Cornea transplant - Another big tissue scandal rocks field

As if transplant patients didn't have enough to worry about!

Another big tissue scandal rocks field
Staff and agencies
27 August, 2006

By MARILYNN MARCHIONE, AP Medical Writer 3 minutes ago

It could have ended three years ago, when a leaky FedEx box containing
an arm and legs turned up in Missouri. Or years before that, when a
judge convicted him of embezzling money from the sale of a corpse that
belonged to a medical school in California.

By then, he had supplied hundreds of tissues for knee repairs, spine
surgeries and other medical procedures around the nation, many of them
allegedly procured in an unsterile funeral home embalming room.

Despite his conviction, he twice was able to register companies with
the U.S. Food and Drug Administration to provide tissue for
transplants.

Guyett, 38, denies any wrongdoing, and insists he went out of business
on his own accord some months back. No one yet knows how many people
received tissue he supplied or what risks they may face. Companies have
been quietly recalling his products from doctors and hospitals since
early July.

Donated cadaver tissue is used in more than a million procedures each
year, and most of these operations do a lot of good.

"In this business what really rules is: Do you have the goods? Can you
give the body parts that I need? If you have a sketchy background, that
doesn't really make a difference. People just want to get the parts,"
said Annie Cheney, author of the book "Body Brokers."

"Our mission," he said when pitching tissue donation to residents of a
suburban Raleigh retirement home last year, "is to give donors and
their families an informed choice when considering making an anatomical
gift." In a video of the May 2005 talk, his audience, which included
funeral directors, is seen applauding at times.

The resume also lists Guyett as a "forensic specialist" from 1993 to
1997 in the Clark County, Nev., coroner's office. But that title
isn't used at the Las Vegas agency and Guyett only volunteered there
some weekends between 1994 and 1996 and was not a paid employee, said
Coroner Michael Murphy.

Undisputed, though, is that Guyett was an administrator at the willed
body program at Western University in Pomona, Calif., in 1999 when
police charged him with selling a cadaver to another school and keeping
the $1,100 payment.

By the fall of 2003, he was in Las Vegas, registering Donor Referral
Services with the FDA as a human tissue business. Soon afterward,
Missouri police discovered human limbs in a leaky FedEx container
Guyett's company had shipped to a Missouri man who provides body
parts for medical research and teaching. Much ado about nothing, Guyett
told the St. Louis Post-Dispatch.

"Boxes break," the newspaper quoted him as saying. "If a box leaks and
it's carrying a cornea, no one freaks."

At the time, Guyett and his second wife, Jennifer, lived in Henderson,
a Las Vegas suburb, in a four-bedroom home bought in November 2002 for
$258,676.

But business apparently was slow. Officials at virtually every funeral
home and crematorium in Las Vegas told the AP they didn't do business
with him, or even know him.

By the summer of 2004, Guyett was planning to relocate.

Larry Parker, president of Cremation Society of the Carolinas, a
Raleigh funeral home, got a call from Guyett, whom he didn't know,
saying he was thinking of moving to be closer to the East Coast tissue
banks he worked with.

By November 2004, Guyett had sold the Nevada house, with a profit of
nearly $200,000, moved to Raleigh, and was paying Parker $1,000 for
each successful donor family he referred and use of his embalming room.


"If they said, 'yes,' that's as far as we went," and Guyett would
take over, interviewing the family about the donor's medical history
and suitability for transplant and obtaining consent, said Parker, who
added that he had never been involved in tissue procurement before but
became convinced "there's a terrific need out there."

Guyett tried to drum up business at a seminar sponsored by the Funeral
Consumers Alliance of the Triangle and the American Association of
Retired Persons; this was the gathering captured on video. Guyett
played a funeral director in a skit involving a family arguing over
whether to donate a dead father's organs and tissues. Parker narrated
the skit.

Guyett also pursued a related business - recycling titanium screws,
implants and pins left over after cremation. Randy Bright, owner of
Covenant Cremation Service in Wake Forest, N.C., was among those who
let Guyett take these materials.

"There's no money exchanged at all," Bright said. "What are we going
to do with them? We had no idea. It didn't cost the family or
anything for that. And we didn't really have a way to dispose of
them. ... It sounded like a good situation."

When Guyett proposed expanding the recyling business through the
Cremation Association of North America, he made business claims that
have come into question. He gave Jack Springer, the group's executive
director, a list of 10 mortuaries that he said he dealt with regularly.
Reached by AP, at least two - Miller-Jones of Hemet, Calif., and
Serenity Mortuary Service of Phoenix - said they didn't know Guyett
or his company.

"He had never done anything with us," said Timothy Hassett, owner of
Serenity.

Likewise, Mike McGhee, general manager of Forbis & Dick Funeral Service
in Greensboro, N.C., said he had no idea why Guyett listed his company
as one of his business affiliates.

"I have been here for 27 years, and I can assure you that our firm has
never had any dealings with this gentleman," he said. "This is
abhorrent and repugnant to me," McGhee said of the concerns about
Guyett. "I intend to find out why he used our name."

Guyett even claimed a relationship with the federal government, telling
the seminar crowd: "Over the last six months, we've recovered over
1,000 tissue specimens that were sent to the National Cancer Institute
for research. Eighty percent of those donors were also accepted for
transplant allografts."

A cancer institute spokeswoman said neither Guyett nor his firm has
been a supplier.

The FDA closed Guyett's Raleigh operations down on Aug. 18.

According to the FDA's order, Guyett altered paperwork on the health
history and age of at least five dead donors, eliminating mention of
factors like cancer and drug use that might make them ineligible.

In a brief interview last week at his two-story brick home in Wakefield
Plantation, a new and upscale subdivision in north Raleigh, the
goateed, slightly balding Guyett said the FDA did not force him out,
and that he had done nothing wrong.

"I closed on my own free will to pursue other ventures. I'm out of
the tissue recovery business as of December," Guyett said.

Yet as recently as three months ago, Guyett repeated requests to David
Campbell, owner of Cape Fear Crematory in Stedman, N.C., to use his
facility on the outskirts of the Fort Bragg Army base to harvest
tissues and medical implants. As he had in the past, Campbell declined,
and said, "I'm kind of glad from what I'm seeing in the press these
days."

The Guyett case follows that of Biomedical Tissue Services, a
now-defunct New Jersey company accused of plundering corpses for tissue
without families' permission, including the body of "Masterpiece
Theatre" host Alistair Cooke. A former dentist, Michael Mastromarino,
and three others face charges in that scandal.

That company, like Guyett's, was not accredited by the tissue bank
association. There are more under-the-radar tissue brokers out there
than the FDA would like to think, said Areta Kupchyk, a former FDA
attorney who helped write tissue regulations and consults with tissue
companies.

"He's probably an example of many small-timers around the country,"
Kupchyk said of Guyett. "They're the ones that are the most
dangerous. They get a small niche and they can cause a lot of trouble."


___

Contributing to this story were science writer Seth Borenstein in
Washington, national writer Allen G. Breed in Raleigh, N.C., AP writer
Adam Goldman in New York, Western regional writer Angie Wagner in Las
Vegas, and researcher Judy Ausuebel in New York.