Family wants to keep life support for girl brain dead after tonsil surgery #2

[wendiesan]

Is the guy they wanted to examine her a pediatrician? I noticed that the papers say he "visited" rather than "examined."

Yes. Byrne can't practice in CA. He does not have hospital privileges at CHO. He can visit. He can talk. Byrne's a pediatrician, so he is not qualified in any state to diagnose brain death, but he doesn't believe brain death exists. He can, of course, state his opinion. CHO has already spoken about his credentials in previous court submissions, which are linked in the last thread. Byrne can reinforce what the family already believes because that's what his books are all about. He is against organ transplants, and believes that "brain death" is a way of taking organs from a living person. I have links in the last thread, but, since this is a nameless doctor, I have no way of knowing if it is, in fact, Byrne.

 

[Piekun]

IMO the family has fabricated some facts. The surgery was not routine nor was the child healthy before she went in for surgery, that is how the case was presented to the media when the family first went public.

They have also stated that certain readings on her breathing machine have indicated that she is recovering and attempting to breathe on her own. They have been told by the nurses that the readings they were seeing were not evidence of recovery or attempts to breathe on her own, but they still have made that claim to the media.

 

[jandkmom]

From a public relations standpoint at this time, I would think the hospital would come out with a statement saying that they send their condolences to the family and that they will do anything within their means to try and help the family deal with their loss. They should say that if the family would like to move their daughter to another facility for their peace of mind, then the current hospital will do all they can on their end to make it possible.

The hospital doesn't need to look like they are being hard-hearted to a family that hasn't come to terms with the loss of their child. If there is going to be a lawsuit, and I imagine that there will be, the hospital needs to show that they did all that they could do medically and emotionally to help this family. A jury will not look kindly to a hospital that refers to a grieving family in an unkind way.

 

[scmom]

The mother had to sign the consent form for the surgery to be done. I'm sure she was trying to do the right thing for her daughter's health. Unfortunately for Jahi and her family, there were complications which have resulted in her death. I have no doubt the mother is blaming herself for giving consent to the surgery and she is overwhelmed with guilt and grief. She does not want to let Jahi go but the child is gone. Only her body is lying in that hospital bed and her mother will never again hear her laugh or cry. If the family is successful in having Jahi moved to another facility there will be no improvement in Jahi's condition and eventually all of her organs will stop functioning. I feel sympathy for the pain Jahi's mother is going through but there's not going to be a happy outcome. I guess it's really up to the court to say how long Jahi's body will be maintained by mechanical means.

 

[vlpate]

From a public relations standpoint at this time, I would think the hospital would come out with a statement saying that they send their condolences to the family and that they will do anything within their means to try and help the family deal with their loss. They should say that if the family would like to move their daughter to another facility for their peace of mind, then the current hospital will do all they can on their end to make it possible.

The hospital doesn't need to look like they are being hard-hearted to a family that hasn't come to terms with the loss of their child. If their is going to be a lawsuit, and. I imagine that there will be, the hospital needs to show that they did all that they could do medically and emotionally to help this family. A jury will not look kindly to a hospital that refers to a grieving family in an unkind way.

I've seen the spokesperson (singer?) offer condolences and understanding in a few of the articles. Moving brain dead patients to nursing facilities is hardly a common practice for hospitals...I don't think they are being hard-hearted, this is a highly unusual case. They still have to consider their liability because they are a business. I've sensed no unkindness as far as what I've actually seen quoted from the hospital. I think the PR for the family has made it seem they have been harsh though.

 

[Piekun]

From a public relations standpoint at this time, I would think the hospital would come out with a statement saying that they send their condolences to the family and that they will do anything within their means to try and help the family deal with their loss. They should say that if the family would like to move their daughter to another facility for their peace of mind, then the current hospital will do all they can on their end to make it possible.

The hospital doesn't need to look like they are being hard-hearted to a family that hasn't come to terms with the loss of their child. If their is going to be a lawsuit, and. I imagine that there will be, the hospital needs to show that they did all that they could do medically and emotionally to help this family. A jury will not look kindly to a hospital that refers to a grieving family in an unkind way.

BBM, they have said and done that repeatedly. They have offered their condolences in almost every statement they've made, they have relaxed their visiting hours and rules for the family, they have offered support services for the family, etc.

