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

[J1981]

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

I love your posts! Great point about no doctor wanting his/her name on the chart for legal reasons alone.

 

[Steft50]

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.

Thank you for saying what I was feeling and thinking as well.

 

[MyBelle]

Once again, please remember this is not a routine tonsillectomy and the patient was already scheduled to go to the PICU after the surgery.

I am quite sure the Pediatric ICU nurses at Children's Hospital are qualified to take care of these kinds of patients.

There are many kinds of work experiences and levels of competencies within the ranks of the RN degree and I think you are making unreasonable assumptions about RN's in a field you don't appear to have expertise in.

Do you have any links to support your claims the grandmother is neither a registered nurse or qualified to provide care?

According to the mother's declaration filed with the court and posted here, the move to the ICU was not "already scheduled" and came as a surprise.

 

[Karmady]

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/

http://www2.dca.ca.gov/pls/wllpub/WLLQRYNA$LCEV2.QueryView?P_LICENSE_NUMBER=136796&P_LTE_ID=815


to the main search engine if that link doesn't work:

http://www2.dca.ca.gov/pls/wllpub/WLLQRYNA$LCEV2.ActionQuery


or

http://www2.dca.ca.gov/pls/wllpub/wllqryna$lcev2.startup?p_qte_code=VN&p_qte_pgm_code=9110

 

[Herat]

I love your posts! Great point about no doctor wanting his/her name on the chart for legal reasons alone.

THIS.

I have to think no one is willing to risk losing their malpractice insurance, either.

 

[MyBelle]

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

Multiple media have referred to the grandmother as a registered nurse but it really doesn't matter.

Most grandmothers are capable of recognizing the fact that blood gushing from a child's mouth and nose is a cause for alarm in an ICU setting and should result in an immediate call to a physician.

 

[Morag]

Why wasn't Jahi required/encouraged to lose weight before her doctor would agree to operate?

Why didn't they do only the tonsillectomy at first, and then do the other surgeries after a period of recovery?

Why did she remain in the PICU for so long rather than being rushed back into surgery?

Why wasn't the family allowed into PICU for about half an hour? Were they stabilizing her, dealing with bleeding, or was there a shift change going on?

This case is so sad. The mother just wants to be able to be by her warm and breathing daughter's side. The family may be difficult and unreasonable, but surely- SURELY- the hospital could have handled this better, even if they share no blame at all in the aftermath of the surgery-ESPECIALLY- if they made no errors.

Medical professionals are not perfect; they do make mistakes, and they may have in this case. I would expect a great hospital to be less offensive to the family's sensibilities.

If they are calling Jahi 'the body', well, that's beyond the pale. When my loved ones have died, we always referred to them as, "Dad","Gramma", "Uncle Will", and the like, never "the body."

 

[Zuri]

Most ICUs have a physician who is a "criticalist", someone whose job it is to care for patients in the ICU. In Jahi's case, bleeding is to be expected, however the amount of blood varies. Unfortunately, it sounds like Jahi had an abnormal amount of bleeding, aspirated the blood and things went downhill very fast. I don't believe, and I may be very wrong, that the nurses ignored any of this. Situations change in a heartbeat, IME, and you do everything in your power to save your patient.

 

[jjenny]

How do you know she wasn't encouraged to lose weight? Child appears to be obese. I am pretty sure given that she was encouraged to lose weight. She might not have been able to. Losing weight is a lot of effort.

 

[Miziree]

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:

All 3 of my kids had their tonsils and adnoids removed and were offered popsicles (as many as they wanted) after surgery.

 

[iluvmua]

Why wasn't Jahi required/encouraged to lose weight before her doctor would agree to operate?

Why didn't they do only the tonsillectomy at first, and then do the other surgeries after a period of recovery?

Why did she remain in the PICU for so long rather than being rushed back into surgery?

Why wasn't the family allowed into PICU for about half an hour? Were they stabilizing her, dealing with bleeding, or was there a shift change going on?

This case is so sad. The mother just wants to be able to be by her warm and breathing daughter's side. The family may be difficult and unreasonable, but surely- SURELY- the hospital could have handled this better, even if they share no blame at all in the aftermath of the surgery-ESPECIALLY- if they made no errors.

Medical professionals are not perfect; they do make mistakes, and they may have in this case. I would expect a great hospital to be less offensive to the family's sensibilities.

If they are calling Jahi 'the body', well, that's beyond the pale. When my loved ones have died, we always referred to them as, "Dad","Gramma", "Uncle Will", and the like, never "the body."

Again, we are ONLY hearing the family's side of the story.

This hospital has bent over backward many times for this family and all they can do is bash them and blame them for what happened.

 

[Zuri]

Why wasn't Jahi required/encouraged to lose weight before her doctor would agree to operate?

Why didn't they do only the tonsillectomy at first, and then do the other surgeries after a period of recovery?

Why did she remain in the PICU for so long rather than being rushed back into surgery?

Why wasn't the family allowed into PICU for about half an hour? Were they stabilizing her, dealing with bleeding, or was there a shift change going on?

