LOUISVILLE, Ky. (WDRB) -- TJ Hoover was rushed to Baptist Health Richmond in central Kentucky in October 2021 after suffering a drug overdose. Four days later, his family said he was believed to be brain dead, and doctors began preparing him for organ removal surgery.
Hoover was listed as an organ donor on his driver's license, and his name was on the national donor registry.
The problem was he was still alive.
"Almost immediately during his honor walk, his eyes started opening," said Donna Rhorer, Hoover's sister. "... and not only open — they were tracking."
Doctors had already begun preparing Hoover's body for organ removal when the procedure was abruptly stopped.
"It was about 45 minutes, and the physician called us back — called three of us back — and said ... 'He's not ready. He woke up,'" Rhorer said.
"I was right. ... It wasn't reflexes."
The case has become the center of a federal investigation by the Health Resources and Services Administration, which found issues with patient-family interactions, medical assessments and recognition of high neurological function.
Documents obtained by WDRB show HRSA identified "potentially serious and ongoing risk to patients and families" involving Kentucky Organ Donor Affiliates, the organization that had managed the donation process. KODA merged with the Network for Hope in 2024 and now oversees organ donation in Kentucky, Indiana, Ohio and West Virginia.
Hoover's case and others were discussed in a recent Congressional hearing.
"This is a story that's more for a horror movie than a Congressional hearing frankly," said Rep. Neal Dunn, R-Fla.
"If a patient is dying, but (they) take the patients' organs before they die — that's euthanasia," Rep. Gary Palmer, R-Ala., added.
During the hearing, Network for Hope CEO Barry Massa — who wasn't the CEO in 2021 — acknowledged Hoover's case was during the height of the COVID-19 pandemic, but said he wasn't using that as an excuse.
"We don't want another experience like this as well," Massa said.
Network for Hope's website says there are 104,000 plus people nationally who who need a life saving organ transplant, 24,018 donors saved and healed lives in 2024, and 48,149 transplants occurred in 2024.
The HRSA report stated hospital staff noted Hoover was "thrashing on the bed," showing "purposeful movement to pain," and that "patient eyes open and tracking" — all signs of neurological activity.
"Because in my heart of hearts, I knew TJ was in there," Rhorer said. "I knew he was alive."
She described the ordeal as "happening too much in Kentucky," pointing to data in the federal investigation. HRSA reviewed more than 350 cases handled by KODA and found about 70 patients had neurological conditions that made them unfit for organ donation. Of those, 28 may not have been dead at the time the organ donation process began.
One documented case from December 2022 described a patient with "watering eyes" who "began to move around." That patient ultimately died three days later.
A separate incident detailed in the report showed KODA attempted to obtain consent from a cognitively impaired individual who was "child like ... at the time of the authorization discussion," the investigation said. "After a hospital physician and unit manager verbalized concerns that the next of kin did not understand the ... process, a repeat discussion was held the following day and the decision to proceed was reversed."
The investigation said there was a case in 2023 of the OPO (organ procurement organization) staff trying to get authorization for organ consent from two family members, even with concerns that multiple staff said the family members were "clearly inebriated" and "high off of something."
"In a rush to get the organs, many of the providers are saying this is putting pressure on them to certify death, when, in fact, the person may be even moving," said Rep. Diana DeGette, D-Colo.
Rhorer, who documented her brother's case, told lawmakers in a letter: "How is this happening in America — where organ contractors can mislead families and patients can be wheeled in the OR, sometimes having been knocked out with drugs like fentanyl, to take their organs, when they are not dead?"
Dr. Raymond Lynch with HRSA testified the results of the investigation were "unacceptable" and apologized for the "care that was delivered to your constituents to the people of Kentucky."
Massa told Congress that changes have since been made.
"We developed hard stops," he said. "So any time during the process, we have huddles with everyone involved in the case and treatment. ... so if any concerns are raised, they can raise concerns at that time."
But Massa also admitted the former CEO of KODA is now the chief operating officer at Network for Hope, something Dunn said is "concerning."
"I think they should lose their license. This happened 30% of the time in Kentucky. Something's bad (and) wrong," Rhorer said. "You may have changed your name, you may have new CEOs or whatever, but if you have the same people ... how can people trust that anything's going to be any different?"
Baptist Health Richmond released a statement, saying: "Baptist Health Richmond is thankful that the patient's condition improved, leading to the appropriate decision not to proceed with removal of life support, which was discussed with the family. The organ donation process only occurs after a patient has passed away, which did not happen here."
Network for Hope says its leadership is out of town this week. The organization is hoping to schedule an interview with WDRB next week.
The scrutiny over Hoover's case has caused some Kentuckians to question the organ donation process itself.
"I mean, it should make anybody question," Rhorer said. "I don't necessarily think people should run and not be organ donors but I think it should definitely change how people respond.
"I don't feel like it should be on our license and I don't feel like it should be on a national database."
WDRB contacted all local hospitals since some are concerned about organ donations and transplants.
Norton Healthcare said: "Kentucky law provides protocols for transplants, including identification of potential donors as well as notification with organ procurement agencies. We continue to follow those protocols and honor the wishes of donors."
UofL Health said: "We value and respect the precious gift of life of all organ donors and their families. We comply with all federal and state policies regarding organ procurement including that donors must be deceased, except for living donor cases such as kidney and partial liver. The donor's family can halt the procure at any time, as well as any member of the medical team."
Rhorer said her brother remembers what happened.
"He'll continually say, 'Why did they want to kill me?'" she said. "That's a pretty bold statement of remembering."
Now, she says he's trying to find a reason behind it all.
"He'll say, 'What's my purpose... for being left here?'" Rhorer said. "And, since all this has come about, I tell him 'Bub, I feel like your purpose is to change the world, change the law, so that nobody else has to go through this.'"
