‘Living with a death sentence’: NHS cadaver implant leaves woman with one of world’s rarest diseases
A woman infected with an incurable brain disease due to an NHS operation when she was three years old has told Sky News she is “living with a death sentence”.
Natalie Bralee-Brett was born with spina bifida, a birth defect caused by a gap between the brain and spinal cord.
In 1975, her mother Maureen was told by doctors at Great Ormond Street Hospital that Natalie would have an improved and prolonged life if they operated on her using a new procedure.
But this, unknown to Maureen at the time, involved taking membrane taken from dead bodies and inserting it into Natalie’s spinal cord. Now nearly 40 years later this treatment is the very thing that could kill her.
Natalie Bralee-Brett was born with spina bifida
It has caused microbleeding on her brain, leading to memory loss. Natalie, 53, is also falling over constantly and suffers debilitating headaches.
It also means Natalie is at high risk of dementia and could suffer a catastrophic stroke at any time.
“Living with a death sentence, this is the only way I could describe it,” Natalie told Sky News.
“Because every day, if you get a headache, you’re thinking ‘is this a sign of an episode that is linked to this problem? Is it a stroke?'”
“I want to know why I’ve got this problem. And that probably makes me more angry than actually having to deal with this condition.”
Search for answers
Sky News has been following Natalie’s case for more than a year, and we have spoken to experts around the world to try to help Natalie get answers.
Natalie was given a dura mater graft in 1975. This is a piece of membrane collected from dead bodies. Its use is intended to protect the spinal cord and prevent fluid from leaking.
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Cadaver surgery leaves patient with incurable disease
Natalie as a child
But over years, proteins already in the membrane can build up and cause plaques, leaving patients at high risk of diseases like Alzheimer’s. It can also make them vulnerable to strokes and brain haemorrhages.
The procedure was common in the 1970s in the UK, across Europe and the US.
It’s thought tens of thousands of patients around the world might have undergone the procedure, but it is not known how many might be suffering the same life-limiting and potentially fatal consequences today.
Natalie was diagnosed with a brain tumour in 2009, aged 37. A year later it was confirmed she had epilepsy. But it wasn’t until 2022 that Natalie was diagnosed with iatrogenic cerebral amyloid angiopathy (ICAA).
Her family have now suffered another devastating blow.
Natalie’s brother Neil, who also had surgery for spina bifida in 1980, was diagnosed with ICAA in July. He’s no longer able to work and is suffering from Alzheimer’s.
Natalie and Neil with their mother Maureen
Natalie and Neil as children
The siblings were born with the same condition, underwent the same procedure, and are now infected with the same incurable brain disease.
Natalie and Neil, 45, are the only siblings identified on the international ICAA register, which has just 52 confirmed cases.
Natalie says her mother Maureen is “heartbroken”.
ICAA cases ‘a heartbreaking tragedy’
Cases of ICAA have been identified in the Netherlands, Australia, Japan, Croatia, Austria, Italy, Spain, Slovenia, and the US.
Explained: Why cadaver implants are causing brain disease
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How cadaver graft caused incurable brain disease
Harvard Professor Steven Greenberg is one of the world’s leading ICAA experts.
“We hope and believe the numbers will be limited,” he said. “The hope is that we’re talking hundreds.”
But for those who are impacted, “it is a heartbreaking tragedy, and we feel it very much as the healthcare providers taking care of them”.
ICAA is caused by a medical examination or treatment, relates to the brain, involves amyloid proteins that can stick together and cause a range of problems for major organs – and that is a disease of the blood vessels.
Doctors believe there are three possible causes of the illness: cadaveric material introduced into a body during surgery, the use of human growth hormones containing cadaveric material and surgical tools not sufficiently sterilised.
Professor Greenberg explained: ”When I was in medical school, one of my professors said ‘the I stands for I, the doctor caused the problem’.
“And in the case of iatrogenic CAA, this is kind of a heartbreaking echo of an era when it appeared that a good neurosurgical procedure was to use tissue from human cadavers to close defects in the nervous system.
“And I am not a surgeon and I certainly wasn’t practising at the time. But my understanding is that it appeared to be good natural biological material for closing up areas and then had this unexpected and tragic effect of introducing some kind of protein that would later cause disease in the brain.”
