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

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How practical is it to transfer Jahi to a long-term facility in New York when her family lives in California? Presumably, they would want to be close to Jahi while she continues to "recuperate". Does this family have the means to move across the country and/or stay in temporary housing for weeks, months, or longer? Perhaps they are too emotionally distraught to consider the big picture. :moo:
 
How practical is it to transfer Jahi to a long-term facility in New York when her family lives in California? Presumably, they would want to be close to Jahi while she continues to "recuperate". Does this family have the means to move across the country and/or stay in temporary housing for weeks, months, or longer? Perhaps they are too emotionally distraught to consider the big picture at the big picture. :moo:

The next thing we will be hearing is that Obama is involved in this. jmo
 
I posted this on the previous thread shortly before it was closed. I don't think that anyone responded, so perhaps not many folks saw my post. I'm curious about what Jahi knew/understood about her surgery.

I've only read a few articles, watched/listened to some reports about this case but haven't read every post in this discussion. Has there been any mention of how thoroughly Jahi herself was educated about her impending surgery? I realize that physicians and her parents had the ultimate say in the procedures, but was Jahi made aware of the inherent risks of the surgery?

I was away at college when one of my sisters had open heart surgery at age 14, but I knew that she was included in most discussions regarding the procedure. My mom told me that the surgical "team" met with my sister and talked to her about each step of the procedure. She was able to ask questions and had ample knowledge of what to expect before, during, and after surgery.

I hope that Jahi's family can let go and begin to grieve and heal.

I'm not sure. I recall an article (don't have the link handy) that said she was afraid of the procedure. She was afraid she wouldn't wake up, per the mother. Other than that, I don't know. :dunno: Maybe someone else does.

I'll see if I can find the link....


ETA: Here it is.....

"Before the surgery she said, 'I am scared Mommy.' I said, 'Why Jahi?' She said, 'I am afraid I won't wake up.' I told her it was going to be fine, it was a simple procedure. I should have listened to her.

http://www.mercurynews.com/breaking...-letter-from-jahi-mcmaths-mom-keep?source=pkg
 
Do we know for sure that the grandmother is a nurse? Could she be an OR tech? Or a scrub tech? The only thing I have read is that the grandmother is employed by the Kaiser Permanente Department of Surgery IIRC. Sometimes the press will use the term nurse to describe any healthcare worker involved in patient care. Big difference between levels of education and accountability to standards of care. Nurse practitioners and nurse anesthetists have more education than I do, usually at the masters level. I would never dream of walking from the ER to the OR and try to do the OR tech's job either. My career has been mainly in adult critical care. Even though I have worked in adult ICUs, I would never presume to be able to walk in and work in a pediatric or neo natal ICU without significant training and orientation. JMV, IMO, JMO, IMPO, JMPO
 
Do we know for sure that the grandmother is a nurse? Could she be an OR tech? Or a scrub tech? The only thing I have read is that the grandmother is employed by the Kaiser Permanente Department of Surgery IIRC. Sometimes the press will use the term nurse to describe any healthcare worker involved in patient care. Big difference between levels of education and accountability to standards of care. Nurse practitioners and nurse anesthetists have more education than I do, usually at the masters level. I would never dream of walking from the ER to the OR and try to do the OR tech's job either. My career has been mainly in adult critical care. Even though I have worked in adult ICUs, I would never presume to be able to walk in and work in a pediatric or neo natal ICU without significant training and orientation. JMV, IMO, JMO, IMPO, JMPO

She is an LVN, licensed in the state of CA since 1987 I believe.
 
I'm curious about post op instructions. Was she supposed to be talking immediately after surgery?[/QUOTE]

I'm sure there are strict instructions for a patient who just has sugery. Jahi was not just going in for a routine surgery. Her mother lied about that.

From what I know, she was going in for 3 different surgeries.

It seems to me that the family broke the rules following instructions and now they are bashing and blaming the hospital.

I do not trust this family at all.

Again, We are only getting the families side of the story.
 
The courts will put a stop to this.

Psychologically, the mother may have been backed into a corner where she cannot comfortably accept the reality and inevitable outcome without a severe loss of face in public, and probably a huge reprimand from the attorney she is hoping will deliver millions of $$$$ in the lawsuit.

Lots of coercive factors operating here. Someone needs to find her an "out". That is what negotiations and mediation are about.

Exactly, Herat. Agree 100%. Professional negotiators (good ones) always strive for some kind of "win win" outcome that allows both sides to maintain dignity and save face.

Making it into a situation where both sides dig in and one side has to "lose" is never productive, IMO. The situation only escalates.

This situation has recruited such a social media following of supporters for the family that there is a real psychosocial/ cultural issue with "loss of face" as the family continues to "battle the courts and the hospital".

