Considering the nature of its work, Donor Network of Arizona (DNA) connects with families in moments of tragedy and loss. There are no words possible to comfort the Tune family who grieve the loss of their son, but we wish them peace.

ABC15 Arizona aired a report Monday, June 10, 2019, in its evening newscast about a local donation case from 2016. The parents claim DNA recovered corneas from Christopher Tune, 31, without authorization. The family sued DNA and lost. Two judges dismissed all claims in the complaint in two rulings, saying DNA acted in good faith. Public record shows Tune was listed in the DonateLifeAZ Registry by ADOT MVD error, a detail described as an undisputed fact by a judge. The family has appealed.

DNA’s commitment to Arizonans is to be constantly vigilant about the integrity of our work in the field of donation. We work around the clock throughout the year with thousands of families at a difficult time in their lives to provide a tremendous gift to someone who is waiting for a new or renewed life. We take very seriously our responsibility to donors, their families and transplant recipients as well as our future ability to both save and improve lives. This responsibility continues to be the basis for our strategic direction, policies, protocols and practices.

Arizonans with questions regarding their registration status, or about donation in general, can contact DNA anytime at registry@dnaz.org.

Could my name be incorrectly listed in the DonateLifeAZ Registry?

Multiple safeguards are in place to make sure the DonateLifeAZ Registry is accurate. Clear communication is key to making sure only those who wish to be organ and tissue donors are listed in the DonateLifeAZ Registry.

Starting in 2008, a confirmation letter is sent to the address listed by the first-time registrant who completes the ADOT MVD application. The “DONOR ♥” printed on someone’s state ID or driver’s license also indicates that they checked yes and that their information has been added to the DonateLifeAZ Registry—an addition implemented in July 2014. Both changes are a signal for Arizonans to know they opted to be organ and tissue donors. They always have the opportunity to correct errors if necessary or remove themselves completely if they so choose.

How do I make sure I’m not registered?

If you received a confirmation letter, or if you have the “DONOR ♥” on your ID, you may be in the DonateLifeAZ Registry. For questions about your registry status in Arizona, or about organ and tissue donation in general, Arizonans may contact DNA anytime at registry@dnaz.org.

Why does the DonateLifeAZ Registry supersede a family’s objection?

An individual has the right to make end-of-life decisions for themselves, and organ, tissue and cornea donation is no different.

Per the Uniform Anatomical Gift Act (UAGA), donor registration with the DonateLifeAZ Registry is a legally-binding authorization at the time of a donor’s death, and it cannot be revoked by anyone other than the registrant. If someone is registered in the DonateLifeAZ Registry, DNA acts in good faith to honor the final decision of donors.

It is never DNA’s intent to add burden to families in a moment of loss. It is always our hope that donation can offer a meaningful way someone’s life will be remembered and honored.

How could an error like this happen?

If a potential donor is in the DonateLifeAZ Registry at their time of death, DNA staff will act in good faith to recover organs, tissue and corneas for transplantation. This individual was in the registry, found by the judge as an undisputed fact. The second judge to rule in DNA’s favor stated DNA “had every right to rely on the accuracy of the Registry.”

ADOT MVD Donor Registration Process:

1. A person checks the box on their driver’s license or ID application.
2. An ADOT MVD staff member manually enters a person’s information, including their donation registration decision, into the ADOT MVD computer system.
3. A temporary credential is issued, and if the person chose to become a donor, the credential features the “DONOR ♥” The insignia is also printed on the permanent credential sent to the client in the mail several weeks later.
4. Each week, the ADOT MVD computer system electronically sends information of those who registered to the DonateLifeAZ Registry.
5. The information is automatically uploaded into the DonateLifeAZ Registry.
6. All new registrants receive a letter from DNA detailing their decision to be an organ, cornea and tissue donor.
7. If a person changes their decision or doesn’t wish to be a donor, they can call DNA to be removed from the registry.

Why doesn’t DNA always check the MVD application prior to recovery?