Prof Greenberg hopes cases of ICAA are restricted to hundreds
‘I deserve answers’
Natalie’s health is steadily deteriorating. The bleeding on her brain is causing memory loss, and she dreads what the next few months will bring.
“The pattern seems to be every time I go for a scan, I’m being shown to have more bleeding,” she said.
“And the last scan showed that I also had inflammation. It’s always hanging over you because you get a headache, and you think ‘is this going to turn into something worse?’
“And because of being at risk of a stroke it’s constantly there, and it’s a condition that is going to get worse.”
Natalie’s agony is further compounded by the lack of information.
She wants to know more about the donor of the diseased membrane implanted into her brain. But there is no record of where the dura mater came from.
And most of the time these grafts were made up from more than one body.
Natalie said: “I think I deserve answers. And if you’ve got something wrong with you, you want to know it’s human nature. You want to know why you’ve got this problem.”
Diagnosing ICAA has only become possible due to advancements made in MRI scanning.
Specialists including Professor Greenberg have set up the international register so any neurologist suspecting ICAA can flag cases to their peers.
This isn’t the first time cadaveric dura mater grafts have infected patients.
The World Health Organisation advised against their use in 1997 after it was discovered they had been giving patients Creutzfeldt-Jakob disease (CJD) which at the time was also being spread by eating cattle infected with BSE or ‘mad cow disease’.
There were 228 of these confirmed cases worldwide.
Dura mater grafts were used in more than 20 surgical procedures over 25 years, with the last known use in the UK in 1992.
Natalie Bralee-Brett says she is ‘living with a death sentence’
‘Something is seriously wrong’
Simon Stratford was only 34 and a father of four young children when he died in April 2003.
That was nearly 16 years after having surgery to remove a brain tumour. During the operation a Lyodura graft was inserted into Simon’s brain. The membrane was infected with CJD and a coroner’s inquest found that it was this procedure that caused Simon’s death.
Simon Stratford with three of his children
Speaking exclusively to Sky News, his widow Colleen said she warned doctors treating her husband that she knew he was dying.
“I kept saying to the doctors he’s getting worse and something seriously is wrong, and you know, Simon did say to me at that point he thought he was dying.
“He had a brain tumour removed which saved his life and then was given a life sentence. They said it was the Lyodura dura mater that took his life.”
Colleen Stratford said she warned doctors treating her husband that she knew he was dying
Sky News asked B. Braun, a major German manufacturer which made Lyodura, to help with our investigation. They declined to comment on the link between dura mater grafts and ICAA.
For more than a year we have been speaking to experts around the world. Scientists in Europe declined to be interviewed. Natalie’s own medical team in the UK also refused to be interviewed.
The risks posed by the grafts are being better understood but the scale of the damage they have caused is not.
Some specialists who spoke to Sky News but did not want to be named are keen to stress that surgeons who carried out operations using these grafts were acting on the best available medical evidence to improve the length and quality of patients’ lives.
Natalie had her operation at Great Ormond Street Hospital. It’s likely, at least hundreds of patients would have undergone the same procedure.
Sky News has been speaking to experts around the world about cadaver implants for more than a year
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Following our investigation, its medical director Dr Sophie Varadkar told Sky News: “We understand that this situation may be deeply worrying for former patients who believe they could have been affected.
“At the time, this type of product was commonly used in surgical procedures worldwide, and sadly, the risks associated with it were not yet understood.”
“For any of our former patients who think they may be affected, we will support you with getting access to your medical records to allow you to discuss your concerns with your current doctors.”
The Department of Health told us concerns around ICAA – including new forms of transmission – were being investigated.
“The Advisory Committee on the Safety of Blood, Tissues and Organs is currently considering this issue with a view to providing further advice to the Government,” a spokesperson said.
“We encourage anyone with concerns about historical treatment to speak with their GP or specialist healthcare team for appropriate support and guidance.”
Do you have a story to share with us? Contact NHSstories@sky.uk
Victims of grooming gangs and modern slavery are being denied compensation by a government scheme because of their criminal records, Sky News has learned.
Analysis of official figures by Sky News’ Data & Forensics team shows more than 11,000 victims of crime over the last decade have been denied payouts because of their unspent convictions, including children.
