'Dead' people waking up is rare, but one doctor says he's seen it twice

• A woman in Ecuador woke up and knocked on her coffin hours after being pronounced dead.
• It is "amazingly rare" for "dead" people to wake up, an emergency medicine consultant said.

A woman who was pronounced dead woke up and knocked on her coffin during her wake.

Bella Montoya, 76, was rushed back to the hospital following the incident in Ecuador on Friday and put into an intensive care unit where she remained on Monday, The Associated Press reported.

Montoya had been admitted to hospital earlier in the day on Friday with a potential stroke and cardiac arrest. She did not respond to resuscitation and so a doctor pronounced her dead.

The family then took her to a funeral home where they held a wake for her.

Her son said: "After about five hours of the wake, the coffin started to make sounds. My mom was wrapped in sheets and hitting the coffin, and when we approached we could see that she was breathing heavily."

This is the fourth known report of a "dead" person waking up this year. In February, a man was found breathing after being declared dead by medics at his home following a cardiac arrest.

This came after an 82-year-old woman was pronounced dead in February and then found to be breathing hours later after being transported to a New York funeral home. And on January 3, a woman, 66, was found to be gasping for air when unzipped from a body bag in Iowa after being declared dead earlier that day.

Signs that someone has died include no breath or heartbeat, not waking up, pale and waxy skin, half-open eyelids, fixed pupils, and their mouth falling open.

Dr. Stephen Hughes, senior lecturer in medicine at Anglia Ruskin University, UK, told Insider such events are "amazingly rare" but said he has witnessed them twice in his 20-year career as a consultant in emergency medicine.

A coroner inspected the 'body' and found she still had a pulse

The first time he experienced it, Hughes was a junior doctor in a rural hospital. A woman with epilepsy had taken an overdose of phenobarbital — an old-fashioned barbiturate drug used to treat the condition.

"What barbiturates do is they slow everything down, they knock you out" he said.

Her primary care physician arrived on the scene and asked the patient questions with no response. He couldn't hear the patient's heartbeat, couldn't feel a pulse, or detect any breathing.

The physician announced her death and she was taken to the mortuary.

There, the mortuary attendant noticed the patient's leg twitching slightly. He also saw that the veins were fuller in the legs than they should be. He then inspected the "body" further and found she still had a pulse.

The patient was taken to the intensive care unit.

"If I recall correctly, she recovered," Hughes wrote in The Conversation.

In the other example, a woman was in the resuscitation room but medical professionals in the room believed she was dying and so, eventually, they stopped resuscitating her. The woman was declared dead.

Hughes and his colleagues left while another doctor filled in the paperwork. All of a sudden, the deceased patient started breathing again.

"It was quite freaky," Hughes said.

As with many of these cases, the patient did not regain consciousness and died later that day, he said.

Hughes said that this is one of the cases he reflects on most, simply because the patient had not been examined properly. If the doctor had kept a monitor on, they would have seen there was still cardiac activity.

Dilated pupils can be a sign of death — or a sign of drugs in the system

Hughes explained that "death is a process and not an event," which can cause confusion.

"Different body systems shut down at different rates and so it is not unusual to still hear a few bowel sounds around or even just after the time of death. This can cause confusion by masking quiet heart sounds," he said.

One final check for death is if the pupils remain fixed and dilated. But if the patient has certain drugs in the system, pupils are still likely to be dilated anyway, he said.

Hughes said that there were a lot cases of "dead" people waking up written about during Victorian times, but since then the death confirmation process has been formalized and is taught at medical school, so it is much less likely to happen.

He said that situations like those recently reported could be due to the world doctor shortage, which is partly caused by medical professionals being stretched thin during the pandemic. He explained that if final checks are being delegated to those who aren't fully trained, this could cause problems.