Organ, cornea and tissue donation for transplantation comes with the challenge of time sensitivity. In accordance with American Association of Tissue Banks’ (AATB) national standards, donated tissue and corneas must be recovered within 24 hours to be viable for transplantation. That 24-hour timeframe includes speaking with the family, obtaining authorization if the donor was not previously registered, gathering information to determine transplant suitability, further testing and recovery.

DNA, and organ donation in general, is a 24-hour operation. For efficiency, DNA needs to confirm registry status at any time of the day or night using the DonateLifeAZ Registry.

In 2017, DNA revised its authorization protocol related to donors with registration dates between 2008 and 2014—a date range during which confirmation letters were sent but no “DONOR ♥” insignia was printed on Arizona credentials. If there is uncertainty about a donor’s registration status—even after checking the DonateLifeAZ Registry—DNA will request a copy of the person’s ADOT MVD application. Recovery would not proceed without the ADOT MVD application.

What procedures are in place to ensure a case like this won’t happen again?

Ensuring that there is accuracy and transparency in the donation process is vital to our ability to carry out DNA’s mission to save and heal lives. Since launching the DonateLifeAZ Registry in 2003, DNA has made improvements over time to ensure accuracy and clear communication in donor registration through ADOT MVD. See examples below:

• 2008 – For the first time, the names of people who checked the box at ADOT MVD were uploaded to the DonateLifeAZ Registry on a weekly basis by ADOT MVD. A confirmation letter is mailed to the address provided by first-time registrants, as this confirms donor registration, allows the individual to make changes if they see fit, and correct any errors.
• 2014 – ADOT MVD began printing a heart insignia on a person’s state ID or driver’s license as a clear symbol that a person has been added to the DonateLifeAZ Registry.
• 2017 – In addition to sending a confirmation letter, DNA revised its authorization protocol related to donors with registration dates between 2008 and 2014—a date range during which no insignia was printed on Arizona credentials. If there is uncertainty about a donor’s registration status—even after checking the DonateLifeAZ Registry—DNA will request a copy of the person’s ADOT MVD application. Recovery would not proceed without the ADOT MVD application.

DNA’s commitment to Arizonans is to be constantly vigilant about the integrity of our work in the field of donation. We work around the clock throughout the year with thousands of families at a difficult time in their lives to provide a tremendous gift to someone who is waiting for a new or renewed life. We take very seriously our responsibility to donors, their families and transplant recipients as well as our future ability to both save and improve lives.

Why is DNA protected under “good faith” immunity?

Good faith immunity is statutory protection common in the health care and emergency medical service industries. It is important for professionals in the field of donation, and in place in the model Uniform Anatomical Gift Act (UAGA) for states, because of the speed at which everyone must work to make organ and tissue donation for transplantation a reality.

Immunity for acts in good faith was written into the original model Uniform Anatomical Gift Act created for all states by the National Uniform Law Commission. In commentary related to this section, the Uniform Law Commissioners write:

“If parties were held to an overly strict adherence to this [act] when transplants must be made shortly after the decedent’s death, it might well have a chilling effect on the making of anatomical gifts for the purpose of transplantation or therapy. This [act] retains the meaning of the term of “good faith” in the 1968 Act in order to encourage and facilitate transplantation. On the other hand, if a person acts in subjective “bad faith” the common law provides remedies.”

Who regulates DNA?

DNA is a highly regulated organization subject to oversight and audits by multiple organizations and programs, including:

• Centers for Medicare and Medicaid Services (CMS)
• The Office of Inspector General (OIG)
• Association of Organ Procurement Organizations (AOPO)
• American Association of Tissue Banks (AATB)
• Eye Bank Association of America (EBAA)
• United Network for Organ Sharing (UNOS)
• Food and Drug Administration (FDA)

For tissue recovery cases in which transplantation occurs—including ocular tissue—the Food and Drug Administration (FDA) is the regulatory agency responsible for any enforcement action. The American Association of Tissue Banks (AATB) and the Eye Bank Association of America (EBAA) would be the accrediting agencies responsible for any reaccreditation action.