The Criminal Injuries Compensation Authority can award money to victims of violent crime, including sexual abuse.
It is the only government compensation scheme for victims – for those unable to work due to injuries, the money can be vital.
But, if an applicant has a criminal record, they are automatically refused compensation with limited exceptions.
Those with unspent convictions sometimes receive reduced sums.
Sky News has found that at least 130 children with criminal records have received reduced awards over the last 10 years, including 50 victims of sex abuse, four victims of brain damage, and one child who lost sight in an eye.
This rule on unspent convictions is based on the idea that public funds should only compensate blameless victims of crime and not, for example, a gang member who was injured in a fight.
But many argue the policy punishes those who have been forced to offend by exploiters, as well as victims of child sexual abuse.
‘I was frustrated that I wasn’t being believed’
Arthur Sherry, 43, from Perranporth in Cornwall was regularly abused by his babysitter from the age of five, including suffering rape.
In 2008, he reported it to Devon and Cornwall Police, alongside two other victims. He alleges the police did not believe him, and charges were not brought against his abuser.
Arthur Sherry, who was abused as a child, says he was denied compensation because of his criminal record
Arthur became angry and descended into addiction as a “coping mechanism”, becoming suicidal, and was repeatedly arrested for minor offences, such as making false calls to the emergency services.
“I wasn’t getting support from any agencies, and no one asked me, ‘Why is this man ringing the emergency services all the time?'”
“It was a cry for help. I was frustrated that I wasn’t being believed.”
Eventually, Arthur’s abuser, Shaun Burton, was convicted of multiple offences against children, including 11 counts of indecency with a child in relation to Mr Sherry.
But when Arthur, who suffers from complex PTSD, subsequently tried to make a claim through the Criminal Injuries Compensation Authority in 2013, it was rejected because of his criminal record and because he submitted his application beyond CICA’s time limit.
He was not allowed to appeal the decision.
Arthur, aged 12 in the picture, was regularly abused by his babysitter, Shaun Burton, from the age of five
Many survivors of grooming gangs have criminal records due to being exploited and coerced.
While the government recently announced plans to disregard child prostitution convictions for these victims, many are urging authorities to go further and pardon all related offences.
Former victims’ commissioner Dame Vera Baird said: “They were not exercising their own free will and voluntarily committing crime, so there should be a discretion to look at that and say, ‘No, that wasn’t their fault’.
“They should get compensation for all the evil that was done to them by that gang.”
In 2022, the Independent Inquiry into Child Sexual Abuse recommended that the government amend the Criminal Injuries Compensation Scheme so that “applicants with unspent convictions are not automatically excluded where offences are likely to be linked to the circumstances of their sexual abuse as a child”.
The government has refused to act on this recommendation.
However, Labour MP Sarah Champion has tabled an amendment to the upcoming Victims and Courts Bill, hoping to implement it, as well as widen eligibility to the scheme.
“Victims are seen as running a cannabis farm and get a conviction, before it actually turns out that they were a victim of modern slavery.
“These people, who are very clearly recognised as victims and survivors, aren’t getting the money that’s owed to them. The system is broken and the ministers need to get rid of it.”
‘I was frustrated that I wasn’t being believed,’ Arthur tells Sky News’ Alice Porter
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A government spokesperson said: “Last year, more than £164m was paid out under the Criminal Injuries Compensation Scheme to victims, and we are going further by removing the time limit for civil personal injury claims and doubling Home Office funding for services supporting adult victims and survivors of child sexual abuse.
“Changes to the way we compensate victims have been considered by successive governments, and our priority must always be to treat all victims of violence equally.”
Devon and Cornwall Police said: “Tackling sexual offending is a key priority for Devon & Cornwall Police and we are working hard to bring offenders to justice.
“We take reports of all sexual offences seriously and will carry out thorough investigations into reports, looking at all viable lines of enquiry.”
Nathan Gill was at Manchester airport, about to board a flight to Russia, when accepting bribes finally caught up with him.
Gill, the former leader of Reform UK Wales and a one-time member of the European Parliament, who on Friday was jailed for 10-a-half-years, was stopped by police before boarding and had his phone seized in 2021.
While they interrogated him, his home in Anglesey was raided, with detectives discovering more electronics and cash piles of €5,000 (£4,400) and $5,000 (£3,800) respectively.
