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Thread: Family of brain dead California girl battles hospital to keep machines on

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    Elite Member Laurent's Avatar
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    Default Family of brain dead California girl battles hospital to keep machines on

    Has anyone else been following this story? The girl went in for a tonsillectomy to help treat her sleep apnea and started hemorrhaging in recovery, she went into cardiac arrest, and now several doctors have deemed her brain dead. Her family has been battling the hospital for weeks about not turning off the machines because they don't believe she's dead. Terri Schiavo's parents have now jumped into the fray.

    Jahi McMath's family, Oakland hospital discussing girl's transfer


    By Lateef Mungin and Chuck Conder, CNN

    updated 4:03 PM EST, Fri January 3, 2014

    (CNN) -- A California court hearing concluded Friday with the family of Jahi McMath -- a 13-year-old girl on a ventilator who has been declared dead by doctors -- and a hospital agreeing on a protocol for the release of the girl to another facility.

    The specifics of any such release -- how she'd be transferred, by and to whom, and at what time -- continue to be discussed. So while Friday's California Superior Court hearing did signal apparent progress in the hot-button case, it does not represent a final agreement.

    Earlier in this hearing, the judge asked attorneys for the McMath family and Children's Hospital Oakland to confer to attempt to settle the issue of what will happen with Jahi.

    After this hearing broke, representatives for both the family and hospital headed to federal court.

    There, a magistrate will oversee mandatory talks between representatives of the hospital and the family, CNN affiliate KTVU reported.

    Both hearings occurred on the same day that the coroner for Alameda County issued a death certificate for Jahi. This action is not directly connected to Friday's pair of legal proceedings.

    Meanwhile, a deadline looms. A judge has ruled that Jahi can be cut off a ventilator at 5 p.m. Tuesday.

    Bleeding profusely

    Last month, Jahi had surgery to remove her tonsils, adenoids and extra sinus tissue. Doctors had recommended the surgery to treat pediatric obstructive sleep apnea, a condition that made her stop breathing in her sleep and caused other medical problems.

    Before the surgery, Jahi was worried that she would never wake up, according to her uncle. She seemed fine after the surgery and asked for a Popsicle because her throat hurt.

    It wasn't long before something went terribly wrong. In the intensive care unit, the girl began bleeding profusely -- an image that her mother said would be forever seared in her mind.

    According to family members, Jahi went into cardiac arrest. Days later, she was declared brain dead.

    Hospital officials have said privacy laws prevent them from discussing details of the case.

    More support

    The family of Terri Schiavo has joined the battle recently.

    "Together with our team of experts, Terri's Network believes Jahi's case is representative of a very deep problem within the U.S. healthcare system -- particularly those issues surrounding the deaths of patients within the confines of hospital corporations, which have a vested financial interest in discontinuing life," the Terri Schiavo Life & Hope Network said in a statement.

    Schiavo was a brain-damaged woman who died in 2005 after living on a feeding tube for more than a decade. She was the subject of a lengthy legal battle between her parents and her husband, Michael Schiavo, who maintained that she wouldn't have wanted to live in a "persistent vegetative state."

    The organization said it has been overseeing the efforts of several groups to help get Jahi transferred out of Children's Hospital Oakland and brought "to a safe place."

    Jahi's family said Tuesday that it had found a facility in New York willing to take her. The Oakland hospital "refused to agree to allow us to proceed in that matter," Jahi's uncle Omari Sealey said.

    The hospital denied the accusation.

    "We have done everything to assist the family of Jahi McMath in their quest to take the deceased body of their daughter to another medical facility," hospital spokesman Sam Singer said.

    "To date, they have been unwilling or unable to provide a physician to perform the procedures necessary, transportation, or a facility that would accept a dead person on a ventilator. Our hearts and thoughts go out to them in this tragic situation, but the statements being made by their attorney and some family members are misleading and untrue."

    Family attorney Christopher Dolan had accused the hospital of being "hell-bent" on ending Jahi's life.

