention says it has found no confirmed cases of disease transmitted by the potentially tainted implants. His lawyer contends she represents several clients who have developed diseases after receiving implants that originated in BTS' cutting rooms. "I can tell you that in some of our disease cases, their physicians have opined that they contracted the disease through the implants. There have been cases where they have ... negative tests prior to surgery and, as result of the recall, they were tested and it came back positive.

"The fact that none of those cases have yet been proven to be directly related to BTS' activities has more to do with the plodding pace of the judicial system than with any safeguards in the industry itself," Melissa Hague says. The bottom line, she says, is that "it hasn't been proven in a court of law yet because the judge hasn't allowed us to get to that point yet."

Speaking to Radar a few days after the Philadelphia indictments were unsealed, Vitola confessed that he harbors a secret fantasy of the proper retribution for Mastromarino and his alleged coconspirators if they are convicted.

"I'd love to see these guys ... pay for what they did for an easy buck," he says. Prison, even decades in prison would not be enough. "Complete payment would be to have a body that's diseased ... have them have those bodies lay out for 12 or 15 hours and have them have implants put into their necks ... and see what they go through."

***

For now, both Mastromarino and Crucetta are cooling their heels in jail. Cutters like Vickers, while free, are worried, not just about criminal charges or pending lawsuits, but also about their own physical well-being. They contend that they relied on Mastromarino to obtain the proper consents, to do it legally, and to make sure that the bodies they carved up were not incubating potentially diseases. As Vickers put it in an interview with Radar, as a cutter he was exposed to the same potential infections as the recipients of all that dodgy tissue. "I was first in line for that risk," he says, and yet he never really questioned it, because his bosses at BTS had told him over and over again, "Don't worry about it."

Besides, he says, if he had any doubts, they were erased when he learned that the FDA inspected BTS and had given it the green light. "When the FDA says you're good to go, I was like, who am I to question why?" he says. It wasn't his job to ferret out potential fraud, he says, adding that he sees his role at BTS as sort of like a mechanic in an auto shop. "Your boss says, 'Okay, change the brakes on the Honda this morning.' You don't call the owner of the Honda at home and say, 'Are you sure you want this done?' It's implied consent," Vickers says.

But there are others victims as well.

****

Sitting in his home on the outskirts of Rochester, now unemployed and spending his days debating with himself whether to spend his meager income on a pack of smokes or a loaf of bread, Vickers says he is still haunted by images from his days at BTS. "It's been a nightmare," he says. "Imagine you're me. You put your head on the pillow, and you have to think about it all."

It isn't the work itself that troubles him. It isn't even the fact that the authorities in Rochester want to put him in prison for doing it. What bothers him most is the thought that the allegedly tainted body parts that he helped harvest may have infected the public with the deadliest disease of all—doubt.

"Once the shit hits the fan ... in Brooklyn and Philadelphia and upstate here in Rochester, once ... the details start coming out, people are not going to want to donate." Not all of them of course, maybe 10 percent, maybe 20, maybe even 30. But that would be enough to cheat some people out of a chance to experience the miracle of healing that can come from death. It's a miracle that Vickers has seen firsthand, and all the gore and horror cannot erase the memory of it. "I removed the corneas of a 72-year-old female, and four months later, I saw them in a 12-year-old girl," he says. "That puts a lump in your throat."

Losing that, he says, would be the greatest tragedy in the whole grim saga.