There is a way to save face, IMO. The family needs to take control of decision making in the ways that they can, and communicate that with confidence to the media sand their supporters, if they need to.

For example, to "take control", they could announce that they have made the loving decision to take Jahi home, and request support (hospital bed, volunteer staff, etc) from their group of supporters. That would give goal directed purpose to rallying "their" troops. And allow the family to both save face, and be in control.

They could announce that they will be making no further media or social media statements personally, or thru their lawyer, and that they need media distance and privacy to come to terms with the best way to proceed. They could explain that they are exhausted, drained, and need to withdraw for a while and focus on their needs, and the needs of their other kids, as they make decisions. And profusely thank their supporters, and exit the media frenzy.

Another example is that they could announce that they (not the hospital) have decided to withdraw ventilator support. The hospital would be happy to confirm, at the family's request, that the family had made the difficult decision to withdraw support, and they would do their best to continue to support the family's needs as the family makes the final arrangements. I'm guessing the hospital would even do a joint press conference with the family, and let them be the speakers while the attorneys and docs just stand there quietly.

There are a number of ways, IMO, to get to a "save face" resolution. I really hope there are professional negotiators behind the scenes trying to arrange this.

I wish the judge had ordered mediators to be involved from the beginning, along with counselors (or social workers or psychologists) from outside the hospital. The judge could have mandated daily structured meetings with a negotiation team that reports back to the judge every 48-72 hours or something. (NOT a yelling and shouting fest-- a structured and focused meeting, with ground rules, and an list of issues and topics to update progress every day.) The family, or the family lawyer, and a clergy rep or other supporter could attend, as they prefer, for example. That is how purposeful negotiation works best. The judge could have gagged both sides, and quelled the media frenzy. Or the judge could have put limits on what kind of press releases occur from both sides, such as only allowing written statements released to media. (Maybe, I am not a lawyer, but these types of things seem reasonable to me.)

As it stands, the judge (IMO) paved the way for this battle to continue, and escalate. Look at the fiasco of Singer and Dolan bickering in front of a crowd of cameras-- good grief.
 
I'm curious about post op instructions. Was she supposed to be talking immediately after surgery?[/QUOTE]

I'm sure there are strict instructions for a patient who just has sugery. Jahi was not just going in for a routine surgery. Her mother lied about that.

From what I know, she was going in for 3 different surgeries.

It seems to me that the family broke the rules following instructions and now they are bashing and blaming the hospital.

I do not trust this family at all.

Again, We are only getting the families side of the story.

I wonder if Jahi actually asked for a popsicle or if her mother suggested it to her daughter. Jahi's mother seems obsessed about her child's eating. :moo:
 
Thank you, SwampMama, and thank you K_Z.

My next question: is CHO legally required to feed her at this point? She has been declared deceased by six? doctors and a judge. From what I understand, the ventilator extension is so that the family can have more time to move her to a facility. I have tried to read the court documents but I can't load all of them for some reason, so any input would be appreciated.

BBM.

No. The judge ordered continuing the current (as of that hearing) therapies. I presume there was another order to not perform the trach and feeding tube, since the family atty had to file an appeal of that ruling.

Whatever she had in place at that first hearing (vent, IV fluids, monitoring, meds) likely has been continued "as is", with no new medical intervention. Her body certainly is receiving physical care from nurses-- bathing, mouth care, suctioning, skin care, turning, recording various vital signs and machine settings, etc.

I don't think she ever had NG feeding initiated, from what I can gather. She was found to be brain dead before that became an issue of concern.

Tube feeding is really completely unnecessary, at this point, and would only create far more problems than they currently have. IMO. The mother's public comment about feeding, and comments about her being "thick" and "still looking good" were really appalling to me. I really cannot grasp a mother saying that in public in this situation. I can't imagine a mother saying that to someone in private, and it is beyond cringe-inducing to hear it from the mother in such a public forum, IMO. My jaw literally dropped open. It did nothing to improve the public perception of this mother and family, IMO. And it did nothing to lift up and enhance the image and perception of their daughter. It was unconscionably rude and disrespectful, IMO. My eyes stung with tears for Jahi when I heard her say that. How embarrassing and heartbreaking that would be to a 13 year old if they could hear their mother say that about them as they lay connected to a ventilator, brain dead? Painful.

I would be interested to know what orders or guidelines there are for the staff in the notes that instruct what should be done if the heart begins to have rhythm disturbances. Do they have parameters for interventions for things like BP? CVP? Blood glucose? Oxygenation? ETCO2? AGB's? Labs? If urine output drops off, do they do anything? Etc, etc, etc. This doesn't really fit the category of DNR, or even care related to maintaining the body for organ harvest, and yet it isn't a "full code" situation either. It's not really a palliative care situation, either. So, I'm curious how all of the care orders are maintained in a situation like this, weeks after declaration of death. I'm sure we will not hear anything about this, but I'm curious, nonetheless.
 