    In addition to the coroner, a judge has declared Jahi brain dead as well. Doctors say there's no chance she will come back to life.

    Sealey said Wednesday that the family still hopes to move her to another facility.

    He accused the hospital of starving his niece by not using a feeding tube to provide her with nutrients.

    Singer said a judge had dismissed the family's request for additional medical procedures Tuesday, including a feeding tube.

    CNN's Greg Botelho and Elizabeth Landau contributed to this report.
    Jahi McMath's family, Oakland hospital discussing girl's transfer - CNN.com
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    Elite Member Brookie's Avatar
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    I feel sorry as heck for the family, but I do not understand what they hope to accomplish here.
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    Elite Member Laurent's Avatar
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    Quote Originally Posted by Brookie View Post
    I feel sorry as heck for the family, but I do not understand what they hope to accomplish here.
    I saw video of the mother earlier in the week and her comment was that she didn't understand how the girl could be dead when her body is able to expel the air from the vent and is capable of making urine. She said that dead bodies aren't capable of doing that and I've also heard comments that she feels that the girl is making voluntary movements and is therefore still able to recover.

    I've read in other articles that her brain is decomposing, though. That brings up disturbing images if it's not just atrophying, but actually decomposing.
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    Elite Member Sarzy's Avatar
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    I know it's very easy to say and a hell of a lot harder to do, but they need to let her go IMO.

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    Elite Member MmeVertigina's Avatar
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    I was waiting for someone to post this. This hits very close to home for me so I didn't want to post it, I really shouldn't even have opened it, it's so upsetting to me.

    But I did so...my issues with the hospital are that they botched a surgery which was recommended to an obese child to cure her sleep apnea. First of all I take issue with recommending a tonsillectomy as a way to cure her apnea, my father was not obese, had apnea, and needed a uvula shortening, his soft palate layered, tonsils out, septum repaired and a long recovery in the ICU as recommended by his doctor. The first line of treatment for this child should have been weight loss, if that was already suggested and not followed through on then perhaps involving social services to figure out what the hell was going on with her weight (and assisting the family in figuring out the correct way to help this) might have been a good idea. Before putting her under and removing her tonsils which might not even have helped in the long run had she survived for longer than a day. So yeah, I am pissed at the treatment plan here.

    Then, when she was suffering in recovery it took them several tries to get someone to help her! She ended up "dying" yes, but I do think that the hospital absolutely does not want there to be any chance that she regains any of her brain function. They would be liable for her treatment for the rest of her life. I can't cite them specifically, but I have seen a few people posting about where a clinically brain-dead person has regained consciousness at some point, read the links, seems viable.

    On a personal note, I can completely see how this family is so pissed and traumatized by this situation that they do not want this hospital to be the last place where they have their daughter in their care. They don't want to let go of her there, in that place, which represents so much hurt and anger to them. The mom of the patient has given interviews where she started that her daughter was so afraid something would go wrong, and she told her everything would be fine, I think guilt probably plays a large part in this.

    In any case, the hospital needs to let this go, let the family take their daughter to die where they want to her to die. If they didn't see any purpose on putting her on a breathing tube they could have turned it off immediately when her brain function ceased. Unless they were blocked by the court, I am not sure about this, could be one reason. If she went from comatose to brain dead and before they could even remove the tube the family was there with a court order.

    We're following this every day, as I said this is a local situation, I will definitely think twice about using that hospital for anything other than the ER, and then only if absolutely necessary.
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    Elite Member witchcurlgirl's Avatar
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    She didn't just have a tonsillectomy, she also had a uvulapalatopharangoplasy, and removal of nasal turbinates, which is much more complex and runs a higher risk of bleeding.

    This is tragic, but surgery is dangerous. So many people take it for granted, but the risk of complication after surgery is a real risk, even for 'minor' procedures.

