In a media report by BBC, Bella Montoya, 76, was pronounced dead by a medical physician in the Babahoyo city following a suspected stroke. Before her scheduled burial, family members gathered in a funeral home and held a vigil for her before placing her in a casket. The woman gasped for oxygen when they finally opened the coffin to change her before the burial, over five hours later.

“My mum started to move her left hand, to open her eyes, her mouth; she struggled to breathe,” her son Gilbert Balberán stated the moment when he came to know the fact that his mother is alive.

While another mourner complains that the ambulance they summoned has not yet arrived, video captured by a mourner shows her trying to breathe as she lies in an open coffin. Firefighters come shortly after and carry Bella Montoya back to the hospital where she had been pronounced dead. She was in serious care, but her son informed Ecuadorian media that she was still awake and talking.

“My mum is on oxygen, her heart is stable. The doctor pinched her hand and she reacted, they tell me that’s good because it means she is reacting little by little,” newspaper El Universo quoted his words.

Mr Balberán mentioned that his mother was rushed to the hospital roughly around 09:00 “and at noon a doctor told me [she] died”.

He said that a death certificate had even been produced, stating that she had had a stroke and then experienced cardiac arrest. There are more people who have “come alive” after being pronounced dead besides Bella Montoya. An 82-year-old woman was discovered to be breathing in a funeral parlour in New York State in February. Three hours earlier, a nursing home had declared her dead.

Such instances are extremely rare, but Dr. Stuart Hughes, a senior lecturer in medicine at the Anglia Ruskin University School of Medicine in Chelmsford, notes that “death is a process.”

“Sometimes somebody may look like they’re dead but they’re not quite dead,” Dr Hughes spoke to BBC. “Careful examination is necessary to confirm death.”

According to a consultant in emergency care, doctors should listen for heart sounds and monitor breathing effort for at least a minute if patients are unresponsive and have no pulse. “If that’s all absent then you can say they’re dead.”

However, it could be challenging even for medical personnel to confirm a death, for instance when bodies are extremely cold. “The patient in such instances will have an almost imperceptibly slow heart rate and their bodies will have shut down,” Dr Hughes says.

He adds that some medications can also slow down bodily functions, providing the impression of death. These “confounding factors” may appear if the examination is hastily conducted or rushed.

A commission to look into the occurrence has been established by Ecuador’s health minister.

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