On the day he lost consciousness and fell into a coma in December 2024, James Martin seemed to be talking to someone in his bedroom who didn’t exist.
“I had to go wake him up and go, ‘Honey, who are you talking to?” Kim Martin, his widow, recalled.
No one knew it at the time, but medical professionals believe James, 59, had been infected with rabies about five weeks earlier, during an encounter with a skunk in the front yard of his Idaho home.
The delirium may have been a symptom of the fatal disease that had been quietly working its way through his system.
“We had no idea,” Kim said.
Her husband and the father of their three kids had ongoing health problems in the preceding months that may have made it difficult to see what was really happening to his body.
Due to nerve issues with his legs, it was challenging for him to walk or get out of bed. In the morning, she found him talking to himself. She said he told her he needed to go to the restroom, but she was not strong enough to support his weight to help him get there. So, she brought him a jar and gave him some privacy.
She told her husband to call for her when he needed her help back in the room.
But he never called for her.
“It was like, ‘Why isn’t he calling me?” Kim said. “I came back in, and...he was collapsed on the floor. His face was blue.”
She tried CPR to bring her husband back to life, but he would remain in a coma until he passed away a few days later.
At the time, his death seemed like a heart-related issue, so his organs– untested for rabies - were donated to recipients and researchers in six states.
How investigators believe James contracted rabies
James Martin loved puns and poetry and cuddling with his three kids as they grew up.
He had a soft spot for cuddly animals, too – especially the feral cats he and his wife would rescue near their rural home in the Idaho panhandle.
He was particularly fond of one tiny white kitten they rescued in the fall of 2024.
“He just picks her up ... and just cuddles her like a little baby,” said Kim. “To him, it was his grandchild.”
In October that year, the kitten was perched on James’ arm as he sat in his wheelchair inside a small shed at the front of his house when an aggressive skunk approached James on the property.
His protective instinct took over, and James stunned the skunk before it could attack the kitten.
“He said he grabbed it by the neck, and he literally, you know, pushed it up against the house,” Kim said. “He said he just gave it a few punches and everything, but in grabbing it, he said he got scratched.”
James downplayed the wound on his left shin.
“He’s like, ‘I’m - I’ll be fine. It’s just a scratch. I’ll just put, you know, Neosporin on it, and I’ll be fine after I get it cleaned,” Kim remembered.
But he wasn’t fine.
Over the next few months, that scratch would lead to a series of medical catastrophes.
James was an organ donor
The first day James was in the hospital, Kim said she learned her husband had signed up to be an organ donor.
"It just made me smile and go, 'That’s him. That’s just him. Like, that’s the big, tender panda bear of him, to help someone else,’” she said.
She said she answered multiple questions from medical professionals about her husband’s health history and disclosed that he had been scratched by a skunk.
According to the CDC, the information about the skunk scratch was documented among many other details on a Donor Risk Assessment Interview (DRAI) questionnaire, a standard set of questions to help evaluate the safety of a transplant.
The transplant process proceeded.
Within a few days, doctors had prepared James’ heart and lungs to be shipped to Maryland for research, while his kidney went to Ohio. Tissue from his corneas was designated for recipients in Idaho, Missouri, California, and New Mexico.
Why didn’t anyone test for rabies?
While federal guidelines required James’ organs to be tested for more common diseases like HIV and hepatitis before being shipped to transplant recipients around the country, a laboratory screening for rabies is not a standard procedure because the test is complicated and the disease is incredibly rare.
Fewer than 10 people die each year from rabies, according to the CDC, and in December 2024, there had only been three documented incidents of rabies transmission through organ donation since 1978.
“The testing is very complex and can only be done at certain centers,” said David McCormick, a medical officer in the CDC’s Office of Blood, Organ, and Other Tissue Safety who helped investigate this case but was not involved in the transplant.
“Given that there is such a need for organs and that timing in organ donation can be very critical, if we had to wait two or three days to test every organ donor for rabies...that could delay care, could delay people receiving organs that they need, and just with how rare rabies is, it wouldn’t be cost effective and would likely result in organs not being used when they could’ve been used and could’ve saved people,” he said.
Who received the infected organs and tissues?
In December 2024, Barney Kurowicki, a father of four grown children and the grandfather to 11, was hoping for a life-prolonging kidney transplant after enduring dialysis for more than two years.
The retired postal worker and farmer was living in Tecumseh, Michigan, when he was added to a national list of hopeful transplant recipients.
According to legal filings, within four days of being placed on the donor registry, Kurowicki was offered a kidney by an organ procurement organization, and the surgery was scheduled for the next day at the University of Toledo Medical Center in Ohio.