Judge is the one who extended the time twice. The first time so she can be examined by another specialist. The second time I see no apparent reason, since she is legally dead in CA and hospital has a right to turn off ventillators on legally dead patients. Judge did declare her to be legally dead. So why is he extending the time?

All of this is being done on an extremely expedited basis given the TRO procedures and appeals. I continue to believe that there are two reasons the time has been extended. The first is probably the primary reason, imo, and that is due to the ability of the lawyers and judges to have time to file papers and schedule emergency hearings in the middle of the holiday season. The courts have been closed on and off over the past two weeks due to the holiday schedule, etc. So I think it's the timing coupled with the nature of the issues involved. The Judge would want to ensure that things are handled expeditiously but fully.

The second reason is, imo, that the trial court judge doesn't want to be the final arbiter. That's not uncommon even in far more mundane matters. jmo

I haven't seen the Fed Court order. Does anyone know where I can read it?

eta: Also, many times Judges make decisions that can appear biased in one direction and then come down in an entirely different way. Lots of times a Judge faced with a controversial issue will allow more leeway just to ensure that the final decision is unimpeachable. jmo
 
I'm just very puzzled that they're even suggesting that airlifting their braindead daughter across the country to move her to a construction site in NY would be a desirable course of action. If construction sites are an option, can't they find one in California?

BBM. It would almost be funny, if it weren't true, and so very sad. And warped, and misguided, and a whole host of other adjectives. That kind of a "plan" doesn't do anything to improve the public and court perception of the family, their lawyer, and others "involved" with setting up this ridiculous "plan".

I can't imagine the judge is going to be accepting of a plan to move a brain dead person to a construction site across the country. It's beyond absurd and delusional.

And beyond that, why is the MSM not writing and reporting about the construction site "plan"?? Good grief, if we can find out info about this place in Medford with a few strokes of the keyboard, so can they.

The "journalism" in reporting about this sad case has been beyond incompetent, imo. No balance, no research, factual and medical errors in nearly every article. I guess my expectations for journalists are too high. :twocents:
 
I'm not sure. I recall an article (don't have the link handy) that said she was afraid of the procedure. She was afraid she wouldn't wake up, per the mother. Other than that, I don't know. :dunno: Maybe someone else does.

I'll see if I can find the link....


ETA: Here it is.....

"Before the surgery she said, 'I am scared Mommy.' I said, 'Why Jahi?' She said, 'I am afraid I won't wake up.' I told her it was going to be fine, it was a simple procedure. I should have listened to her.

http://www.mercurynews.com/breaking...-letter-from-jahi-mcmaths-mom-keep?source=pkg

Personally, I don't think it matters. Lots of kids are scared of surgical procedures and have them anyway. Same with adults. In my situation, if my dd needed surgery I'd have to tell her I was taking her shopping just to get her in the car. And she'd likely have to be sedated to get her into the hospital! In her case, I'm not sure what good a doc informing her would do. I'm pretty sure it wouldn't matter, and might even make the situation worse. Of course we don't know what Jahi was like in that regard...so. Imo, this is just a Mother taking a normal fear and erroneously attributing some prescient quality to it. jmo
 
She is an LVN, a licensed vocational nurse.

She has very limited ability to provide basic nursing care, but cannot administer meds, start IV's etc. She can probably take vital signs using an automated instrument on non-critically ill people, bathe them, provide some assistance with meals or dressing or toileting.

On the nursing hierarchy, she is on the next to the lowest step and not at all qualified to be making any comments about surgical procedures, medications, or ICU care.

BBM. Link please. Various media have consistently reported the grandmother is a registered nurse, many have also added she has worked for years at Kaiser and in the surgery department and so far, Kaiser has not disputed it.

Jahi's grandmother, Sandra Chatman, who is a registered nurse, said last week. "I know Jahi suffered, and it tears me up."

http://www.cbsnews.com/news/jahi-mcmaths-family-faces-monday-life-support-deadline/
 
I asked Dr. Zuri, who is a GP in private practice since 1987, if a judge could force a physician to perform a trach and insert a feeding tube on a brain dead patient. He said No. IHPO, it would be "unethical" and considered "torture". He also said, no physician wants their name on that chart unless absolutely necessary because of LAWSUIT. Generally, In a malpractice lawsuit, every single person whose name appears on the chart is going to be named. Nurses are usually covered under the hospital's malpractice insurance policy. I believe Physicians that are employed by the hospital are covered as well, however a lot of them carry additional coverage IIRC. JMO
 
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