After inmate Jim Kennedy Jr. died last year at the Limestone Correctional Facility in Harvest, Alabama, his sister-in-law got an unusual call from the funeral home preparing the body for burial.
“Did y’all realize he came back without his organs?” Sara Kennedy recalled being told. “Liver, heart. All of your major organs. They were gone.”
“He had nothing,” said Kennedy’s brother, Marvin.
Another inmate suffered a similar fate. Arthur Stapler was 85 when he died five months after Kennedy Jr. at the Brookwood Baptist Medical Center in Birmingham. He had been housed at Hamilton Aged and Infirmed Center, which is also run by the Alabama Department of Corrections.
“It’s like a horror movie that I can’t wake up from,” said Stapler’s son, Billy, who learned about the missing organs after hiring a private pathologist to perform an autopsy on the body.
It was only after contacting the University of Alabama at Birmingham – which is among the providers that conducts autopsies for the prison system – that Stapler’s family received what they were told were his brain and heart in plastic viscera bags. The lungs and some other internal organs came back in pieces, but not all were returned.
With more than 26,000 inmates, Alabama’s severely overcrowded and understaffed prisons are the target of a US Justice Department lawsuit that alleges the state not only fails to prevent violence and sexual abuse behind bars but does not protect inmates from excessive force by prison staff or provide safe conditions.
Alabama’s men’s prisons are also the country’s deadliest, with a homicide rate in 2019 more than seven times higher than the national average, according to a report by the non-profit Equal Justice Initiative.
And the state’s mass incarceration nightmare does not appear to end with death.
The state Department of Corrections and the University of Alabama at Birmingham now face disturbing allegations from the families of five inmates whose organs were removed and reportedly kept without consent, according to lawsuits filed last week in Montgomery County Circuit Court. A lawyer for the families alleged the organs were retained for teaching purposes.
“It’s the wild, wild west. There’s no governance,” Lauren Brinkley-Rubinstein, an associate professor at the Duke University School of Medicine and an expert on prison standards, said of the allegations involving the handling of inmate organs in the prison system.
“It’s like, the provision of health care. No standards. What that health care should look like, who has bodily autonomy and who doesn’t, and who, when someone dies, acts as next of kin to people who are incarcerated – all those things are just undefined. There’s no standard and there’s no oversight.”
Prison warden empowered to give consent, lawsuits say
The Alabama Department of Corrections is the largest law enforcement agency in the state, with 28 facilities and nearly 2,000 officers.
The University of Alabama at Birmingham Heersink School of Medicine bills itself as one of the nation’s top academic medical centers for research, education and clinical care. It houses one of America’s largest academic hospitals.
Under an agreement between two state institutions with divergent missions, UAB said it conducts autopsies for the corrections department, which is “responsible for obtaining proper authorizations from the appropriate legal representative of the deceased.”
“The authorization forms not only provide permission for the autopsy, but also specifically include consent for the removal of organs or tissues for diagnostic or other testing including final disposition,” said UAB in a statement, adding that privacy laws prevented comment on specific autopsies.
A case of finger-pointing has broken out between the university and the corrections department on the issue of who ultimately authorizes autopsies.
UAB also said it doesn’t comment “on pending or threatened litigation,” but it complies with laws governing autopsies and is responding to “incorrect and misleading assertions” about the procedures it performs for the corrections department.
“UAB only conducts autopsies after obtaining consent or authorization from the appropriate state official,” the statement said.
The Alabama Department of Corrections also declined comment on pending litigation but said it does not authorize or perform autopsies. UAB has maintained that corrections authorizes inmate autopsies.
“Once an inmate dies, the body is transported to the Alabama Department of Forensic Sciences or (the University of Alabama at Birmingham) for autopsy, depending on several factors, including but not limited to region and whether the death is unlawful, suspicious, or unnatural,” the corrections department said in a statement.
Birmingham attorney Lauren Faraino said the families she represents in the five suits insisted to her that none of the inmates were organ donors, nor were their families asked for authorization to retain the organs. At least two other lawsuits were being prepared, she said.
Instead, the attorney said, UAB’s own autopsy authorization form – which CNN has obtained – empowers a prison warden to give consent “without limitations” for the autopsy as well as the final disposition of an inmate’s organs. She said that means UAB gets to keep and dispose of the organs as it sees fit unless told otherwise.
Under an autopsy agreement between corrections and the UAB Board of Trustees dating to around 2005, the warden signs off as the “legally designated representative and therefore am legally entitled to grant permission for the completion of an autopsy and the removal of organs or tissues for further study on said inmate.”
