Handing the organ to nurse Tammy Nelson, Shaknovsky told her to mark it “spleen,” even though it weighed at least 10 times as much as the average spleen and was clearly a liver, according to Bryan’s lawsuit. Nelson allegedly did as she was told.

Within minutes, other doctors and hospital higher-ups swarmed the operating room, the suit states. All of them allegedly recognized the organ that had been removed was a liver but nevertheless covered up Shaknovsky’s mistake by documenting on official records that he had cut out Bryan’s spleen.

Shaknovsky allegedly tried to persuade hospital staff members that it was the spleen. He repeatedly left and returned to the operating room to tell people that Bryan had died of a “splenic aneurysm,” the suit states. In informing Bryan of her husband’s death, he allegedly told her the cause was a spleen so diseased that it had swelled to four times the normal size and shifted to the other side of his body.

Ascension nurse Kathleen Montag chased Bryan into the parking lot and lied about how her husband had died to get her signature agreeing to forgo an autopsy, the suit states.

The cover-up fell apart when the district’s medical examiner performed an autopsy and determined that the organ that had been removed was Bryan’s liver while his spleen was untouched and in the normal position, state disciplinary records show. The medical examiner ruled Bryan’s death a homicide caused by bleeding to death and having his liver removed.