They have also said that they would consent to having her moved to another facility, but they are not going to operate on a dead body to add in the feeding tube. They are not in the minority there either, IIRC the family said one of the facilities withdrew their offer because their doctors objected to operating on a brain dead patient.

 

[MyBelle]

It's already happing if the patient is brain dead and there is no hope of recovery. Ventillator is turned off. They don't normally keep brain dead persons on ventillators forever. There is no point to it, since it's not possible to recover from brain death.

The entire original point of this complaint is that the law recognizes the parent has a right to make the decision, not the hospital.

In this case, according to the court documents, the Judge found that the hospital did NOT follow the recognized standard when the first two physicians determined brain death and that is why he ordered another one.

The mother sensed the hospital was doing something wrong and I admire her determination to go to court. Every parent who has made the decision to disconnect the ventilator on their child at that hospital should be concerned.

 

[jjenny]

Yes. Byrne can't practice in CA. He does not have hospital privileges at CHO. He can visit. He can talk. Byrne's a pediatrician, so he is not qualified in any state to diagnose brain death, but he doesn't believe brain death exists. He can, of course, state his opinion. CHO has already spoken about his credentials in previous court submissions, which are linked in the last thread. Byrne can reinforce what the family already believes because that's what his books are all about. He is against organ transplants, and believes that "brain death" is a way of taking organs from a living person. I have links in the last thread, but, since this is a nameless doctor, I have no way of knowing if it is, in fact, Byrne.

Oh yea, it's him.

"In a declaration filed with the federal action by Jahi's family, Dr. Paul Byrne, a pediatrician who has questioned the definition of brain death, said he visited Jahi's bedside and observed her responding to her grandmother's voice and touch with a squirming movement."

http://www.sfgate.com/news/medical/...nded-for-girl-declared-brain-dead-5100915.php

 

[vlpate]

IMO the family has fabricated some facts. The surgery was not routine nor was the child healthy before she went in for surgery, that is how the case was presented to the media when the family first went public.

They have also stated that certain readings on her breathing machine have indicated that she is recovering and attempting to breathe on her own. They have been told by the nurses that the readings they were seeing were not evidence of recovery or attempts to breathe on her own, but they still have made that claim to the media.

Do you have any of the articles handy that explain the other procedures...I saw something in the Daily Mail, but ...well, it's the Daily Mail. I gather there was more to it as far as removing tissue for the sleep apnea...and maybe a procedure for incontinence? Going off memory so I would love a good reference article for exactly what she had done. Thanks

 

[Piekun]

Do you have any of the articles handy that explain the other procedures...I saw something in the Daily Mail, but ...well, it's the Daily Mail. I gather there was more to it as far as removing tissue for the sleep apnea...and maybe a procedure for incontinence? Going off memory so I would love a good reference article for exactly what she had done. Thanks

Here's an article from NBC:

http://www.nbcbayarea.com/news/loca...ep-Jahi-McMath-on-Life-Support-236808851.html

Relevent snippet:

"Doug Straus said this case is not about a “routine” tonsillectomy. He said the surgery was complicated from the beginning, as three procedures were being done simultaneously. The three surgeries, according to court documents, were: an adenotonsillectomy; a uvulopalatopharyngloplasty, or UPPP, which is tissue removal in the throat; and submucous resection of bilateral inferior turbinates, which is nasal obstruction. The family has previously said the surgery was to help fix Jahi's sleep apnea."

 

[Zuri]

I am not familiar with CHO, but I would imagine every single social worker, pastoral care, grief counselor have also been involved with Jahi and her family. They deal with children's medical problems every day. I really hope this mom has really good pastoral care on the outside. Not a grandstanding one, but one of compassion and understanding. This is such a sad case. I hope whatever the mother is hoping to accomplish, she can. She needs to give herself forgiveness and permission. And Mourn her daughter.

 

[Piekun]

Oh yea, it's him.

"In a declaration filed with the federal action by Jahi's family, Dr. Paul Byrne, a pediatrician who has questioned the definition of brain death, said he visited Jahi's bedside and observed her responding to her grandmother's voice and touch with a squirming movement."

http://www.sfgate.com/news/medical/...nded-for-girl-declared-brain-dead-5100915.php

Oh jeez. :banghead:

The family requested him at the original hearing earlier in the month and was denied, correct? Hopefully the judge does the same here.

