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

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"The family plans to keep Jahi on the ventilator long enough to have her flown to the New York facility, "an organization that believes in life," according to family attorney Christopher Dolan. The girl's uncle, Omari Sealey, said the family has contracted with an air ambulance to fly her across the country under the watch of a California doctor."

http://www.mercurynews.com/breaking...tal-fights-court-remove-brain-dead?source=rss

BBM.. what? Surely that doesn't mean they will remove the vent and allow her to rest in peace. I guess it means they want her on the vent on the medical transport flight? Then they can do the trach when ever they get to whatever place they say they are whisking her away to? Isn't a vent a somewhat large machine that runs on electricity?
 
I agree with you. I believe the context that you mention is tied to whatever faith-based beliefs one adheres to in a world so reliant on technology and science.

What some seem to have missed in reading the legal filings is the Hospital's failure to adhere to the standards in their first evaluation to determine brain death. All hospitals are required, by law, to adhere to standards. That seems to have bothered the Judge enough for him to extend deadlines. It certainly bothers me.

all, JMO

I didn't read the legal filings (bad lawyer!) so I'm not sure...what was their reasoning for finding that the hospital didn't adhere to standards? I did read that they held the doctors weren't sufficiently independent, and so they appointed other experts. Was there an additional problem with the brain death determination?
 
My FIL was airlifted by helicopter 40 miles to a level one trauma center recently, at a cost of $25K.

When he was moved to an acute care rehab hospital across the city, his ground ambulance transport bill was $14K.

How in the world will an air ambulance JET be able to move a vent dependent patient clear across the country for $27K, unless they are doing it for that fee as a donation of services? That wouldn't even cover aircraft operating costs.

From my experiences as a military flight nurse, I question whether or not a small jet can even do that trip on "one tank" of fuel, without stopping mid country to refuel.

So, what happens if the plane has a maintenance issue while refueling on the ground that takes hours to fix, or get another plane? What happens if the ET is dislodged? What happens if her heart has rhythm disturbances? Will they treat this on the tarmac, or try to admit her body to a local facility? There are soooo many issues surrounding the movement of this girl's body, that I can't even begin to describe it. For example, can they declare an inflight medical emergency for a patient declared brain dead, in order to obtain expedited landing somewhere?

I flew airevac for 4 1/2 years on active duty in the pacific, middle east, and europe, and another 3 years as a reservist. I can't wrap my head around all the issues surrounding this potential move. It isn't "just" planning for the ventilator, oxygen, and electrical inverters, etc. There are other fairly complicated things to coordinate, including ground transportation at either end, and any stops.
BBM Iam glad you commented on this! I was hoping you would.
I had lots of questions too.
•what is the length of the flight from California to New York?
• How much duplicate machinery/back up supplies would be required for the flight?
• How many people would need to be on board in the event of an emergency with Jahi?
• what if the doctor had a health emergency who would back him up?
•what if for some unforeseen reason she had to be manually ventilated? How long could one person do it alone?
•What effect would the ascent/descent and altitude have on her brain pressure, blood pressure and /or other bodily functions?
• What about autonomic dysreflexia. I know she is brain dead but can she have problems like quadriplegics do?
• Will ventilator settings need to be tweaked during takeoff and landing?
*I just don't see this plane ever leaving the ground.
• Who would be held responsible if her heart stops beating on its own during the flight?
Moo
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I wonder if the mother or any other family member were allowed to observe any one of the numerous (6 or 7) examinations done on Jahi to diagnosis brain death, specifically if they witnessed the respiratory drive testing (ie when they turned off the vent and Jahi did not show any sign of breathing on her own). I know that it's not standard practice to allow the family to observe but it seems like in this case it would have been undeniable proof to even the mother that Jahi is gone.
 
Agree. There is an awful lot of exploitation going on in this case, IMO. And the longer it goes on, IMO, the more exploitation there will be. The circus will get bigger and more bizarre.

There is no shortage of people willing to insert themselves and glom onto an opportunity like this to further their own agenda.

The family has the complete ability to stop the whole circus, IMO. They could keep everything confidential at this point, and stop giving interviews. Stop releasing statements thru their lawyer to the media. Shut down the social media sites, and just communicate privately with a core group of their closest supporters and family members, while the rest of this sad saga plays out. They can still pursue all the "alternative medical treatments" they wish, work to locate a facility to transfer Jahi's body to, file documents and injunctions, and work with CHO to try to get what they want (which I'm not so sure even they know what that is anymore.) They could choose to do all this privately.

IMO, the family continues to make choices to escalate this sad circus. And that directly leads to exploitation and charlatans. IMO.

I'm curious about who came up with the idea to get into the sweat shirt industry. I also wonder how long it will be before we hear about movie deals.
 