This case is so sad. The mother just wants to be able to be by her warm and breathing daughter's side. The family may be difficult and unreasonable, but surely- SURELY- the hospital could have handled this better, even if they share no blame at all in the aftermath of the surgery-ESPECIALLY- if they made no errors.

Medical professionals are not perfect; they do make mistakes, and they may have in this case. I would expect a great hospital to be less offensive to the family's sensibilities.

If they are calling Jahi 'the body', well, that's beyond the pale. When my loved ones have died, we always referred to them as, "Dad","Gramma", "Uncle Will", and the like, never "the body."

Good questions and IMO we don't have all the information yet. As for losing weight prior to surgery, ?. Why didn't she go back to the OR, ? Typically, patients are assessed upon arrival to an ICU without family members present and 30 minutes is pretty typical. If Jahi was stable upon admission to the ICU and settled in, the nurse could have been tending to another patient. from the info relayed by the family, it sounds like things went from stable to unstable pretty quickly. JMO

 

[MyBelle]

Most ICUs have a physician who is a "criticalist", someone whose job it is to care for patients in the ICU. In Jahi's case, bleeding is to be expected, however the amount of blood varies. Unfortunately, it sounds like Jahi had an abnormal amount of bleeding, aspirated the blood and things went downhill very fast. I don't believe, and I may be very wrong, that the nurses ignored any of this. Situations change in a heartbeat, IME, and you do everything in your power to save your patient.

I agree that some bleeding would be expected but the bigger question remains as to why the bleeding wasn't better managed and was allowed to escalate to a catastrophic outcome.

The Mother's declaration to the court states says nurses refused their request to summon a physician. I've not seen any link to an explanation from the hospital as to why the nurses delayed summoning a doctor.

 

[MyBelle]

Good questions and IMO we don't have all the information yet. As for losing weight prior to surgery, ?. Why didn't she go back to the OR, ? Typically, patients are assessed upon arrival to an ICU without family members present and 30 minutes is pretty typical. If Jahi was stable upon admission to the ICU and settled in, the nurse could have been tending to another patient. from the info relayed by the family, it sounds like things went from stable to unstable pretty quickly. JMO

If she was too obese for the surgery, why did the surgeon go ahead with it? I'm still uncertain why all three procedures were required at the same time.

 

[momrids6]

http://www2.dca.ca.gov/pls/wllpub/WLLQRYNA$LCEV2.QueryView?P_LICENSE_NUMBER=136796&P_LTE_ID=815

to the main search engine if that link doesn't work:

http://www2.dca.ca.gov/pls/wllpub/WLLQRYNA$LCEV2.ActionQuery

or

http://www2.dca.ca.gov/pls/wllpub/wllqryna$lcev2.startup?p_qte_code=VN&p_qte_pgm_code=9110

Using this middle name- I get no results: maybe I am doing something wrong. I thought the LVN has a middle initial/name beginning with M?

Jahi’s grandmother, Sandra Jo Chatman, told KTVU she kept asking for help from nurses but says no one would answer her pleas.

http://newsone.com/2813129/teen-goes-in-for-routine-tonsil-surgery-winds-up-on-life-support/

 

[iluvmua]

I agree that some bleeding would be expected but the bigger question remains as to why the bleeding wasn't better managed and was allowed to escalate to a catastrophic outcome.

The Mother's declaration to the court states says nurses refused their request to summon a physician. I've not seen any link to an explanation from the hospital as to why the nurses delayed summoning a doctor.

There will not be an explaination about ANY of this case from the hospital because Jahi's family refuses to let the hospital speak.

The hospital wants to speak, but the family will not allow it.

 

[iluvmua]

Using this middle name- I get no results: maybe I am doing something wrong. I thought the LVN has a middle initial/name beginning with M?

Jahi’s grandmother, Sandra Jo Chatman, told KTVU she kept asking for help from nurses but says no one would answer her pleas.

http://newsone.com/2813129/teen-goes-in-for-routine-tonsil-surgery-winds-up-on-life-support/

I doubt very seriously the nurses would not respond to the calls for help.

 

[momrids6]

I've not seen any link to an explanation from the hospital as to why the nurses delayed summoning a doctor.

RSBM: As it has been stated, the hospital is not allowed to discuss anything.

 

[MyBelle]

Again, we are ONLY hearing the family's side of the story.

This hospital has bent over backward many times for this family and all they can do is bash them and blame them for what happened.

It was Judge Grillo who decided the Hospital failed to follow standards when initial brain death was determined. The Hospital has offered no explanation why they didn't follow standard procedure. The hospital's willingness to ignore standards does indicate the hospital's administrator, Dr. Duran, wanted to rush the family's decision because at the point Jahi was declared brain dead, Jahi's financial value to the hospital substantially increased, in my humble opinion.

all, JMO

 

[MyBelle]

RSBM: As it has been stated, the hospital is not allowed to discuss anything.

The hospital is allowed to discuss it in their court filings and responses, imo.