 

[sherbetjello]

The mother is to blame because she followed a physician's opinion? Did she force the surgeon to perform the procedure? And are you saying the gushing of blood was because the child was talking? That's all new.

Please provide links to where you heard all of this. Thanks.

Not who you asked to respond, but here is an article:

Family members say the 8th grader was alert and talking after doctors removed her tonsils, adenoids and extra sinus tissue in a surgery earlier this month.

http://www.cnn.com/2013/12/30/health/jahi-mcmath-girl-brain-dead/index.html


Another article, based on 12/16/13, from SFist:

When Jahi came out of surgery, she appeared healthy and alert, and was eating a Popsicle, her mother said. The girl was talking and reading notes before blood began pouring from her nose and mouth, she said.

http://sfist.com/2013/12/16/oakland_girl_brain_dead_after_routi.php

 

[BeginnersLuck]

Jahi was examined by 2 hospital physicians, 3 physicians unaffiliated with the hospital and the court appointed physician

http://www.mercurynews.com/breaking...land-court-appoint-independent-expert-examine

In a legal filing, an attorney for Children's Hospital Oakland maintained that "two separate Children's physicians determined that Ms. McMath was brain dead. In addition, at the request of the family, three additional independent physicians -- unaffiliated with Children's and either selected or approved by Ms. McMath's family/next of kin -- examined Ms. McMath.

"Each confirmed the diagnosis of brain death. ... Accordingly, Children's has declared Ms. McMath to be dead."

 

[BeginnersLuck]

From a public relations standpoint at this time, I would think the hospital would come out with a statement saying that they send their condolences to the family and that they will do anything within their means to try and help the family deal with their loss. They should say that if the family would like to move their daughter to another facility for their peace of mind, then the current hospital will do all they can on their end to make it possible.

The hospital doesn't need to look like they are being hard-hearted to a family that hasn't come to terms with the loss of their child. If there is going to be a lawsuit, and I imagine that there will be, the hospital needs to show that they did all that they could do medically and emotionally to help this family. A jury will not look kindly to a hospital that refers to a grieving family in an unkind way.

They have said these almost exact same words.

 

[jandkmom]

BBM, they have said and done that repeatedly. They have offered their condolences in almost every statement they've made, they have relaxed their visiting hours and rules for the family, they have offered support services for the family, etc.

They have also said that they would consent to having her moved to another facility, but they are not going to operate on a dead body to add in the feeding tube. They are not in the minority there either, IIRC the family said one of the facilities withdrew their offer because their doctors objected to operating on a brain dead patient.

I didn't mean to imply that they haven't, just that in every statement that the need to repeat that, because their statements will be read in court.

If she already isn't on a feeding tube currently, why would they need to install one before she leaves? Couldn't the receiving facility do that? If the receiving facility refuses to take the patient, the the family will have no choice. I hope that she can transfer somewhere else just for the peace of the family.

 

[jjenny]

I didn't mean to imply that they haven't, just that in every statement that the need to repeat that, because their statements will be read in court.

If she already isn't on a feeding tube currently, why would they need to install one before she leaves? Couldn't the receiving facility do that? If the receiving facility refuses to take the patient, the the family will have no choice. I hope that she can transfer somewhere else just for the peace of the family.

Receiving facilities might not be equipped to do these surgeries. The hospital will agree to have a doctor come in and do them from a different hospital.
So if there is any doctor out there who doesn't believe in brain death then presumably he/she can come in and do these things.
Although of course if the child's body doesn't make it through the procedures will this doctor be sued for malpractice?

 

[SeekingJana]

END OF THE LINE IN THE ICU
jmo- but it sounds like heck on earth!
This is a long article and not for the faint of heart, but for those realky wanting to know what (could) be going on with sweet Jahi, very infromative.
moo
Original article.
http://www.brooklynrail.org/2012/11/express/end-of-the-line-in-the-icu

Reprinted in a blog -same article.
http://thehealthcareblog.com/blog/2012/11/16/end-of-the-line-in-the-icu/

Sent from my SGH-T679 using Tapatalk 2

Respectfully, I read the article, and I think this particular nurse is too young emotionally to be in any situation with long term care patients.
She might do well in E.R., or O.R., but she is obviously living in a dream world to think that every elderly patient will have a DNR in place, or will have one ordered by the attending physician for her emotional comfort.

