Earlier this week, family members of 76-year-old Bella Montoya gathered to mourn her at a funeral parlor in Ecuador. About five hours into the funeral, they heard a strange sound coming from the coffin. 

When family members opened the coffin, they found Montoya gasping for air. Paramedics returned her to the hospital where, only hours earlier, she had been declared “dead” by doctors due to complications with a stroke. Montoya remains in the hospital in intensive care.

While we only hope that incidents like these remain few and far between, Montoya is hardly the first person to “come to life” in a coffin at a funeral home. According to CNN, earlier this year, an 82-year-old woman was pronounced dead at a nursing home on Long Island, NY, only to be discovered breathing at the funeral parlor a few hours later. Luckily, in these cases, the two were found alive before premature burials. 

As unfortunate and nauseating as it is to hear, people have been buried before their time, so much so that specialized coffins were once used to alert those on the surface that the coffin’s occupant still drew breath. As medical technology advances, it begs the question of how this could possibly happen.

Nearly Buried Alive 

So, how often are people almost buried alive? It happens more often than we’d like to think. Other cases like Montoya’s have occurred around the world.

For instance, a man in Mumbai was presumed dead after he was found at a bus stop, unconscious and apparently “covered in maggots.” A senior doctor stated that they had checked for a pulse but found none and sent the man straight to the mortuary, where he later regained consciousness. It was later learned that the man had a metabolic disorder and was then treated at the hospital.

Another incident occurred in 2014 after a Polish woman freighted mortuary staff by moving in a body bag. The 91-year-old woman returned to her family and warmed up with soup and pancakes. 

One of the most notable cases though of being nearly buried alive is the case of Angelo Hays. In 1937, the Frenchmen was riding his motorcycle when he was involved in a crash that smashed his face into a brick wall. He was declared dead at the scene and buried two days later. However, due to insurance reasons, his body was exhumed a few days later and found to still be alive. 

Hays’ accident had caused his body to slip into a comma, and needed little oxygen. After some time, Hays completely recovered and went on to tour the country in a coffin he had invented himself. 

The Lazarus Effect

There are medical explanations as to why a person would wake up before their burial. One in particular is called the Lazarus effect.

If someone suffers cardiac arrest, medical professionals usually pronounce the person dead after they administer resuscitation attempts, such as CPR, and there is no response. But there are rare cases where a patient suddenly has a spontaneous return of cardiac activity and “comes back from the dead.” In these cases though, according to the Cleveland Clinic, they were never dead to begin with. 

This is known as the Lazarus phenomenon or Lazarus syndrome. In medical terms, it’s called “autoresuscitation.” The patient usually regains blood flow within 10 minutes of CPR, though there are some cases where patients have awoken hours later.

According to the Cleveland Clinic, most people don’t survive much longer after experiencing the Lazarus phenomenon. From 1982 to 2018, there were 65 documented cases of the Lazarus phenomenon, but only 18 of those cases saw a full recovery. 

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How the Lazarus Phenomenon Works 

The Lazarus phenomenon usually only happens after medical professionals administer CPR. Though it’s unclear why, some experts believe that CPR causes hyperinflation — where there is too much air in the lungs, and pressure builds in the chest. 

This pressure can prevent blood from flowing to the heart and thus make it seem like the heart has stopped. As the pressure decreases and blood begins flowing again, it can appear as if the person has come back to life; however, only for a short time in most cases. Though patients are closely monitored, the human body can react in different ways after death or presumed death. Which can then lead to people seeming to “come back to life” at their funerals. 

Some researchers, according to the Cleveland Clinic, believe that this phenomenon occurs more often than is documented. Rodney Davies, in his book The Lazarus Syndrome: Burial Alive and Other Horrors of the Undead (1998), claims that anywhere from 1 to 2 percent of burials in the U.S. and Europe are premature. Though this is a dated estimation, it’s not clear how many burials are premature. 

The Lazarus phenomenon is just one likely cause for premature burials, and hopefully you won’t have to encounter it in your lifetime.

Read More: Can Science Explain Near Death Experiences?