    The ruling just came down, the family can move her.
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    Elite Member louiswinthorpe111's Avatar
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    Sleep apnea is absolutely helped by weight loss. When my hubby drops 20 lbs, his snoring drops off significantly.
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    Elite Member MmeVertigina's Avatar
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    Quote Originally Posted by witchcurlgirl View Post

    The ruling just came down, the family can move her.
    Aren't they still having issues with the switch to a trach tube?


    ETA: http://www.sfgate.com/bayarea/articl...ke-5111584.php

    But the family, who believe Jahi is alive because her heart continues to beat while she's on a ventilator, was making arrangements to move the girl out of the hospital and into a care facility.
    Under the agreement, Jahi's mother, Nailah Winkfield, is "wholly and exclusively responsible for Jahi McMath the moment custody is transferred in the hospital's pediatric intensive care unit and acknowledge(s) that she understands that the transfer and subsequent transport could impact the condition of the body, including causing cardiac arrest."
    Jahi will be moved with the ventilator that is keeping her breathing.
    Grillo refused the family's request to require doctors from the hospital or an outside physician to insert a feeding tube and a tracheostomy tube in Jahi, which the family had argued was necessary for her to be transferred.
    Hospital attorney Douglas Straus told the judge the hospital would not allow any doctor to perform procedures on a deceased human being.
    Christopher Dolan, attorney for Jahi's family, said the agreement removes the barriers the family had faced in taking the girl out of the hospital. The hospital had said it would allow the girl to be transferred to another facility but had not heard from any such facility.

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    Elite Member MsDark's Avatar
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    I'm with you in that I think it's crazy they did this kind of surgery on a child her age.

    Brain Death - Criteria For Brain Death - What Is Brain Death
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    Elite Member sluce's Avatar
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    Sadly we can only hear the family's side of the story regarding the surgery and following complications. The hospital and doctors can't make any statements. I'm sure the details will come out when the family sues the doctors and the hospital.
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    Elite Member McJag's Avatar
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    The child is dead. Let her go. We have had to make this same decision and it was sad and horrid and had to be done.
    There comes a time when science speaks. Too late to debate should/should not surgery have been done. You have to deal with the here and the now.
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    Elite Member MmeVertigina's Avatar
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    Quote Originally Posted by McJag View Post
    The child is dead. Let her go. We have had to make this same decision and it was sad and horrid and had to be done.
    There comes a time when science speaks. Too late to debate should/should not surgery have been done. You have to deal with the here and the now.
    A major issue with me is that they would not let the parents remove the body. I can completely see how they would want to move her to a more peaceful place for them, and then let go. My grandmother was the victim of a medical error, it was very hard to see her dying there and not at home as she would have wished. I understand technically this girl is already dead, but I am sensitive to the emotional and traumatic stress aspect of this as far as the family is concerned. It doesn't harm the hospital to let them move their daughter, but it might harm them irreparably emotionally to just have it end there. It will be interesting to see if we hear anything about this after she is moved.
    Last edited by MmeVertigina; January 3rd, 2014 at 10:26 PM. Reason: words. fucking words.

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    Elite Member McJag's Avatar
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    I suggest you reread the original article. Especially this part:

    The hospital denied the accusation.

    "We have done everything to assist the family of Jahi McMath in their quest to take the deceased body of their daughter to another medical facility," hospital spokesman Sam Singer said.

    "To date, they have been unwilling or unable to provide a physician to perform the procedures necessary, transportation, or a facility that would accept a dead person on a ventilator. Our hearts and thoughts go out to them in this tragic situation, but the statements being made by their attorney and some family members are misleading and untrue."
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    Elite Member MmeVertigina's Avatar
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    Quote Originally Posted by McJag View Post
    I suggest you reread the original article. Especially this part:

    The hospital denied the accusation.

    "We have done everything to assist the family of Jahi McMath in their quest to take the deceased body of their daughter to another medical facility," hospital spokesman Sam Singer said.

