It sounds like a low-budget horror flick. You’re at a funeral, mourning a loved one, and then you hear a thud. Then another. Suddenly, the person inside the casket is gasping for air. This actually happened. In June 2023, the world watched in absolute shock as Bella Montoya, a 76-year-old retired nurse in Ecuador, "came back to life" right in the middle of her own wake.
She wasn't a ghost. She wasn't undead. She was just a victim of a massive medical error and a rare physiological state that fooled doctors completely.
People often use the phrase "the girl who wasn't dead" to describe several cases, but Montoya’s story is the most visceral example of the "Lazarus phenomenon" we've seen in recent years. It raises a terrifying question: How does a professional medical team declare a living human being dead?
What Really Happened in Babahoyo?
Bella Montoya was rushed to the Martín Icaza Hospital in Babahoyo after suffering a possible stroke and cardiopulmonary arrest. Doctors tried to resuscitate her. They failed. Or, they thought they did. After she didn't respond to their efforts, the physician on duty declared her dead and even handed a death certificate to her son, Gilbert Balberán.
She was in that coffin for about five hours.
Imagine the scene. Family members are gathered. They are grieving. They open the casket to change her clothes for the burial, and they see her left hand hitting the side of the box. She was struggling to breathe. Honestly, it’s the stuff of nightmares. Her son later told reporters that his heart was racing when he realized his mother was still moving.
The Medical Glitch: Catalepsy and Cardiorespiratory Arrest
How does this happen? Usually, it involves a condition called catalepsy.
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This isn't some mystical state. It’s a real nervous condition. It causes muscular rigidity, a total lack of response to external stimuli, and—this is the kicker—extremely slowed-down breathing and heart rate. If a doctor isn't incredibly thorough, or if the hospital lacks advanced monitoring equipment, a person in a deep cataleptic state can look, feel, and "test" as dead.
In Montoya's case, the stroke likely triggered a systemic collapse. Her body went into a sort of "power-save mode" so deep that the stethoscope didn't pick up the faint rhythm of her heart.
The Lazarus Phenomenon Explained
The medical community calls this the Lazarus phenomenon. Specifically, it's the delayed return of spontaneous circulation (ROSC) after CPR has ceased.
- Pressure buildup: Sometimes, the intense pressure during CPR prevents the heart from filling with blood. Once the chest compressions stop, the pressure drops, the blood flows back in, and the heart restarts on its own.
- Drug delays: In some instances, the adrenaline injected during resuscitation efforts doesn't reach the heart immediately due to poor circulation, only "hitting" the system minutes after the doctor has given up.
- Hyperkalemia: High potassium levels can also mess with the heart's electrical signals in ways that mimic death.
There have been about 65 documented cases of this since the early 1980s. It’s rare, sure. But for the people involved, it’s life-altering.
Why Mistakes Like This Keep Happening
You'd think with modern technology, we'd have a 100% success rate in identifying death. We don't.
Medical systems in developing regions often face immense pressure. Overcrowded hospitals, exhausted staff, and a lack of EKG machines that can run for extended periods can lead to "rushed" pronouncements. In the case of Bella Montoya, the Ecuadorian Ministry of Health ended up forming a technical committee to review how the hospital issues death certificates. They had to. You can't just have people waking up in funeral homes.
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Another famous case happened in 2020 with a young woman named Timesha Beauchamp in Detroit. Paramedics declared her dead after 30 minutes of CPR. She was sent to a funeral home, where employees realized she was breathing. Sadly, unlike Montoya who survived for several days after her "resurrection," Beauchamp suffered massive brain damage from the lack of oxygen and passed away months later.
This highlights the grim reality: even if the heart restarts, the brain is often already gone.
The Cultural Obsession with "Buried Alive"
We have a primal fear of this. It’s called taphophobia.
In the 1800s, this fear was so rampant that "safety coffins" were a genuine business. These caskets had bells attached to them with strings that led down into the box. If you woke up six feet under, you rang the bell. It sounds Victorian and distant, but cases like Montoya's prove the fear isn't entirely irrational.
Modern medicine relies on "brain death" as the ultimate marker, but in emergency rooms and sudden cardiac events, doctors usually rely on the absence of a pulse and breath. If those are faint enough, the human eye and ear can fail.
The Aftermath of the Montoya Case
Bella Montoya didn't have a miracle "happily ever after." After waking up in her coffin, she was rushed back to the same hospital and placed in intensive care. She spent seven days in the ICU.
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She died—for real this time—on June 16, 2023, following an ischemic stroke.
The tragedy is twofold. Her family had to mourn her twice. First, the shock of her "death," then the shock of her "life," and finally the reality of her passing. The Ecuadorian government’s investigation focused on the doctor who signed the original certificate. It served as a massive wake-up call for medical protocols in the region.
What This Means for Medical Transparency
This case isn't just a tabloid headline. It’s a lesson in clinical humility.
- Verification Time: Many experts now argue for longer observation periods before a death certificate is signed, especially in cases of hypothermia or drug overdose, which can mimic death.
- Technological Necessity: An EKG (electrocardiogram) should be mandatory to confirm the absence of electrical activity in the heart, rather than relying solely on manual pulse checks.
- Family Advocacy: If something feels wrong, or if a body feels unusually warm or shows any sign of "life" (like skin color not fading), family members have the right to demand a re-evaluation.
The "girl who wasn't dead" (or in this case, the grandmother) reminds us that the line between life and death is sometimes a lot blurrier than we want to admit.
Actionable Insights for Understanding Medical Accuracy
If you are ever in a position where you are dealing with the sudden loss of a loved one, knowing the protocols can provide a small sense of agency in a chaotic moment.
- Ask for an EKG strip: If a death is pronounced in a hospital, you can ask if an EKG was used to confirm a flatline. It is the most reliable way to ensure no electrical activity remains.
- Understand the "Waiting Period": In many jurisdictions, there is a mandatory waiting period before cremation or embalming. This exists specifically to prevent errors.
- Legal Recourse: In cases of premature pronouncement, families often have grounds for medical negligence lawsuits. This isn't just about money; it's about forcing hospitals to update their resuscitation and pronouncement protocols.
- Check for Underlying Conditions: Conditions like catalepsy, severe hypothermia, or certain sedative overdoses require specific "warming" or "clearing" periods before a person can be legally declared dead.
The story of Bella Montoya is a rare anomaly, but it serves as a stark reminder that the medical field is run by humans. Humans make mistakes. Sometimes, those mistakes are caught just in time—right at the edge of a casket.
To ensure the highest level of care and accuracy, medical facilities must prioritize rigorous verification over efficiency. For the rest of us, it’s a prompt to appreciate the complexity of the human body and the fragility of the systems we trust to monitor it. Check your local hospital's accreditation and their protocols regarding "Death on Arrival" (DOA) cases to see how they mitigate the risk of the Lazarus phenomenon. This knowledge won't just ease a phobia; it will help you advocate for the best possible care for your family in their most vulnerable moments.