“l do, therefore, give my permission for the performance of an autopsy including the removal of organs or tissues from said inmate for diagnostic or other testing, including final disposition thereof,” reads the autopsy authorization form.
The lawsuits cite a 2017 UAB Division of Autopsy publication that said 23% of the division’s yearly income from 2006 to 2015 derived from corrections department autopsies. The corrections department pays UAB $2,200 per autopsy and $100 per toxicology test, according to the suits.
In 2023, Alabama prisons reported a record high 325 deaths, according to the Alabama Appleseed Center for Law & Justice, a non-profit criminal justice reform advocacy group.
The law center reported 1,045 deaths in state prisons from April 2019 – when the DOJ released a report on prison conditions – through the end of last year, citing Alabama Department of Corrections figures and Appleseed data.
“Defendants’ appalling misconduct is nothing short of grave robbery and mutilation,” the lawsuits said. The state institutions are accused of fraud, conspiracy, negligence, unauthorized donations of body parts, unjust enrichment, failing to notify next of kin when retaining organs and other counts.
An Alabama law passed in 2021 requires medical examiners to notify next-of-kin if they will retain a deceased person’s organs to determine identification or the cause or manner of death. They also need the approval of next-of-kin to keep organs for research or other purposes.
A bill now making its way through the state legislature would make a violation of that law a Class C felony punishable by up to 10 years in prison.
“If organs are being removed for donation for medical education, research or any other purpose without appropriate authorization that is both a legal failing and a moral failing,” said Brendan Parent, a lawyer and director of the transplant ethics and policy research program at NYU Langone.
“There’s no reason to believe that a warden of a prison has ownership or property rights to a body just because the person was incarcerated. And so the laws that exist protecting the family’s right to represent the donation wishes, and to represent the burial wishes or laying to rest wishes, those remain.”
In its statement, UAB insisted it “does not harvest organs from bodies of inmates for research.” Its pathology program is accredited by the College of American Pathologists and staffed by physicians certified by the American Board of Pathology, UAB said.
“The dead are voiceless. And so that creates both a major sort of gap in bringing these stories to light,” Parent said.
“It’s incredibly sad but makes sense that there isn’t nearly enough oversight or attention to this because of the vulnerability and lack of representation of the rights of these individuals.”
A 2019 report by the Justice Department and the Alabama US Attorney’s offices did not mention issues with missing organs but said the state corrections department did not have a reliable system of tracking in-custody deaths.
Federal investigators identified at least 30 deaths that were not disclosed to the Justice Department. The report also found Alabama Department of Corrections did not maintain a centralized repository for all autopsies and did not have a way to identify patterns in causes of death.
‘We felt ashamed’
A group of UAB medical students questioned the ethics of the school’s retention of some inmate organs without consent as far back as 2018, a year before the scathing federal report on overall prison conditions.
In a letter to the UAB hospital ethics committee and medical school administrators in July 2018, a group of medical students wrote to “express our concern regarding the consent process for use of organs from incarcerated individuals in our preclinical education.”
“Our concern is not with the practice of autopsy, but with the process of consent for the retention and use of tissue samples,” the medical students wrote in the letter.
“Wardens can limit the autopsy to a strict determination of cause of death, with no tissues retained for research or education. However, by the Division of Autopsy director’s assessment, wardens always sign ‘no limitations’ on the form that initiates the request for autopsy. If our understanding is correct, neither the patient, nor their family, has consented to or been directly informed of the retention of tissues for teaching, education, or research.”
Faraino called the letter and other records of meetings with school officials “concrete evidence that the students are using some of these organs for training in medical school.”
“We can all agree that we want doctors who are trained and who have access to these organs to perfect their craft,” Faraino said. “What we don’t want is for doctors and pathologists to be mining bodies without family permission.”
Two of those UAB medical students spoke with CNN, saying pathology lab instructors acknowledged that many teaching samples came from inmates, particularly because of the more dramatic pathology of the prisoners. The students asked not to be named for fear of repercussions to their careers.
“It’s plainly and obviously wrong,” one student said. “There is no understanding of medical ethics in which this is permissible.“
A disproportionate number of organ samples were from deceased prisoners, the students said. Those samples included brief bios indicating the person died in a correctional facility and some health history.
“We are benefiting from medical inequity,” one student said. “These people are dying sicker, dying with less care and they look sicker, their bodies look sicker and we get to learn from that. That’s supposed to be a win for us?”