    "To date, they have been unwilling or unable to provide a physician to perform the procedures necessary, transportation, or a facility that would accept a dead person on a ventilator. Our hearts and thoughts go out to them in this tragic situation, but the statements being made by their attorney and some family members are misleading and untrue."
    I see that is what the hospital is saying. But what the family is saying on the news is much different. There was one facility which supposedly backed out because of the amount of publicity this was generating. The second (supposedly again) backed out because the hospital wasn't allowing them to come in and use a feeding tube and trach tube. As it says above in the clip I posted, the family did not think it would be possible for her to make the trip without this being done. I don't know where they got their medical advice, but these were originally their thoughts on the matter. The hospital could be telling the truth as they see it. Could the family have been stalling? Who knows. Maybe they couldn't keep her there because of finances and needed extra time to find a facility. I don't know the family personally, but I trust hospitals very little. The very first day I heard about this, they were trying to get the hospital to let her stay on a bit longer, from then on it has been back and forth with the court.

    ETA I am interested to see what exactly happened in the courts, if the hospital was stopping her from being removed, I suppose it will all be released someday. I hope! Like I said this is very emotional for me, I can see the rational side but also the human side of this. I have witnessed more than a few people complaining that they are using tax money to keep her "alive". That's my tax money, and my portion says that's ok. I know not everyone sees this issue in the same way. I do think the final decision to move her to a private facility was the best one. Just how I feel, from my own life experiences, it's what I would support of friend or family member. It should be up to the parents (who legally represent her) of the minor, not the hospital. I do think this could have been about money, and the length the hospital was willing to go after the money stopped coming in to pay for her to be there. If they were willing to allow the family time, why bother with the court?

    This link contains a copy of the actual stipulation for removing her body, just in case anyone wanted to read it in full. I don't know how to copy it because of the format: http://www.mercurynews.com/breaking-...-dead-daughter

    I find this odd:
    The hospital originally required an agreement from an outside facility willing to take Jahi, but backed off that when the family agreed to take "her body unconditionally,"
    Maybe the family really does just want her to "die" anywhere but there. Even right outside the hospital.

    I think this must qualify as a brain-deadifesto or something. I found this commentary and I agree with it. I don't want to keep coming back to this thread because it is so upsetting to me, but I wanted to make sure what I was thinking was coming across correctly. http://www.cnn.com/2014/01/02/opinio...efining-death/
    Editor's note: Robert M. Veatch is professor of medical ethics and the former director of the Kennedy Institute of Ethics at Georgetown University. He is also a professor in the Philosophy Department. He has served as an ethics consultant and expert witness in over 30 legal cases including that of Karen Quinlan (1975-76) and that of Baby K (1992), the child with anencephaly whose mother won the right of access to life support for her.
    (CNN) -- After 13-year-old Jahi McMath had a tonsillectomy, she suffered cardiac arrest and loss of blood flow to her brain. Her doctors pronounced her "brain dead." But what happened next tragically exposed the challenges and confusion in American medicine over defining death. Is it when the brain stops functioning, or when circulation stops?By California law, if the brain is dead, the person is dead. According to the law in all American jurisdictions, it doesn't matter how death is measured. Doctors who persist in calling patients "brain dead" are asking for trouble. These doctors have gotten it.




