As the 4th of July weekend approached, Sam Pifer was so excited to see his family and old high school buddies he left as soon as he ended his second-shift job in North Carolina so he could complete the 12-hour trip to northern Pennsylvania in time to surprise his mother.

Even during the first moments Pifer returned home on June 30 to Galeton, a small rural town in the Potter County, the 21-year-old knew his life would change from the trip as he told his mom, “I know God has a plan for me, and something great will happen this week. That’s why he brought me here.”

Less than three days later, Pifer, described as a soft-spoken, peaceful and caring person with a special gift for playing all kinds of drums, was lying near-death and unconscious in the intensive care unit at Geisinger Medical Center in Danville.

Coupled with the shock that their son had just suffered a severe head injury from falling while trying to get out of his sister’s car amid a sibling dispute along Interstate 180 outside of Williamsport, the Pifers say they were surprised by another quandary: Should Sam’s organs be procured for organ donation?

His parents, Steve and Lore Pifer, claim they said no to repeated requests for permission by the organ donor program. In fact, the Pifers say they gave definitive instructions not to touch Sam’s body.

The Gift of Life Donor Program, which connects transplant hospitals with potential organ donors, said in retrospect the decision was already made by Sam when he agreed to be an organ donor when he got his driver’s license four years ago. And according to state law, the Gift of Life had all the rights to Sam’s organs.

Richard Hasz, vice president of clinical services for Gift of Life, says the interaction with patient families doesn’t change when the patient is a confirmed organ donor or when the circumstance needs authorization from a legal next of kin. What changes though, he says, is the approach.

“There’s two ways of approach,” Hasz said. “One is discussing choice, and the other is more of an explanation of disclosure and how the (organ procurement) process is going to work.”

Hasz wouldn’t say how the Pifers were approached due to company policy of not speaking on specific cases, but according to the Pifers, they were led to believe they had a choice. In fact, they left Geisinger on July 1 after Sam failed two neurological tests and was declared clinically brain dead with the understanding his body was being prepared for the funeral home, not prepped for organ procurement.

A call from a Geisinger official two hours into their trip home changed all of that when they were told Sam was a registered organ donor.

“We’re half way home when we’re told the Gift of Life people were planning on taking the organs,” Lore Pifer said. “How could this be? We said no, but we were told they had a legal right to do it based on Sam being listed as an organ donor on his license.”

Intensive care unit

When the family arrived at the hospital in the early morning hours of June 30, Steve Pifer said they were immediately informed about Sam’s dire outlook.

“They took us into a room with two Geisinger people, a nurse and the chaplain, and we knew right there it was bad,” Steve Pifer said. “The Gift of Life people were already there, and we were asked if he were to die, do we want to resuscitate him and donate his organs. We said to resuscitate him until we figure things out, but under no circumstances are they taking his organs.”

Lore Pifer said she was in shock after not knowing Sam’s severe condition as they drove three hours from Galeton to Danville.

“What were they telling us, there’s no hope,” Lore Pifer said. “I said no right away. I didn’t want anybody taking a part of my son.”

As the family waited while the Geisinger team worked on Sam’s treatment, which included two neurological tests to determine if he would be considered legally brain dead, the Pifers said the Gift of Life coordinators kept a close eye.

“They were right outside on their computers, almost like vultures,” Steve Pifer said. “At one point in time, (a coordinator) came up to us asking for us to talk to them. At least five times they came up. I even avoided them a couple of times when I left the room.”

After Sam failed both neurological tests, he was pronounced dead shortly after 2 p.m. on July 1. The family was given 20 minutes to say good-bye, according to Steve Pifer.

Even as they left the room after paying their last respects, Steve and Lore Pifer said they were approached a final time separately by the Gift of Life coordinators.

“I told them I didn’t want to talk to them,” Steve Pifer said. “I said that I was done here.”

Lore Pifer added, “They wanted to get a statement from me. I told them to leave me alone and said they couldn’t have my son’s body.”

The strenuous moments following Sam’s death have made the family angrier as they look back, according to Steve Pifer.

“I have no idea where the deception stops,” Steve Pifer said. “How do I know we weren’t deceived on his care? Was surgery an option? What’s to stop me from thinking this? I assume not but now knowing how it transpired, I’m sorry, I can’t help but feel that way.”

Who has the choice?

Edward Zych, an attorney in Geisinger’s Legal Services Department, says state law is clear in determining who has the authority in making the final decision whether to go forward with the donation process.

“If a person has designated himself or herself as an organ donor, they have essentially already made the decision,” Zych said. “According to the Pennsylvania State Decedents, Wills and Trusts Statute, a signed donor card is to be treated just as a written will, and the patient’s wishes are to be carried out according to state law after they pass away.”

Hasz said each state is different in its laws stipulating the choice to become a donor. In Pennsylvania, he said 16-year-olds have the first opportunity when they get their driver’s license by checking the permission box. At that time, including 17-year-old drivers, the decision must be witnessed by a parent or guardian and confirmed on another form, according to state law (Pennsylvania Act 102) enacted on Dec. 1, 1994.

The Pifers claim they never consented to Sam’s choice to be an organ honor.

When a person turns 18, it’s their independent decision, according to Hasz, who said the Gift of Life suggests donors to speak with their loved ones about the decision so they’re aware of the choice.

What could’ve been?

Lore Pifer often finds remedy for her sorrow by playing the piano, trying to fill the home with music that once came from the rhythmic drum beats of her son. Surrounded by acoustic guitars once played by Sam and the iconic djembe drum — an African drum Sam made on a trip he took to Ghana after graduating high school — sitting across the room, Lore Pifer says she can’t help but wait for Sam to walk through the front door.

“He had such a special talent, and the things he could do with the djembe I’ll never forget,” Lore Pifer said. “We would come home hearing the drum beats, and we knew right then Sam was home. That’s now gone.

“After he died, for a couple of weeks, I would hear a song on the radio and immediately think of Sam. I could hear him playing the same tune. Now, the drum sound is gone. It’s empty and never to return.”

Geisinger officials, though sympathetic, said they followed the best course of treatment up until it was time for them to hand the situation over to the Gift of Life program.

“While this was a unique case, ultimately, Sam’s wish to be an organ donor was fulfilled in accordance with state law,” Schaeffer said. “We empathize with the Pifer family and are thankful that many people choose to become organ donors.

“Geisinger makes every effort to follow approved procedures for procuring organs from donors, and participates with the Gift of Life Donor Program. Behind those procedures is a commitment to upholding the highest medical, legal and ethical standards.”

If he had to do it all over again knowing the end result of Sam’s case, Steve Pifer says he would’ve approached his final good-bye with his son differently.

“Everybody who has looked at this (case) has said there is nothing we can do legally,” Steve Pifer said. “I guess we’re stuck. Our point is, if we had known what they were doing in keeping him on the ventilator, we would’ve stayed to have more time with him. We freaked out when we got the call. They were telling us he was still lying there, heart beating and everything basically the same as when we left. We said our final good-byes, yet we could’ve had more time with our son.

“If had known what was going to happen, I would’ve had someone watch the door when I said good-bye and just pulled the plug.”

-- E-mail comments to jnorth@dailyitem.com.