On his Sunday away from work as an eye surgeon, Dr. Huck Holz had planned an exciting backcountry ski trip in February 2025.
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He and a friend decided to climb the massive, snow-capped peak of Mount Shasta in Northern California, but as they trudged to the summit, the adventure took a troubling turn with a phone call from the CDC that literally stopped him in his tracks.
“Luckily I had cell phone reception,” he said. “It was one of those calls you never forget.”
Dr. Huck Holz
“They told me I potentially had a rabies patient,” he said.
How deadly is rabies?
Rabies is a fatal viral neurological disease, associated with wild animals such as bats, skunks, raccoons and foxes.
Incubation in the human body can take weeks or months after a bite or scratch, but a series of post-exposure vaccines can prevent the virus from growing.
According to the CDC, more than 100,000 people receive these vaccines each year to prevent the disease, and fewer than 10 people die from rabies each year in the United States.
However, once symptoms appear, the disease is almost always fatal.
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And somehow, Holz’s patient could have been exposed.
Connecting with donors
More than a month earlier, Holz had successfully performed a corneal procedure at Kaiser Permanente on his patient, Inocencio Miramontes, using a small piece of tissue from a deceased donor.
The tissue had been screened for safety and was provided to him by an eye bank.
Rachel Miramontes
Holz said he didn’t know much about the tissue donor’s story beyond a few basic facts the eye bank provided him when distributing the tissue.
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“I knew the donor had died of a heart attack, and I knew his age and gender. I didn’t know much else,” he said.
What no one knew at the time, however, was what donor killed. It wasn’t a heart attack. It was rage. And the donor’s potentially infected corneal tissue had been in Miramontes’ eye for weeks.
Who was the donor?
James Martin was the father of three adult children who loved animals and write poems.
He and his wife, Kim, lived in the Idaho Panhandle before dying of what was initially thought to be a heart attack in December 2024., and his organs and tissues have been donated to people in various states.
Family photo
However, more than a month before his death, Martin was scratched by what is now believed to be a rabid skunk. He was sitting on his porch when the aggressive animal lunged at Martin’s rescued kitten.
“He said he grabbed (the skunk) by the neck and literally pushed it against the house,” said his wife, Kim Martin. “He said he just punched him a few times and stuff, but when he grabbed him he said he got scratched.”
Martin did not resort to post-exposure prophylaxis injections as a precaution, and slowly, rabies silently took over his body.
“He says, ‘I’m fine. It’s just a scratch. I’ll just put, you know, Neosporin on it, and it’ll be fine after I clean it up,'” his wife said.
Doctors now believe James Martin’s other significant medical problems may have masked the symptoms of rabies, leading the medical team to believe he died of a heart attack.
“In this case, hospital staff members who treated the donor were initially unaware of the skunk scratch and attributed its signs and symptoms prior to admission to chronic comorbidities,” the CDC said. in a magazine of this incident.
According to the CDC, the details of Martin’s encounter with a skunk were documented on a standard donor risk assessment form before his organs and tissues were harvested and donated.
But those details weren’t enough to stop the transplant, and Martin was not tested for the virus.
“Some people thought that, ‘Well, he just died of a heart attack,’ and so the other elements were neglected. But that can never be neglected,” Holz said.
Why organs and tissues are not tested for rabies
According to the CDC, deaths from rabies are extremely rare and testing for the virus is complicated and time-consuming, unlike testing for more common illnesses like HIV and hepatitis.
“Rabies is excluded from routine donor pathogen testing due to its rarity in humans in the United States and the complexity of diagnostic testing,” the CDC said in an analysis of this case.
The demand for organs is constant.
There are about 100,000 people on the waiting list for organs, and about 13 people die every day while they wait, according to David McCormick, a physician in the CDC’s Office of Blood, Organs, and Other Tissues Safety.
“Given that there is such a need for organs and the timing of organ donation can be very critical, if we had to wait two to three days to test every organ donor for rabies… that could delay people receiving the organs they need, and given the rarity of rabies, that would simply not be cost-effective and would likely result in organs not being used when they could have been and could have saved people,” McCormick told Scripps News earlier this year.
How eye tissue was examined
Lions World Vision Institute, the eye bank that reviewed the donor’s medical records and provided the corneal tissue for the transplant, told Scripps News that the organization followed Food and Drug Administration guidelines and standards set by the Eye Bank Association of America when selecting the deceased donor’s tissue for possible transplant.
“At the time, donor regulations did not exclude scratches (from animal tissue transplants), but only bites,” said Jason Woody, president and CEO of LWVI, in a written statement.
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At the time, Woody said tissue would have been rejected if a patient was suspected of having rabies or if the person had been bitten by an animal suspected of having rabies in the past six months.
However, animal scratches were not part of the fabric carryover guidelines.
“There was no indication at the time that this was a case of rabies,” said Kevin Corcoran, president and CEO of the EBAA. “They noted that he had been scratched by a skunk, but he had been seen by a number of doctors while he was (in the hospital), and he was not expected to have contracted rabies.”
As a result, donor corneal tissue was sent for surgeries in Idaho, Missouri, New Mexico and California, including the one planned by Miramontes.
The donor kidney, meanwhile, was sent to a grandfather in Michigan named Barney Kurowicki.
Family photo
LifeCenter Northwest is the organ procurement organization that handled the kidney.
“LifeCenter Northwest follows screening and testing protocols for donation in accordance with (Organ Procurement and Transplantation Network) policy, and we provide available donor information to our transplant partners in accordance with national policy requirements set by OPTN,” a spokesperson told Scripps News earlier this year.
How rabies was discovered
More than a month after receiving the kidney transplant, Kurowicki began experiencing strange symptoms – including fear of consuming water.
At first, rabies didn’t seem like the logical culprit, but doctors contacted the CDC to be sure.
At the time, only three cases of rabies transmission through organ transplantation had been documented in the history of the U.S. transplant system, according to the CDC.
But it was happening again.
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By the time doctors and scientists confirmed that Kurowicki had contracted rabies from Martin’s donated kidney, it was too late to save his life.
However, there was still time to warn the people who received the donor’s corneal tissue.
Suddenly, the CDC was looking for Miramontes and three others who had already undergone or were scheduled to undergo corneal transplants with the potentially infected tissue.
Idaho patient discovers threat of rabies
Joseph Bird, 25, suffers from a disease called keratoconus since his diagnosis as a teenager.
His misshapen cornea had progressively worsened over the years, distorting and diminishing the vision in his left eye.
Joseph Bird
In 2025, he hoped some of his vision could be restored through a special new procedure in which his Idaho Falls doctor would insert a custom piece of corneal tissue into his eye, provided by a deceased donor.
“I was pretty excited,” he said.
His doctor told him it would be a few days before he saw results, so Bird remained patient.
“It wasn’t until about four days after surgery that my doctor called me to tell me I needed to sit up,” Bird said. “He said, ‘The donor had rabies, and I should go to the emergency room to get the rabies shots (post-exposure prophylaxis) and that he already called them, and they are all ready for me.’
Although rabies is considered a “medical emergency” rather than an emergency, infectious disease experts urge exposed patients to get vaccinated immediately after being exposed, as the virus is deadly once symptoms appear.
“It’s not something that you get infected and two days later you’re going to develop symptoms,” Rebecca Earnest, head of outbreak intelligence at the CDC, told Scripps News earlier this year. “However, because it is so deadly,…
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