    Jahi is on a ventilator. Her parents wanted a second opinion on whether she met the standard tests for the death of the brain. After the second physician confirmed that the criteria were met, the normal next step would have been to pronounce her dead and stop ventilation. But her parents continued to fight, and another extension on turning off her machines was granted. They are scrambling to move her to a facility that will treat her before the court-imposed deadline of January 7.Now the family of Terri Schiavo has joined the battle. Schiavo's case was another high-profile example of the devastation that happens when there are differences on whether someone is alive and whether to keep that person on support. Terri Schiavo, who was not brain-dead but was severely brain damaged, died in 2005 after her feeding tube was disconnected. Her parents fought for years to keep her alive against her wishes, as expressed by her husband.
    A significant minority in the medical profession continue to believe people with dead brains and beating hearts are still alive. Believers include some of our wisest minds -- a Harvard professor, an National Institute of Health theorist, a chief of neurology at UCLA, and the former chair of the U.S. President's Council all reject brain-based death pronouncement. They agree with Jahi's parents that death is linked to circulatory loss.The standard tests for the death of the brain are fairly straightforward. It is not a vegetative state -- it is absence of brain activity, and constitutes a legal measure of death in all states. And no law prohibits continued ventilation of a dead body. We do it routinely to preserve organs for transplant. Jahi's parents have decided to try to continue ventilation -- if you call it life-support you are taking a stand on whether she is dead -- so the issues become who will provide the treatment and who will pay.
    Others take a position more liberal than the standard law that defines brain death. They favor pronouncing death in some cases even when some parts of the lower brain are still functioning. I have defended that view since 1973.

    Jahi McMath 'tragedy prolonged by court'



    Mom: Jahi is dead only if her heart stops

    Why, then, does American law continue to force one standard of death on Jahi's parents and others who have plausible alternative definitions? Once one realizes that the choice among the options is not a cut-and-dried matter of medical science, why not let people have some choice based on their personal religious and cultural views?This is a "conscience-based" approach to defining death. We need to have a default public policy -- the brain-based definition currently in law -- but people like Jahi's parents should have the option to record their conscientiously held positions and allow pronouncements of death to be based on those beliefs. That's the law in New Jersey and Japan. That would mean Jahi could be classified as alive if that is what her parents choose.That, of course, doesn't end the controversy. Just like it is not illegal to provide medical support for dead people, it is not necessarily illegal to stop life-support on someone who is still alive. We do that every day, particularly for those who are permanently unconscious.The trouble arises when physicians want to stop life-support, perhaps because they believe the case is hopeless, and the patient or family insist that life support continue. We call this the "futile care problem." I defended in court the mother of a severely brain-damaged baby referred to as Baby K who wanted life support to continue even though her doctors wanted to stop. Society should show sympathy for mothers who want their children to be kept alive.If preserving life requires high-tech support like a ventilator, doctors are the ones who should provide it. The costs shouldn't be borne by the hospital. The health insurance company or Medicaid shouldn't pay. But if the family can raise the funds, like Jahi's parents are doing, and the patient is beyond feeling pain, no harm is done by continuing, especially if they can find a facility willing to take the case.Whether this right to medical support should extend to those considered dead by one standard, but alive by another is the question we face with Jahi McMath. If the patient does not suffer, and private funding is available, people should have the right to make this decision for their loved ones.
    Last edited by MmeVertigina; January 4th, 2014 at 12:54 AM. Reason: because I don't type well. Added links.

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    Elite Member Kittylady's Avatar
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    Quote Originally Posted by louiswinthorpe111 View Post
    Sleep apnea is absolutely helped by weight loss. When my hubby drops 20 lbs, his snoring drops off significantly.
    Weight can be a defining factor in OSA and should be the first thing to be addressed but (IMHO) in conjunction with other treatments while the weight loss takes place as sleep apnea is known to contribute to weight problems (I'm guessing the fatigue makes it difficult to be active and sufferers seek out high sugar food or drinks for the energy boost). However not everyone with the condition has weight issues.

    Personally I'm shocked that they jumped straight into surgery for this poor girl as it is known to be a tricky procedure with a long recovery period and some patients still end up having to go on to using CPAP or BiPAP machines within a few years of the procedure. My OH has sleep apnea and was strongly advised by his consultant not to consider the option of surgery due to the risks involved, the long and difficult recovery time, the comparatively low success rate and the high level of relapse. Instead he sleeps with a CPAP machine and wearing a mask that provides continuous air pressure to keep his airways open while he sleeps. It isn't ideal but it certainly beats the risks of leaving it untreated (heart attack/stroke/headaches/high blood pressure etc).
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