The students said the university ethics committee ultimately dismissed their concerns.
A September 2018 response from the ethics committee said organs are “used for the secondary purposes of teaching future physicians and thereby benefits future patients. If such uses are disallowed, these specimens would only be disposed of, serving no useful purpose.” The committee concluded there is “no evidence that deceased prisoners are treated unfairly as compared with non-prisoners in the autopsy procedure.”
“It is hard to see any lack of ethicality in the retention and teaching uses of once-removed organs,” the response said.
UAB in their statement said the medical students’ concerns were “informed by inaccurate data and information.” A panel of medical ethicists reviewed and endorsed UAB’s protocols for autopsies on incarcerated persons, the university said.
UAB said its pathologists in “some cases” keep organs for further testing to determine an accurate cause of death. UAB said it does not use inmate organs to teach medical students.
“We felt ashamed,” one medical student said. “All of us carried it for years.”
Another added, “It has continued to follow me all these years, wondering if I should or could have done more.”
The families question why the organs were missing for most of the inmates, and what UAB did with those organs after the work was completed.
‘Well, we do it all the time’
On April 13, 2023, inmate Jim Kennedy Jr. died at the age of 67 in an Alabama prison, where he was serving a sentence of 300 years for rape, sodomy and kidnapping. A prison chaplain notified his family of the death about four days later, according to the lawsuit.
A funeral director told family members his internal organs were missing. Only the eyes remained.
Marvin Kennedy, who held power of attorney over his brother’s affairs, said the family had not authorized the retention of the organs.
“They made the decisions for you or represented you without your permission in different areas,” Marvin Kennedy said of UAB and prison officials. “And that’s really what really hurts.”
Sara Kennedy demanded answers from UAB and prison officials. “I had a lot of questions,” she said.
When she reached a UAB autopsy department on the phone to ask that her brother-in-law’s organs be returned, she secretly recorded the six-minute conversation.
“We’ve never had this request done before,” the supervisor told her in the recorded call.
“To have the organs back?” she asked.
“Yeah, we’ve never.”
“Who buries somebody without their organs?”
“Well, we do it all the time.”
“We don’t want to do it … We don’t want to do that.”
“Now, I will tell you this … UAB is a teaching institution and any teaching institution that does autopsies, keeps their organs.”
“Well, we did not. We did not and Junior did not want that … We have not agreed with the prison for his body to be turned over for no study. And we want those organs back,” Sara Kennedy told the supervisor.
Stapler died on September 23, 2023. He had been housed at Hamilton Aged and Infirmed Center, where he was doing 10 years for child sex abuse. The cause of death was listed on his autopsy report as congestive heart failure.
The private pathologist hired by his son discovered he had “an empty cavity” in place of his organs.
“There was nothing there,” Billy Stapler said.
Stapler also reached the UAB autopsy department supervisor by phone and arranged for some of his father’s organs to be returned.
“I’m asking where’s the rest of his organs? And he tells me that they possibly got thrown away,” Billy Stapler recalled. “And I’m like, how do you throw away organs? … Why did you even take them out of him?”
Anthony Perez Brackins, 36, who was serving a 21-year sentence for armed robbery, died at Limestone on June 28, 2023, according to his mother, Susie Duncan, and sister, Letesha Brackins. The cause of death was listed as an accidental drug overdose.
After an autopsy at UAB, Duncan and Brackins said, a funeral home informed the family that the body had been “emptied” of all organs. Duncan said her son was cremated without his organs. He was not an organ donor and UAB did not ask for her consent to keep the organs, according to Duncan.
When Brackin’s family contacted UAB to demand the return of his organs, a UAB employee told a relative it was “too late now,” according to the lawsuit.
Kelvin Moore was 42 when he died on July 21, 2023, at Limestone. His family said he was serving a sentence of life without parole for convictions for attempted murder and attempted burglary. A chaplain informed his mother of the death three days later, telling her the cause was a fentanyl overdose, the lawsuit said.
When his family received his body, the mortician discovered most of his internal organs were gone. Relatives later picked up a red viscera bag with what UAB said were his organs. Moore was laid to rest with the bag.
“I call it thievery. I call it barbarism,” said one of Moore’s brothers, Simone.
Simone Moore remembered the words of his 82-year-old mother, Agolia: “She said, ‘You can’t even die no more. Even in death, people robbing you and disrespecting you. Robbing you of your organs. Even in death.’ ”
This story was reported by CNN’s Isabel Rosales and Chris Youd in Alabama and Ray Sanchez in New York. It was written by Sanchez.