The alien medal randomization update seems to have screwed up a thing, and doing a little stuff myself, actually found out why, and it looks like an easy fix. It appears the when the player is given the random item, it ends the whole scene, leaves you on a black screen, and doesn't transport the player. (<END at the end of the item just ends the whole thing, removing that would solve it.) (edit: also removing the <NOD so that the player doesn't have to mash through... invisible text. Because of black screen hiding everything.)
And here's an image. Trapped on a black screen, but still in the main artery. It did also reward the item it was supposed to give (which was the arms barrier).