Hoover, who was taken for organ donation after a drug overdose in Kentucky in October 2021, showed signs of life as preparations for organ retrieval progressed.
“My brother grabbed the doctor’s hand as he tried to harvest his organs…” Donna Rhorer’s account of what happened to her brother, Anthony Thomas “TJ” Hoover II, has become central to a case raising serious questions about patient safety and oversight in the US organ donation system. Nearly five years later, the case has drawn renewed scrutiny after US authorities moved to decertify Network for Hope, the organisation responsible for coordinating organ donations in the region.
The US Department of Health and Human Services (HHS) announced on August 5, 2026, that it had begun the process of decertifying Network for Hope following federal reviews that identified concerning patient-safety practices in multiple cases involving potential organ donors. Because we’re finishing this case, “One of the organisation’s own coordinators called the home office after the doctor refused, she was told, ‘find another surgeon or you’ll lose your job.
Rhorer described her experience in testimony at the Kentucky Attorney General’s office, recounting how her family had been told that Hoover had no reflexes or brain activity and would not recover. However, she said, his behaviour during the subsequent preparations raised questions about whether he was still alive. Rhorer also alleged that a coordinator contacted the organisation’s home office after the doctor refused to continue, only to be told to find another surgeon or risk losing her job. Laws and standards were clearly violated, those responsible must be held accountable,” she said.
They agreed to withdraw life support and honour his wishes to become an organ donor. “And then during the heart cath, he was thrashing, crying and grabbing the doctor’s hands to stop him. Even after those signs the organ procurement continued until the physician refused to proceed. My brother almost died that day, that should never happen to anyone. Former KODA employee Nyckoletta Martin and organ-preservationist Natasha Miller raised concerns about Hoover’s condition. Miller, whose work involved preserving organs after removal, reportedly witnessed Hoover thrashing and crying on the operating table. Other accounts described him moving his head and pulling his knees towards his chest.
Federal investigation identifies wider concerns
In its August 5, 2026 announcement, HHS said the Health Resources and Services Administration had reviewed 351 cases between 2021 and 2024 in which organ donation had been authorised but ultimately did not proceed. Of those cases, 103 had concerning features, according to the department. It said 73 patients displayed neurological signs incompatible with organ donation.
The controversy intensified after federal authorities examined hundreds of cases handled by Network for Hope. The review raised concerns about neurological assessments, communication between medical teams, consent practices and the classification of causes of death, particularly in cases involving drug overdoses. The findings do not mean that organs were removed from all the patients reviewed. Instead, they point to concerns about the assessments and preparations undertaken before donation could proceed. Organ recovery must follow the applicable medical and legal requirements for determining death.