The one thing that is clear is that their ventilator patients are not sedated adequately. I have been conscious and with an endotracheal tube connected to a mechanical ventilator to save my life. It hurt very badly. I had no IV sedation because of the surgical problem I mentioned earlier- they were waiting for me to react completely from a prolonged anesthetic agent.

Beyond that, NO ONE comes into a regional or level one trauma center ICU, especially, with a " cure by" date stamped on their forehead. Some people in all patient care areas will be long term care patients. I once cared for a darling baby girl for 3 months. She was born with part of her brainstem not developed. She could not regulate her body temperature or respirations well. We got her at about 9 months old, and she was a beautiful, loved daughter. Her parents were so grateful for the nursing care and the supportive care we gave them as she got sicker. On the day she passed quietly away without any struggle at all, she was dressed to the nines, clean, smelling so sweet, with her curly hair so pretty around her dimpled face. I guess the point is that love is required when death is on the table.

This nurse was biased against elderly patients. I see that very clearly in her writing, as all her examples are of elderly people. I would like to have told her about the two 19 year old girls I took care of in ICU, next to each other, but strangers. Their families bonded in the ICU waiting room, they posted photos of the girls before their devastating separate car accidents and brain/ facial swelling.
I loved both of those girls, I still remember their names, and I remember their families, and I never heard either girl ever speak a word.

I would cry over their situations, but when I was with them, as I cared for them, I talked to them, I told them jokes, I talked to each one about what was happening on that date, I made sure they faced something pleasant to look at, and that their rooms smelled good, and finally got the families to bring their favorite music, as I believe music bridges so many gaps and stimulates awareness.
Both teenagers did eventually leave our hospital. One walked out, the other, whose parents and twin sibling were killed in what appeared from the photos to be the most minor one car accident imaginable, was transferred to a long term brain rehabilitation center.

My point is that a good nurse does not think she can pick and choose her patients. They come, we assess, and work according to the physician's orders and our best nursing practices.
I am looking back with eyes wide open and over 35 years' experience.

Not all of us called our patients by a room number to other staff members ( one of my pet peeves). Not all of us allowed our patients to get to the point that this nurse did. We got anti-diarrheal medicine ordered before we were " elbow deep in diarrhea". We humanely sedated our ventilator patients with the IV sedation drips ordered for them.
A barely conscious person can tell whether the person standing over them cares for them or not. I know this from being that person.

Contrary to how this nurse viewed Code Blue events, the most grateful patients I ever had were the ones who had a totally unexpected Code Blue, were resuscitated, lived, and were able to tell us " Good- bye" as they were wheeled out to their homes. A Code Blue is not a death sentence.

One last thing that does apply to Jahi- It is my belief that Jahi's nurses consider it a privilege to care for her, to assist her family to be with her and spend time with her. I know they feel the tragedy of the situation away from the hospital but probably not while they are focused on her. I have had high profile people in ICU ( celebrities and their family members) and that part of their personality ceases to matter to those taking care of the person. I do not believe that the publicity of this situation has negatively impacted Jahi's nursing care. If anything, I think the nurses are more careful and communicate more with the family. I know I would.

Thanks for letting me share a different viewpoint about long-term patients in an acute care setting. :loveyou:

 

[jandkmom]

Jahi was examined by 2 hospital physicians, 3 physicians unaffiliated with the hospital and the court appointed physician

http://www.mercurynews.com/breaking...land-court-appoint-independent-expert-examine

I agree that the physicians are independent, but I imagine that the family doesn't trust anyone saying anything that comes out of that hospital. I was hoping that a quick transfer and then a diagnosis from someone that they trusted would bring this to a reasonable conclusion.

If they are seeing their daughter every day and see anything that gives them hope, then a change of facilities may help them see the reality.

 

[scmom]

What I want to know is what stopped the bleeding? Surely there had to have been some procedure done but I haven't seen anything about this. Wouldn't she have been taken back to the OR?