"The family plans to keep Jahi on the ventilator long enough to have her flown to the New York facility, "an organization that believes in life," according to family attorney Christopher Dolan. The girl's uncle, Omari Sealey, said the family has contracted with an air ambulance to fly her across the country under the watch of a California doctor."

http://www.mercurynews.com/breaking...tal-fights-court-remove-brain-dead?source=rss

BBM.. what? Surely that doesn't mean they will remove the vent and allow her to rest in peace. I guess it means they want her on the vent on the medical transport flight? Then they can do the trach when ever they get to whatever place they say they are whisking her away to? Isn't a vent a somewhat large machine that runs on electricity?

and the hospital owns the vent she is currently on- ruling states they do not have to assist- which means another vent has to be acquired- and there is no facility!

then there is the legal issue of the Ca. Health Law concerning transport in a sealed case if deceased is not embalmed...
 
I wonder if the mother or any other family member were allowed to observe any one of the numerous (6 or 7) examinations done on Jahi to diagnosis brain death, specifically if they witnessed the respiratory drive testing (ie when they turned off the vent and Jahi did not show any sign of breathing on her own). I know that it's not standard practice to allow the family to observe but it seems like in this case it would have been undeniable proof to even the mother that Jahi is gone.

The mother and grandmother have been quoted extensively saying they have seen with their own eyes the undeniable proof that Jahi is still right there with them. They do believe in prayer and have held prayer vigils.

JMO
 
I don't know what to think. One of my first experiences in health care was volunteering in the ER of a large hospital while I was in my first year of nursing school. So many times I saw the huge disparity in the way that PTs and families who were judged to be ignorant/uneducated and often poor we're treated vs pts and families who were deemed to be 'educated', who were able to be strong, vocal, present advocates, were well off, or who knew or were related to one of the drs were treated. I have seen drs be totally uncaring, uncompromising, and coldly condescending too many times. I think that Children's bears some fault if the dr indeed tell the mother her child was. 'Dead dead dead dead'. ]/b]No parent should have to bear that disrespect on the worst day of their lives, and I think that the way the family felt they were treated by that dr , as well as feeling pressured by the staff to remove Jahi from life support in the beginning seems to be what caused them to take such an oppositional stance to the hospital. I think from there opportunistic attorneys and denial have kept the batteries in the mothers back to continue. It's horrible; Jahi is gone. There's no doubt about that. Maybe the mother just wants her daughter to have a chance to pass away from the people she blames for Jahi's death?


Everytime I read that I think
of Dr. Gregory House. (Hugh Laurie)
Moo

Sent from my SGH-T679 using Tapatalk 2
 
Hi everyone. I'm new to MS but have been reading through most of both threads on this. I'm not sure how much can be added to the discussion at this point, but I felt a strong need to weigh in! FYI, I'm a lawyer (in CA), but admittedly not well-versed in these issues.



I think the biggest problem here is the precedent that's being set. Jahi McMath is legally, clinically dead. The law is being extended beyond its breaking point because of a family's grief and inability to let go. It really isn't in issue now if she's dead - she is, by the legally accepted definition and in accordance with procedure. More than enough experts have concurred. At this point, the only argument that could be made is overturning the law related to death, and there simply is no reason to do so. No one has recovered from brain death. While people like Dr. Byrne (and anyone else for that matter) are entitled to believe differently, IE that there is no such thing as brain death, that's not what the medical and legal communities as a whole have found. I fear the future ramifications of these decisions. We're bending everything because of this tragedy, and I personally think this is just making it worse for the family.



One thing that I haven't seen raised here (and forgive me if I'm wrong about that) is the idea that one of the reasons to even have legal definitions of death are to avoid these kinds of situations. I'm not a parent yet, so I can't begin to imagine the pain the family is going through, but if this was my kid or my loved one, I can't begin to fathom how I would get to the point of being ready to turn off the ventilator. When we have this kind of medical technology that simulates life, essentially, by keeping the heart beating, it would be so hard to find acceptance and willingness to stop the ventilator. That's why we need objective, bright line rules. So that we can say, ok, the time has come now, and as much as you don't like this/aren't ready for it, this is what has to happen. Then the family can finally begin to grieve. By allowing this to continue because they aren't ready to let go, the family has just been deluded further into believing there is hope. In my opinion, this never should have gone to court. Where is the legal issue? And even when it did, once the Stanford expert came in and concurred in the brain death declaration, this should have stopped. I've seen it argued that the family should be given time to accept it, but just imagining it for myself...I'm not sure that I would ever get there. How do you accept the death of your child? At some point I'm not sure it's fair to give the parents this kind of authority, because they aren't in a place to be making these decisions. There is too much grief. I just feel it's all gotten incredibly unethical, and as a lawyer, I can't agree with their attorney's willingness to go forward with this case.


