I work in surgical theatres in Bristol. The other day, a representative of a private company was hanging out in one of our theatres. That in itself is not unusual, we often have company reps explaining to nurses and even surgeons how to use their new instruments, equipment or implants. This representative came with a cooled box, delivering a particular bone donation, flown in just-in-time from the USA. His company is called RTI Surgical and is one of the world’s biggest tissue and bone donation corporations. I wasn’t aware of the fact that we receive donations from the ‘private sector’, so I spoke to a fellow nurse about it. She told me that one of the reps had mentioned that they receive a fair amount of donations from the prison system. Not wanting to rely on rumours I tried to find out more.
RTI Surgical and problematic donations from Ukraine and beyond
RTI Surgical has many local and international suppliers of tissue and bone donations. The company makes 280 million USD revenue and supplies hospitals in 30 countries. In 2008 it bought the German company Tutogen Medical, which was involved in various legal proceedings around unethical donorship in Ukraine. Families in Kiev complained to police in 2005 that a morgue supplying Tutogen was taking tissue without proper consent. Three years later Ukrainian police investigated another Tutogen supplier in central Krivoy Rog. Families claimed they were tricked, pressured or threatened into consenting. Police said in some cases signatures had been forged. Records show the company has offered Ukrainian tissue to hospitals in New York. Only in 2012 RTI Surgical decided to withdraw from the market in Ukraine.
In 2012, further issues were raised against one of RTI Surgical’s former US-based suppliers. Michael Mastromarino, a former dental surgeon from New York now serving a prison sentence, supplied the company with tissue from more than 1,000 cadavers. In every case, the consent documents were forged. In most cases information about next-of-kin and physicians were fictitious. In some cases the bodies were infected with cancer, HIV or Hepatitis.
Not Squid Game, but the US prison-complex
After the colleague told me about the alleged use of donations from US prisoners I read up on the matter. In general the situation is not very transparent, e.g. only 40% of prison systems having accessible policies. In most US states prisoners cannot donate tissue or organs while being incarcerated, but some states have passed new laws that open the prison complex for the donor market.
In 2023, legislators of the Democratic Party proposed: “The Bone Marrow and Organ Donation Program shall allow eligible incarcerated individuals to gain not less than 60 and not more than 365 day reduction in the length of their committed sentence in [prison], on the condition that the incarcerated individual has donated bone marrow or organ(s).” Also the state of Utah liberalised the use of prison donations in 2012.
We know that it is fairly easy to end up in a US prison if you are poor and even easier if you are poor and black. We know that many multi-national companies already make profitable use of prison-labour, such as Boing, Walmart or McDonalds. We know that there is little freedom of choice once you are in prison and that prison sentences are often arbitrarily extended. We, as NHS workers, should know whether our trust is in any way involved in all of this.
A wall of silence
To be clear, I don’t know whether RTI Surgical receives prison or other unethical donations. As a theatre worker who has to handle donations, I asked the manager of our theatres if she knows more about the connection between our Trust and RTI Surgical. The manager said that they did not and suggested a Freedom of Information Request. I issued the first request to the Trust in July 2025, but received no response. I issued a second request a month later, but they only replied that the Trust has no relations with RTI Surgical. I sent them the exact date and patient details of the surgery where the RTI material was used, but received no reply. I wrote to RTI Surgical directly and asked whether they receive donations from the prison system, but no reply. I wrote to the head of nursing of the Trust, no response.
Our social responsibility as workers
According to the current system we have no say in how we produce things and what we produce. We are forced to sell our labour power to pay our bills and the companies that buy it can do as they please. This puts us in a difficult spot. Officially powerless, it is still us who make the whole system work, who produce all those things, whether harmless or deadly. Recently, more and more workers have become aware of this dilemma.
In France, workers of ST Microelectronics in Grenoble went on strike against the use of their micro-chips in the Israeli war machine. They went on strike to enforce that they are informed about where and how the micro-chips they produce are used. In Genoa and Marseille, dock workers refused to load and unload ships that carried arms. In the USA, tech workers at Google and Amazon protested against the use of their software for military or surveillance purposes. Currently the UK government wants to outsource NHS data processing to the US company Palantir, which also supplies the war machine that commits genocide in Gaza.
Together, as NHS workers, we can question this! This is the power we have to influence what is happening. As you were able to gather from this article, as long as we are alone it is difficult to find out even basic information – but if we get together we can take on responsibility for the world we live in.
