They had planned to bury 20-month-old Akilah Austin yesterday in a white-and-pink princess dress inside a tiny white coffin with pink ribbons.
The whole family would have been there. Her parents, Lisa and Marvin Austin, had spent countless hours by her hospital bed since she took ill with a genetic heart defect in January. Her aunts, uncles, grandmother and family friends wanted to be there, just as they had been when she was implanted with an artificial Berlin heart, then later with a donor heart.
Luca Vricella and other members of the Johns Hopkins Children's Center's cardiac intensive care staff had planned to go to say goodbye to the baby who survived two heart surgeries only to die of pneumonia.
But the funeral plans were dashed after Akilah's parents arrived Friday at the Fleck Funeral Home in Laurel -- with pink hair bows and nail polish for their daughter -- and were told their baby had been cremated, relatives said.
"We just couldn't believe it," said Lucille Czechanski, Akilah's aunt, speaking on the parents' behalf. "After everything that Lisa and Marvin have gone through, then to have this happen. . . . Lisa and Marvin have lost the chance to say goodbye to their baby."
The parents were in seclusion yesterday.
Christopher Downey, marketing director for the funeral home, did not answer questions about the incident or confirm that the baby was mistakenly cremated.
"We regret that an unfortunate event has happened, and we are working with the family to make it right," he said.
Funeral director Shawn Wells refused to comment.
Czechanski said that the Austins had been told that there were two babies in the facility and that the other baby was to have been cremated.
The cremation was the final tragedy for the Austins since the night in January when Akilah turned blue as her diaper was being changed. Tests showed she suffered from a previously unknown genetic mutation called Cardiac Troponin I, which rendered her heart unable to pump blood effectively, Vricella said.
The baby was given priority status on a national waiting list for organ transplantation. To keep her alive until the operation, Vricella and other doctors at Johns Hopkins opted to implant an artificial heart in January -- making Akilah one of only 80 babies in the world to undergo this procedure. She lived with the artificial heart for 178 days, longer than any other American child, as relatives prayed for a heart. Finally, in July, a heart became available in South Carolina. The family received no information about the donor.
After months of prayer, the Austins, along with relatives and friends, camped out in a hospital waiting room for more than eight hours as doctors disconnected Akilah from the heart pump and placed the human donor heart in her chest.
"We're just so thankful," Lisa Austin said shortly after the transplant. She had felt guilty for months as she hoped for a heart to save her child. "The hardest thing about this is knowing that somebody else's child died so that mine can live."
After the transplant, Akilah's new heart stabilized and began to pump as doctors had hoped. Doctors kept her sedated so she would not feel pain and also to keep her still while she healed. Lisa, who had quit her job months earlier and moved into a Ronald McDonald House near the hospital, said she spent hours by her daughter's side. Relatives and friends kept a vigil in the waiting room.
Then the infections started, including fluid in the lungs. Akilah was placed on dialysis to help her kidney function. She contracted pneumonia and a blood infection. Her heart rate began to slow, and Vricella notified family members that they should prepare for the worst.
Just before midnight Sept. 10, surrounded by her parents, friends and relatives, Akilah died. After her death, the funeral arrangements gave loved ones something to focus on, Czechanski said.
Akilah loved pretty dresses, so they had to find the right one. The flowers had to be right. There needed to be music, perhaps Brahms's "Lullaby," which was playing when she drew her last breath.
Lisa found the perfect dress, white and pink, and long like what a princess would wear. They purchased pink bows for her hair and tiny white shoes. An aunt found white tights. An uncle bought a tiny angel to put in the coffin.
Relatives said they had chosen Fleck because they had been impressed with the funeral home's pitch. "He said they didn't profit off babies," Czechanski said. "We liked that, because it showed they were sensitive to babies."
They planned to bury Akilah in the Babyland section of Maryland National Cemetery, near the spot where officials plan to erect a statue of an angel. Everybody was looking forward to seeing her one last time -- to plant one more kiss on her chubby cheek and to touch her silky hair.
Now that will never happen. The funeral will be rescheduled, but the date has not been set.
Czechanski said a memorial tribute, an event that was once planned as a fundraiser for Akilah, is set for Oct. 1 at Clinton Cycles.
"Everybody has lost the chance for closure," Czechanski said, referring to the cremation. "It would have been our last memory. I wanted to kiss her goodbye. They took away the last chance we had to do that."
Despite the tragic end, Vricella said, Akilah's case offered hope for other children who could benefit from an artificial heart while awaiting transplant.
"She got seven more months with her family, and I think that the Berlin heart was a success, leading to a difficult transplant that unfortunately had a complicated course," he wrote in an e-mail. "I know that another child at Johns Hopkins will someday benefit from her unfortunate story."
Akilah Austin -- shown in March with her mother, Lisa -- was born with a genetic heart defect. She died this month.