Family upset at Removal of Patient's Organs in Autopsy

It was at the funeral home, when she embraced her dead daughter, that Maria Guadalupe Soto noticed the difference.

"She was too light," Soto recalled.

It wasn't the imagination of a grieving mother. Medical records show that Sonia Soto's body weighed 157 pounds at the start of a hospital autopsy and only 100 pounds when it reached the funeral parlor.

The 27-year-old's heart, lungs, liver, kidneys, spleen and brain had been removed and disposed of, leaving her parents distraught and angry. The Sotos are seeking to have Parkland Memorial Hospital change what they say is an unclear autopsy consent form.

Sonia Soto's father, Ruben, signed the form in the hours after her death, but the Sotos said Parkland officials never told them their daughter's major organs would be removed and eventually cremated.

Their removal, her parents said, violated a promise they made to their daughter.

"She wanted to be buried complete," Maria Soto said.

The Sotos said the consent form was unclear because it did not offer an accurate description of the procedure, including any reference to possible organ removal and disposal.

Parkland later apologized for the "miscommunication."

"We regret there was miscommunication regarding our procedures for organ removal and retention during autopsy," Jennifer Bentley, Parkland's associate director of patient safety and risk, wrote in an Oct. 29 letter to the Sotos.

"We understand this was not clearly communicated to you at the time the autopsy consent form was signed and sincerely apologize for that."

The hospital's one-page form signed by Ruben Soto "authorizes the preservation and study of any tissues which may be removed."

But it makes no mention of possible organ removal, the family's right to get the organs back or how a loved one's body parts would be disposed of.


The College of American Pathologists recommends using a consent form that lays out all those possibilities.

Pathologists are the doctors who perform autopsies in an effort to determine a patient's cause of death.

"The body is treated with dignity and respect, and the wishes of the family are maintained at all times," the pathologist association noted on its website.

A sample consent form on the site states that a family member has the right to limit the extent of an autopsy – including requiring organ and tissue samples to be returned before the funeral.

But Parkland would not say Wednesday whether it will change the consent form to give families a better understanding of what an autopsy involves.

Instead, the Dallas County public hospital released this statement:

"Autopsies are useful to determine the cause of death, document existing conditions, and to provide information to physicians that may contribute to the care of living patients.

"At autopsy, the body is examined, the organs are removed, and samples of the organs are taken for microscopic examination. The organs are saved for approximately 1 month after completion of the autopsy procedure in case further examination is necessary."


Sonia Soto was hospitalized at Parkland during three episodes of unexplained brain hemorrhaging between September 2009 and her death on March 10.

At first, the Sotos were happy to have Parkland taking care of their daughter. Previously, she was sent home from another Dallas hospital, where doctors insisted she only had the flu.

During the third bout of bleeding, Soto appeared to be recovering and her family was feeling hopeful – but then an infection struck and she died.

Immediately, the Parkland doctors began asking for permission to do an autopsy.

Parkland noted in its Wednesday statement that "the procedure is explained to the patient's next of kin by their physician. If they choose to proceed, an autopsy consent form is signed."

Since the Sotos do not speak English, a Spanish translator assisted in the discussion with their daughter's neurologist, Dr. Cyrus K. Dastur, and in signing the consent form.

Afterward, the Sotos were so upset about the organ removal that they contacted Dallas lawyer Domingo Garcia. He arranged for them to meet with the Parkland doctors and other officials involved in their daughter's care.

"We accuse Parkland of unauthorized removal of organs and unauthorized cremation of organs," Garcia said.

"The family wants an apology for the way they were treated and the way their daughter was treated."

At the Oct. 25 meeting at Parkland, the Sotos were informed that their daughter's organs had been cremated after the autopsy, her mother said. The couple was offered ashes purported to be from their daughter's remains. But Maria Soto rejected the offer because there was no way to tell if the ashes had come from her daughter or someone else.

Later, the family received a sworn statement, dated Oct. 28, from two Parkland doctors, Tasha Z. Greenberg, medical director of autopsy service, and Kyle H. Molberg, chief of pathology.

The doctors itemized what had happened to Soto's organs: Most of the major organs were "disposed of" about a month after the autopsy, the statement said. Smaller organ samples were "discarded" on Aug. 13, as was her brain on Sept. 17.

However, the notarized statement did not describe the means of disposal other than to say it followed the hospital's "procedural guidelines."

Dissatisfied, the Sotos decided to contact the news media last month.


In the end, Sonia Soto's autopsy did not determine the underlying cause for her bleeding. The exam looked for obvious medical explanations as well as possible genetic reasons to explain the episodes.

Her doctors thought she might have Ehlers-Danlos syndrome, a rare condition in which blood vessels and organs are prone to tearing or rupture. Tests showed she didn't.

Instead, Sonia Soto's final autopsy report indicated that she died as the result of an E. coli infection that caused her to develop a fatal inflammation of the brain and spinal cord.

Such bacterial infections can be transmitted by unwashed hands or contaminated food. But no one can say how she got it. It was detected 10 days into Soto's final Parkland stay. She died four days later.

At the time of her death, Sonia Soto had lived in Dallas for only a year. Her father, a construction worker here for more than 20 years, had successfully petitioned the U.S. government to allow his wife and three children to come to Dallas from Mexico.

Sonia Soto was the eldest, arriving with her brother, Juan, now 24, and a sister, Maria, now 10.

"They wanted to be here legally," said Sara Soto, a cousin who lives in Dallas. "They wanted to have a life together again. And then Sonia got sick and everything changed."

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