Alicia Dawes of Medford received a graft of cadaver bone harvested by a New Jersey company that has been indicted for taking body parts without legal consent and without proper screening. (Mail Tribune / Jim Craven)

Alicia Dawes never imagined that a slice of stolen bone would find a home in her neck.

The Medford woman had a piece of cadaver bone implanted in her spine to correct a nagging problem last summer, months before investigators discovered improperly harvested bone had been used in thousands of patients across the United States, including a handful in Southern Oregon.

Back in August, before the scandal surfaced, Dawes thought using donor bone sounded like a better choice than having bone removed from her hip and placed in her neck. One surgery was better than two, she reasoned.

A few months after the surgery, she got a letter from her doctor. There had been some "irregularities" when her donor's bone was collected. The donor apparently had not been tested for diseases that might have prevented the bone from being used. Although the chance of becoming ill was extremely small, she might want to get tested for HIV/AIDS and hepatitis.

"I was just irate about the greed and the morbidity of it all," Dawes said. "Some of the people they took tissue from would never have been eligible for tissue donation. That's just disgusting. That's not right. That's beyond not right."

Six months after investigators first learned of the grisly business connected with a New Jersey company called Biomedical Tissue Services, the fallout continues to spread. Even though the federal Food and Drug Administration believes the risk of infection is low for anyone who received the stolen bone, Dawes and thousands of other patients across the United States are struggling with the psychological stress of having human bone inside them that was harvested without permission.

"I almost feel guilty myself because I have a piece of someone's family member," said Dawes, 37, a single mom who works as a freight broker. "There are lots of reasons people don't donate. You can just imagine what their family members are going through."

Details of the criminal investigation into Biomedical Tissue Services suggest the company may have stolen bone from as many as 1,000 bodies that were in the custody of funeral homes. BTS sold the tissue to five distributors, where it entered the legitimate medical-tissue market, which provides materials such as skin, bone and tendons to surgeons and hospitals.

While the stolen bone was obtained without permission, the distributors who purchased it apparently processed it just like legitimately harvested bone to make it safe for transplant. Donor bone is typically irradiated or treated with anti-viral materials to sterilize it before use.

"We have always been told bone grafts are very poor sources of viral transmission," said Dr. Donald Ross, Dawes' surgeon.

Ross contacted Dawes after the FDA issued a recall for stolen bone that had not yet been used and encouraged physicians to inform their patients who already had received implants. Bone that had been implanted in patients such as Dawes was left in place.

"I sympathize with her suffering," Ross said. "She doesn't know what her exposure is."

So far, nobody has become ill with any disease that can be traced to the stolen bone, said Stephen Ladd-Wilson, who tracks emerging infectious diseases for the Oregon Department of Human Services.

"That's the bottom line," Ladd-Wilson said. "Nothing has shown up among bone recipients for any infectious diseases."

Nevertheless, lawsuits have been filed in several federal courts, and some plaintiffs allege they became ill after receiving stolen bone. Other suits focus on the emotional distress patients have suffered after learning about the source of the bone, or the anxiety that may arise from the possibility of contracting a serious disease such as HIV/AIDS, hepatitis or syphilis.

Ladd-Wilson said it's unknown at this time how many Oregonians may have received the stolen bone. Medical privacy laws with stiff financial penalties make hospitals reluctant to share information that might be used to identify a patient. Ross said he and his colleagues sent letters to a total of five patients. Each of Jackson County's three hospitals received notice of the recall from Medtronic, a bone distributor that received its material from one of the five companies that originally acquired the bone from Biomedical Tissue Services.

None of the hospitals was willing to say exactly how many of its patients had received stolen bone because the number was so small that they were concerned someone might be able to identify a patient if the hospital disclosed the exact number. Each hospital said it had "fewer than five" patients who had received stolen-bone implants.

Dawes said she's not normally a person who seeks the spotlight, but she wanted people to know how the system had failed. She said she plans to follow Medtronic's recommendation that she be tested for HIV/AIDS, syphilis and hepatitis B and C. Medtronic is offering to pay for all the tests at a lab of its choosing, but she's leery of going to its lab and trusting its results.

"After all that's happened and all that they'd be liable for, I'm not sure all the results will be correct," she said.

Bert Kelly, a spokesman for Medtronic in Tennessee, said that no one who has been tested to date has become ill from stolen bone, and one test should end all doubts.

"The best medical guidance we have from the federal Centers for Disease Control is that if they test negative now they'll have nothing to worry about 10 or 15 or 20 years from now," Kelly said.

Kelly said Medtronic is one of many intermediaries in a complicated distribution chain in which everybody assumed everybody else was following the rules to screen donor tissues for viruses.

"We're one step in the supply," he said. "We didn't see any of this coming."

Physicians find themselves in the middle, too, said Ross, the neurosurgeon. "We have nothing to do with processing of tissue. ...We just put it in people."

The grisly nature of the bone thefts could have the unfortunate effect of raising doubts about the safety of tissue procurement, said Polly Arnold, director of patient care at Ashland Community Hospital. Ross said the incident likely hasten the use of more synthetic materials for bone grafts.

"In the end we're going to have to get away from this stuff," he said. "There are already viable alternatives. This is going to accelerate the transition to those alternatives."

Dawes said she's been troubled by the lack of compassion in the medical community for her and others who have gone through the same experience.

"I haven't had one single person say 'We apologize' and show some compassion," she said. "We're not just lot numbers. People have to show us some compassion."

Reach reporter Bill Kettler at 776-4492 or by e-mail: bkettler@mailtribune.com