The Organ Thieves: The Shocking Story of the First Heart Transplant in the Segregated South

Hume organized the first International Symposium on Organ Transplants in Richmond to occur at the same time as the trial. As a result, the defense had numerous experts available to testify on behalf of Lower and Hume, including neurosurgeons and transplant surgeons from Harvard, Yale, and Stanford. Most importantly, Dr. Joseph Fletcher, known as the father of biomedical ethics, was in attendance.

On the second day of the trial, local doctors testified. Dr. Hooshang Hooshmand, who did the electroencephalogram (EEG) on Bruce Tucker, testified that it showed no cerebral activity and that Bruce was therefore dead. Only the machine kept his heart alive. Noting that his role was to determine clinical death, he explained its definition as the cessation of brain function. He then stated the other two forms of death: biological, or the death of cells and organs, and theological, or when the soul leaves the body. Next to testify was Thomas D. Jordan, the attorney whom Fatteh consulted on the day of the transplant. He claimed that he had only a brief conversation with Fatteh and was not informed that Tucker was a transplant candidate. Jones observes that this testimony “provided more evidence of how Fatteh was largely flying solo on the day of the transplant” (264).

On the third day of the trial, Lower and Hume testified. Jack Russell emphasized two points: that they had tried hard to find Bruce’s family and that they did not treat Bruce’s head wound. When questioned by Wilder, Lower claimed that his focus was on his patient, Klett. He added that the emergency department had a protocol for handling the belongings of admitted patients and that they had no reason to deviate from it. Despite Wilder’s prodding, Lower kept his anger in check. He explained that Klett’s other organs were beginning to fail because of his poor heart, so time was critical, and he had no reason to question Fatteh’s permission to operate. Hume described the efforts to locate Bruce’s family, including contacting the police twice. When asked why information was omitted from Bruce’s chart, Hume explained that Bruce was not considered the patient in the operation. Jones characterizes the MCV doctors’ view of Bruce as “socially dead.” Dr. William Sewell, who removed Bruce’s heart, was questioned next.

Despite public skepticism of Wilder given the social climate of high racial tensions, the jurors listened closely to him. Jack Russell emphasized the implications for American medicine if the jury ruled against these doctors. The two sides fought over how much leeway the jurors should have in considering the latest medical opinion about the definition of death. Jack Russell asked Judge Compton to dismiss the charges but was rebuffed. Compton ruled that the traditional definition of death, as defined in Virginia law, was the only permissible one. That definition had not been revised to include a loss of brain function. The new Virginia law, which took effect a month after the transplant, allowed a physician to determine the death of a patient. Wilder argued that only the law in effect at the time was relevant, adding that MCV ignored the 24-hour waiting period mandated before organ removal from unclaimed bodies.

In response to the defense’s motion to “strike all the evidence that had been presented up to that point of the trial” (277), Judge Compton wrote a 13-page opinion ruling against the defense. It stated that he would not allow the jury to consider the concept of brain death. The court adopted the legal definition of death in place at the time of Bruce Tucker’s accident and instructed the jury to consider timing, or whether Bruce’s life was terminated earlier than it would have naturally. If so, the jury could consider the financial losses and emotional distress of the family. However, Compton stipulated in his ruling that none of the previous cases or precedents had involved organ transplants.

Jack Russell then called in a parade of medical experts. The head of neurosurgery at Yale, William Collins, testified that Bruce Tucker was dead at the time of the transplant and nothing could have been done to save him. A Stanford heart transplant surgeon, Edward Stinson, explained that medical protocol was changing as to the proper time to stop a respirator. The final witness on the sixth day of trial was Joseph Fletcher, the father of biomedical ethics. He stated that death occurs when brain function ceases. Jones observes that none of these witnesses expressed condolences for William Tucker’s loss.

On the seventh day of trial, Jack Russell called yet another medical expert, the chief neurosurgeon at Mass General, who reiterated that the clinical definition of death as cessation of brain function was correct. These medical experts “turned the tide of the trial in the doctors’ favor” (277). Judge Compton amended his instructions to the jury to allow them to consider loss of brain function as the equivalent of death, thereby implicitly encouraging the jury to rule in favor of the physicians. To rule against Hume and Sewell, who removed Bruce’s heart, the jury had to conclude that Bruce was not dead when his heart was removed. Lower and Fatteh could be held liable only if “they had pursued, with intent, a common plan to commit a wrongful act to remove Tucker’s heart before he died” (287).

In his closing argument, Wilder reminded the jury of the horrors committed by men of science, such as the experiments in Nazi Germany. Jack Russell simplified the task for the jury, claiming that there was only one question: whether Bruce Tucker was dead when his heart was removed. In addition, Jack Russell again emphasized the negative impact on medical progress if the jury ruled in favor of the Tucker family. For the jury, it was easy to rule in favor of the three physicians given that they had to consider the notion of brain death. However, the jury believed that the Tucker family deserved a monetary reward and wanted to hold Fatteh and MCV accountable. Judge Compton informed the jury that the statute of limitations on claims of negligence had expired, so holding them accountable was not possible. Thus, on May 25, 1972, the jury submitted a verdict in favor of the defendants. Wilder’s federal lawsuit was later dismissed. Although he initially promised to appeal the ruling, Wilder lacked the resources to do so.

Lower and his wife, Anne, were elated about the verdict, while Wilder was angry. The case hinged on the change in jury instructions. Years later, after Wilder became the first African American governor in the US, the case still bothered him. He maintained that the law on the books at the time of the transplant should have been the only option for the jury to apply.