As revealed later on, Alexandra is the villainous mastermind of an illegal bone graft selling operation; running it with mortician Nick Martin. The villainess cut the body of a 60-year-old man who died of mesothelioma, and sold the grafts to the hospital--doing so while posing under the Biotech Tissue Services name; a company that folded years ago. As a result of Alexandra's scheme, many patients, including Amy (who received a graft due to an accident) were stricken with cancer, and were either ailing or had passed on.
After Martin was taken in due to bone dust being found in a showroom vent, Brennan confronted Alexandra, who was revealed as the villainess due to her collection of phones (which she used to make her deals). It was also pointed out that Alexandra had become ill due to inhaling the bone dust, which not only revealed that she did the cutting, but she did so without facial protection. Following the reveal, the evil Alexandra ended up arrested, along with Martin (both off-screen), for their callous actions.
- Sumalee Montano later appeared on NCIS: New Orleans as the evil Melanie Pratt.
- Sumalee Montano's villainous characters from Bones and NCIS: New Orleans share similarities. Both were unscrupulous businesswomen who indirectly caused deaths for profit, with the difference being that Melanie Pratt was involved in military affairs, while Alexandra Combs was in the medical field. Also, while Melanie claimed not to have known that the plane coupling was poisonous, it can be inferred that Alexandra was fully aware that the bone grafts were cancerous.