Though the donor’s name was kept confidential because the process is anonymous, Scripps News has learned the organ was coming from James Martin.
At the time, his death was still believed to have been heart-related.
Symptoms of rabies start to manifest
By January 2025, things were not going well with Barney Kurowicki’s transplant.
He started experiencing tremors, lower extremity weakness, confusion, and urinary incontinence, according to a CDC report, which did not disclose Kurowicki’s name publicly.
Kurowicki, who was rapidly deteriorating, also suffered from hydrophobia, a symptom that is associated with rabies.
“Your throat swells up a little bit, so it’s actually painful to drink and swallow,” said Ryan Wallace, a veterinary epidemiologist who leads the CDC’s rabies team in Atlanta. “But it’s more of a neurologic effect, and so people are truly afraid of water.”
By the time the symptoms manifested themselves in Kurowicki’s body and healthcare workers called the CDC for a consultation, it was too late to save his life.
Meanwhile, a group of patients in Idaho, New Mexico, California, and Missouri had either already undergone cornea graft procedures or were preparing for surgery using the same donor's cornea tissue.
The rabies hotline call that kicked off a CDC investigation
When Kurowicki’s medical team alerted the CDC about his symptoms, they did so via a special rabies hotline.
“It gets about 2,000 inquiries a year,” said Wallace. “This one came in through a healthcare provider who called that hotline and was directed to one of our epidemiologists who took the initial consultation.”
Each year, the CDC handles about 150 consultations based on those calls, but only approximately 50 cases meet the criteria that lead to testing at the CDC, according to Wallace.
Of those, fewer than five test positive annually.
“It’s still a relatively rare outcome that these people have rabies,” said Wallace. “A lot of things look like rabies.”
The Kurowicki case, however, had enough red flags that it triggered immediate testing at the CDC.
“The fact that he was an organ recipient, you know, certainly makes you a little concerned that there is a potential that this was donor derived. But they’re so rare, it’s not the first thing we’d expect to have happen,” said Wallace.
Since the CDC team did not initially have a complete picture of the donor’s contact with a skunk, health workers first investigated whether Kurowicki, the recipient, had any exposure to wild animals in recent weeks.
He had not.
“This patient had two clinical signs that I was really concerned about, but the lack of an exposure history, I wasn’t jumping up and down going, ‘This is rabies, we need to act.’”
A few days later, test results would confirm that rabies had killed Kurowicki.
Determining where the virus originated was another challenge.
The rabies testing process
The testing process for rabies is complex, according to the CDC, and the samples can take several days to process.
“If the patient is still alive, we need four different types of samples,” said Rebecca Earnest, an epidemic intelligence service officer for the CDC. “We need saliva. We need a biopsy from the skin from the back of a person’s neck. We’re trying to get at these little nerves at the base of the hair follicle. We need serum, and we need cerebrospinal fluid.”
Earnest said the sample collection method is very specific and can be invasive.
“Our laboratory at CDC is the only one in the country that tests for human rabies for all residents,” she said.
Waiting for the rabies test results
“Those first five to seven days were pretty stressful with a lot of phone calls largely around the idea of: do we start vaccinating people before we even know this is a rabies case?” said Wallace.
Post-exposure prophylaxis, or PEP, is a series of vaccine shots administered to someone after they have been exposed to rabies. The treatment may cost thousands of dollars and is only effective before rabies symptoms develop.
“We usually do not advise that until a confirmed diagnosis of rabies is made,” said Wallace, citing the rarity of the disease, the expense of the vaccine, and supply limitations.
However, this case was unique, with multiple transplant recipients potentially at risk.
“Because (rabies)... is effectively 100% fatal after symptoms begin, if you haven’t received rabies PEP, we always recommend that people really reach out to their doctor if they think they may have been exposed,” said Earnest.
Rabies is considered to be a medical “urgency” rather than an “emergency,” according to Earnest, due to the incubation period of the disease. The time from the infection to when the symptoms actually start may take weeks to months, she said.
“It’s not something that you get infected and...two days later, you’re going to develop symptoms. There is a window there. However...because it is so fatal, we want people to get rabies PEP as soon as they find out they might have been exposed.”
Although the origin of the rabies virus was still unconfirmed, health workers in multiple states worked together with the CDC to immediately alert anyone who had come in contact with the donor’s tissue or organs.
Dr. Christine Hahn, Idaho's state epidemiologist and the medical director for the state’s department of public health, helped with the process.
