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."