It's a tragic and most interesting case for sure.
My own point of view, it's more about how *i* define "life" than death. When my father, whom I adored, when his time came...I let him go. It was the humane thing to do. I loved him enough to allow him to go. He wasn't "living". I held his hand as they shut the machines down and stayed until he was gone. I was shocked at how long it took and couldn't understand why they couldn't simply give him a shot. It was hard listening to his body struggle to breath on his own... Becoming more and more labored. That was hard. I thought it would be quicker. It took hours.
I know people don't like to compare animals to people but my dogs... I have loved, when they were no longer enjoying life, suffering or in pain they couldn't be eased. I love them enough to let them go too. IMO we treat our animals much more humanely when their time comes. A simple shot...it's almost beautiful when compared what we do to humans.


It would be selfish of me to try to keep them here...in my heart and mind anyway.




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I didn't read the legal filings (bad lawyer!) so I'm not sure...what was their reasoning for finding that the hospital didn't adhere to standards? I did read that they held the doctors weren't sufficiently independent, and so they appointed other experts. Was there an additional problem with the brain death determination?

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I think the family is mixing up brain death with being in a coma. How long to they plan on pumping air into a person who is no longer living?
 
I wonder why family hasn't suggested to take her home. There was another case of a brain dead boy the family took home. After one month his heart stopped beating.
With donations they could probably get some nurses to come in and take her of her.

I was wondering the same thing. These places are no more equipped to care for her than her home would be. jmo
 
I agree with you. I believe the context that you mention is tied to whatever faith-based beliefs one adheres to in a world so reliant on technology and science.

What some seem to have missed in reading the legal filings is the Hospital's failure to adhere to the standards in their first evaluation to determine brain death. All hospitals are required, by law, to adhere to standards. That seems to have bothered the Judge enough for him to extend deadlines. It certainly bothers me.

all, JMO

I agree; I think Children's has a lot to answer for even going back as far as why they determined that it was appropriate to perform such a complicated procedure on an extremely high risk pediatric patient (removing the tonsils, adenoids, and the UPPP procedure), which by the way has only about a 50% success rate over time and is not even reccomended by the American Academy of Sleep Medicine as a first line treatment for obstructive sleep apnea even in adults, and certainly not on any pt had not already tried Positive Airway Pressure therapy. See more here: http://umm.edu/health/medical/reports/articles/obstructive-sleep-apnea

Unfortunately those questions have to be separated from the fact that Jahi is now deceased and should be allowed to rest in peace.
 
I agree; I think Children's has a lot to answer for even going back as far as why they determined that it was appropriate to perform such a complicated procedure on an extremely high risk pediatric patient (removing the tonsils, adenoids, and the UPPP procedure), which by the way has only about a 50% success rate over time and is not even reccomended by the American Academy of Sleep Medicine as a first line treatment for obstructive sleep apnea even in adults, and certainly not on any pt had not already tried Positive Airway Pressure therapy. See more here: http://umm.edu/health/medical/reports/articles/obstructive-sleep-apnea

Unfortunately those questions have to be separated from the fact that Jahi is now deceased and should be allowed to rest in peace.

I don't believe the hospital decided on the surgery...that would be her primary doctor and the surgeon.
 
I agree; I think Children's has a lot to answer for even going back as far as why they determined that it was appropriate to perform such a complicated procedure on an extremely high risk pediatric patient (removing the tonsils, adenoids, and the UPPP procedure), which by the way has only about a 50% success rate over time and is not even reccomended by the American Academy of Sleep Medicine as a first line treatment for obstructive sleep apnea even in adults, and certainly not on any pt had not already tried Positive Airway Pressure therapy. See more here: http://umm.edu/health/medical/reports/articles/obstructive-sleep-apnea

Unfortunately those questions have to be separated from the fact that Jahi is now deceased and should be allowed to rest in peace.

Her family does not believe Jahi is now legally dead. Legal questions can only be answered by courts. Any of these courts could agree with them and reverse the ruling. Then what? Do you think her mother should be forced to pull the plug?
 
I didn't read the legal filings (bad lawyer!) so I'm not sure...what was their reasoning for finding that the hospital didn't adhere to standards? I did read that they held the doctors weren't sufficiently independent, and so they appointed other experts. Was there an additional problem with the brain death determination?

In a word, no.

jmo
 
Hopefully they will decide to allow their daughter to be a donor.


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I was wondering the same thing. These places are no more equipped to care for her than her home would be. jmo

I'm not sure of your point. There many families in America right now caring for their TBI children in their homes because there is a shortage of facilities and group homes. It isn't impossible.
 
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