“We mobilized very quickly and got on a call with CDC and other states that were impacted to talk about who all got these tissues, and working with the transplant organization, we were able to determine that really only corneas were the only other tissues that were donated, fortunately,” she said.
Ultimately, hundreds of people were screened, and close to four dozen individuals - including some first responders, medical workers, and family members -received recommendations to get the rabies vaccine.
“We really don’t take any chances, and so, if we think you came in contact with possibly infectious tears, saliva, or innervated tissues like organs or corneas with broken skin or your ears, nose or mouth, we want you to get rabies PEP,” said Earnest.
As part of the process, health officials advised the three people who had undergone cornea grafts with tissue from the infected donor to have their grafts removed and to receive vaccines.
Hahn said she spoke to the doctor of the Idaho patient who received a potentially infected cornea graft.
“It was a pretty tense conversation. The doctor was very grateful for the information, absolutely agreed that the best thing to do was to remove the corneal tissue and also give the shots, the PEP, to prevent any possible rabies,” she said. “I can imagine the conversation he must have had with the ... patient and the family, how stressful that must’ve been.”
Health officials were able to prevent a fourth graft procedure from taking place.
None of the graft recipients experienced any rabies symptoms before receiving the vaccine, even though at least two people had received grafts more than six weeks earlier.
“They were monitored for their immune response to make sure that they were mounting a strong immune response after receiving that vaccination, and they all remained asymptomatic,” said Earnest.
The tissue from each graft procedure was also tested for rabies. One tested positive.
All of the cornea graft recipients survived.
“I think, ultimately, I was impressed by how quickly it all unfolded and how quickly all the different (health agency) partners kind of understood their role and how to snap into place,” said Earnest. “I think the speed with which everyone was able to get together – that everyone recognized that this was a serious public health risk...I look back, and I feel good about how we were able to come together and address this and make sure that the risk was mitigated to others.”
Hahn said she believes multiple lives were saved during the rapid crisis response. “I am super proud of public health in this situation,” she said. “Unfortunately, the gentleman who passed away, the initial recipient, did not survive, but the fact that we were able to jump into action and get these other folks protected just makes me really proud.”
How did this happen and what might prevent it in the future?
The last time the CDC documented a patient contracting rabies through an organ or tissue transplant in the United States was 2013.
Before that, it was 2004.
And the only other documented case occurred in 1978.
Meanwhile, the last time a rabid skunk was documented in Idaho was in 2014.
According to records kept by the state, there had only been one other rabid skunk documented by the state since the year 2000, and that was in 2004.
So, getting rabies from an organ transplant, potentially caused by a rabid skunk, in the state of Idaho, is extraordinary.
“I’m an epidemiologist. I should be able to come up with probabilities. The probability of all these things happening at the same time is ridiculous,” said Wallace.
Because of the extreme rarity, Wallace said his team did not automatically assume Kurowicki’s rabies infection was linked directly to James Martin, the organ donor.
Another challenge was that testing ultimately showed Kurowicki’s infection was caused by a rabies strain linked to a silver-haired bat – not a skunk. “Silver haired bats are one of the more common variants and species of bat associated with human infections,” Wallace said.
Because neither the organ recipient nor the organ donor had encountered a bat to anyone’s knowledge, health officials began looking for clues that might help them explain what the testing revealed.
Wallace said he believes the skunk that scratched James Martin may have contracted the silver-haired bat rabies strain by eating a rabid bat.
He pointed to research conducted from the fall of 2013 through the fall of 2015 by Tad Theimer, who is now a professor emeritus at Northern Arizona University. In the study, Thiemer and his team placed non-rabid bat carcasses in areas accessible to multiple mammals and captured their behavior on camera.
“Overall, we found that skunks were the most common mammal we saw approaching bats and were far more likely to take or eat them,” Theimer told Scripps News.
In this case, Wallace said he believes a rabid bat in Idaho likely became a meal for the skunk that eventually scratched James.
“We have a rabid silver-haired bat.... It probably drops dead in front of a skunk who picks it up and carries it back to his den and eats it. That skunk then – because it ate a dead, rabid bat – gets rabies...and before that rabid skunk dies (it) happens to interact with the organ donor,” he said.
“This is a very rare event,” said McCormick, explaining that people should not be deterred from donating or accepting organs as a result of this incident. “Organ transplantation in the United States is very safe. The main problem with organ transplantation is that there are not enough organs for everyone who needs them...13 people die every day waiting for organs,” he added.
Nevertheless, a special committee tasked with reducing donor-derived illnesses during organ transplants in the United States has proposed a few changes to the organ screening process to help prevent future rabies incidents.