Nathan Gill being questioned. Pic: Met Police
The evidence on Gill’s phone would damn him – he was in contact with a pro-Russian politician in Ukraine, Oleg Voloshyn, and had agreed to boost pro-Russia viewpoints in exchange for money.
Voloshyn would dictate the statement, and Gill would repeat it – in some cases, almost word for word – in the media or the European Parliament.
In one instance, Gill appeared on the now-banned Ukrainian TV channel, 112 Ukraine, which was known for its pro-Russian stance.
In the interview, he was critical of the Ukrainian decision to open criminal proceedings against Viktor Medvedchuk, the owner of the television channel and a personal friend of Vladimir Putin.
Nathan Gill. Pic: Met Police
Speaking to the outlet, he said he was “very concerned” about the investigation, and wondered whether it was meant to silence “opposition politicians”.
Prosecutors said messages on Gill’s phone showed that this was at his paymaster’s instruction, with Voloshyn offering a “reward” if he would say that it was unacceptable to persecute a person for their political convictions.
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Voloshyn also offered the MEP €2,000 (£1,750) if he would express concern that Mr Medvedchuk could no longer mediate with Russia on Ukraine’s behalf, the court heard.
He added that “V” – understood to be Mr Medvedchuk – did not believe Ukrainian President Volodymyr Zelenskyy had “true intentions to pursue a peace agenda”, prosecutors said.
Bundles of cash were recovered from Gill’s home. Pic: Met Police
Sure enough, Gill appeared on 112 Ukraine saying it was “very sad” that Mr Medvedchuk felt he no longer had Mr Zelensky’s backing to act as a mediator with Russia, and suggested that using him “would be a sensible thing to do”.
The messages traded in innuendo, referring to the exchange of “Xmas gifts” or “postcards” instead of money.
But as the pair grew more comfortable with each other, they bargained more explicitly, with the sum of “£5k” quoted for Gill’s work.
Dominic Murphy, head of Counter Terrorism Command at the Met Police, said Gill had also offered access to other MEPs.
“This is where we get into that slightly odd situation where it feels very much like a real effort to undermine democracy here,” he said.
“This is Nathan Gill reaching out to individuals that he knows, who are Brits, who might be willing to be paid to go and make speeches.”
Commander Murphy declined to name names, but said there was an ongoing investigation and that other people had been spoken to.
None of the pro-Brexit MEPs Gill allegedly approached have been interviewed under caution.
Pic: Met Police
Police confirmed there was no evidence to suggest Reform UK leader Nigel Farage was involved.
Gill was stopped at Manchester Airport on 13 September 2021, under schedule 3 of the Counter Terrorism and Borders Security Act 2019.
He offered police no explanation for his actions and answered no comment in a March 2022 police interview.
But the 52-year-old is believed to have had financial problems.
Mr Murphy added that while Gill appeared to have pro-Russian sympathies, he was primarily motivated by money.
The ex-MEP has been jailed for 10-and-a-half years after pleading guilty to eight counts of bribery between December 2018 and July 2019.
Following an investigation by counter-terrorism police, officers said they believe Gill likely took a minimum of £40,000 in cash and was offering to introduce other British MEPs so they could be bribed.
Voloshyn was picked up by the authorities on a trip to the US in 2021, which enabled the FBI to discover his end of the conversation.
He is now believed to be in Russia, but has been sanctioned by the UK government over allegations of trying to destabilise Ukraine.
Nathan Gill pleaded guilty to eight counts of bribery over pro-Russian statements. Including to media outlet 112 Ukraine. Pic: Met Police
He remains wanted in both Britain and Ukraine.
A Reform UK spokesman said: “Mr Gill’s actions were reprehensible, treasonous and unforgivable.
“We are glad that justice has been served and fully welcome the sentence Nathan Gill has received.”
Mr Farage, the Reform UK leader, said: “An investigation into Russian and Chinese influence over British politics would be welcome.”
The MP for Clacton previously described his former colleague as a “bad apple” and said he was “shocked” after Gill pleaded guilty to eight counts of bribery.
He said: “Any political party can find in their midst all sorts of terrible people.
“You can never, ever guarantee 100% that everyone you meet in your life, you shake hands with in the pub, is a good person.”
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