According to the federal government’s Health Resources and Services Administration, the proposed changes include developing screening questions that will help determine if a donor has had contact with rabies and establishing a procedure through which the organ procurement organization would contact the CDC for help determining risk.
The proposed changes would also require transplant teams to alert organ and tissue recipients if the organ being offered has “any known risk of having rabies” and require recipients to be monitored and given PEP “when needed” after a transplant.
These proposed changes have not yet been voted on or approved.
Hahn said she hopes this incident will be a learning experience for people across the country.
“This should be an opportunity for us all to try to prevent anything like this from happening again,” she said. “I do hope that this incident prompts some changes into how we do look at... that animal exposure questionnaire and might take an opportunity for an exposure like that to lead to more in-depth questioning because I think with some in-depth discussion with the spouse, it might’ve come to light that... this was more of worrisome incident than initially realized.”
Although Kim Martin did provide information about her husband being scratched by a skunk during a screening process prior to his organs being donated, she said it would have been helpful if the medical professionals had asked her to remember more details about specific, significant events in her husband’s life.
When someone is distraught over a loved one, she said, it is difficult to think of specific details beyond what the current diagnosis seems to be.
“When something like this happens, you think automatically, ‘cardiac arrest,’ you don’t think about events,” she said. “We all knew he had health problems prior, but it’s like doctors need to ask more...sometimes they need to be a little more personal than just a file.”
One family is suing. The other is apologizing.
The Kurowicki family is now suing the doctors, hospital, and transplant agencies that were involved with their loved one’s organ transplant.
In legal filings, the family claims – among other things - the medical professionals were negligent in “failing to detect and remedy deficiencies in the vetting of donor organs that resulted in Mr. Kurowicki receiving a kidney with rabies.”
Scripps News reached out to all the defendants named in the legal filings.
None of the doctors involved responded to a request for comment from Scripps News.
The University of Toledo Medical Center provided this statement:
UToledo Health is deeply committed to the safety and well-being of all patients and families who place their trust in our care. We worked closely with public health authorities and conducted a thorough review of this case. That review confirmed that all established safety protocols and best practices were properly followed.
LifeCenter Northwest responded by providing this statement:
We extend our deepest condolences to the loved ones of the patient, the donor’s family, and everyone impacted by this highly unusual rabies case. We cannot comment on specifics due to confidentiality and ongoing litigation.
In the United States, organ donation and transplantation operate under strict federal requirements established by the Organ Procurement and Transplantation Network (OPTN), with oversight by the Health Resources and Services Administration (HRSA) and Centers for Medicare & Medicaid Services (CMS). The OPTN balances a variety of considerations to maintain access to lifesaving transplants and promote appropriate standards for consistency and safety across the donation and transplant system. LifeCenter Northwest follows screening and testing protocols for donation as per OPTN policy, and we provide available donor information to our transplant partners in accordance with national policy requirements set by the OPTN.
No reliable test currently exists to diagnose asymptomatic rabies infections in humans. This limitation is widely recognized across the healthcare system.
In December 2025, the OPTN proposed a new policy and screening protocols related to rabies in organ donors. We are encouraged to see OPTN considering policy changes that may better serve public health needs.
We remain committed to our mission of saving lives through organ and tissue donation."
Buckeye Transplant Solutions provided this statement:
We are deeply saddened by the loss of the transplant recipient in this case, and our thoughts are with the patient's family. Buckeye Transplant Solutions did not screen this particular organ as it was not part of our scope of services in this case. For additional information regarding this matter, we would refer you to the public court filings.
Kim Martin said she was unaware of what happened to the recipients of her husband’s organs and tissues until December 2025, about a year after her husband’s death.
At that time, the CDC published a report, summarizing the incident and the outcome, and many newspapers and other publications wrote news stories about it.
Although no names were ever revealed in the report, Kim says she immediately knew the case that was referenced was her husband’s.
“My jaw just dropped,” she said of learning another person had died of rabies following the transplant.
“I would just apologize,” she said. “We didn’t do this on purpose. We didn’t know, and we actually had to go through a lot afterwards.”
She and her family members were among the dozens who were advised to receive PEP following James’ death once the real cause of his death was determined. The cost of the shots for her son, she said, was $4,000. Her family remained asymptomatic.
Now, she keeps her husband’s ashes in a decorative box at her Idaho home, thinking often of their decades-long friendship.
“I still constantly think about him,” she said. “We all have our ups and downs and stuff like that...We all have issues, but the biggest bond anyone can have is the friendship between each other. And that’s one of our strongest bonds. I mean, if you can have a fight and laugh at the end, that makes it all worth it.”
