Family wants to keep life support for girl brain dead after tonsil surgery #3

[J1981]

"At 1 p.m. on Tuesday, U.S. District Judge Saundra Brown Armstrong in Oakland is expected to hear arguments about possible violations of Jahi's civil rights, and the rights of families - not doctors, lawyers or politicians - to determine a loved one's death, based on their religious or personal beliefs."

Link: http://m.sfgate.com/bayarea/article/Jahi-McMath-family-hospital-to-meet-for-5109332.php

This is scheduled for 4 hours before the TRU expires. Me thinks it will be extended again. IMO.

 

[Softail]

FYI- The links to all the court documents have been added to the opening post of the thread.



Broken quotes are a very tedious time consuming task requiring going back through the pages to confirm the original poster. It takes the moderator away from alerts and reading the thread. All the broken quotes on this thread have been repaired.
Please alert as soon as one is posted!!!

Broken quotes happen for so many reasons.... Y'all can self help....

If a quote seems to be broken.. fix it yourself.. The format Is

 

[Minette]

For those posters with medical backgrounds, a question about preoperative testing: are the tests that are done the same for adults and children, or are there certain tests that are done for adult patients (e.g., pregnancy, etc.) but not for children? If different tests are done for children, is it based strictly on age?
Thanks!

 

[MsSeal]

Thank you Steft50

I applaud you for the best said comments on real feelings today!!

I was in Walmart yesterday and saw a few girls that reminded me of Jahi and there was a such a wave of sadness that came over me.

 

[sherbetjello]

Judge orders talks between Jahi McMath's family, Children's Hospital Oakland
The judge issued an order Thursday instructing representatives of Children's Hospital Oakland and the family of Jahi McMath to attend the mandatory settlement conference and try to avoid going to trial.

http://www.cbsnews.com/news/judge-o...hi-mcmaths-family-childrens-hospital-oakland/

 

[Herat]

"At 1 p.m. on Tuesday, U.S. District Judge Saundra Brown Armstrong in Oakland is expected to hear arguments about possible violations of Jahi's civil rights, and the rights of families - not doctors, lawyers or politicians - to determine a loved one's death, based on their religious or personal beliefs."

Link: http://m.sfgate.com/bayarea/article/Jahi-McMath-family-hospital-to-meet-for-5109332.php

This is scheduled for 4 hours before the TRU expires. Me thinks it will be extended again. IMO.

I think it will be extended again, too. Just too much going on in the courts with different judges and different items. I think this is a very weak argument, but linking her to the ADA as disabled may be take a longer time to discuss and review in court.

Now this is distrupting the lives of people who were planning on having their own court cases heard in these jurisdictions.

 

[al66pine]

As ppl have noted, this particular legal procedure by Jahi's mom to force the hosp to keep Jahi on vent, etc. could end w. ---
--ct. order to hosp to keep her on vent indefinitely, and Jahi may 'die' (per mom's definition) while still on vent in hosp, in days, weeks, or perhaps months or yrs; or
-- ct order allowing hosp disconnect vent, and Jahi would 'die' (per mom's definition) in a matter of a few minutes or perhaps hours.

Either outcome for Jahi, mom, family, et al is tragic, whether that 'death' (per mom's definition) is sooner or later.

If the ct allows hosp to follow the CA statute and disconnect vent, I wonder how that will effect future behavior of--
-- patients,
-- parents & other family members,
-- other persons named by patient as H/C surrogate,
-- GALs,
-- attys considering rep'ing pt or fam for brain death situations.

IIRC before TRO action was filed, CHO spokewoman said there was "no policy' on brain-death situation and each is handled case by case.

IIRC someone posted link to a CA hosp policy stating that once brain death had bn determined, the vent
(and maybe other devices?) would be disconnected after a given period of time - 12 hours or 36 hours(?).

I wonder if CHO spoikeswoman's 'no policy' stmt was accurate.
If CHO actually had a 12 or 36 hr disconnect policy in place, I wonder if it was not disclosed to Jahi's fam,
in the hope that Jahi's mom would come to grips w her dau's brain-death as death.

Healing thoughts to all involved: Jahi, mom, other fam, the drs and other med care providers, hosp employees,
the other CHO patients and fams exposed to this sad situation.

JM2cts.

 

[Roxye]

For those posters with medical backgrounds, a question about preoperative testing: are the tests that are done the same for adults and children, or are there certain tests that are done for adult patients (e.g., pregnancy, etc.) but not for children? If different tests are done for children, is it based strictly on age?
Thanks!

I am not an expert by any means, but as a parent with a child who went through a duel tonsillectomy/adenoid removal, and my own experience with duel bunion surgery in addition to eventually ACL removal, on top of totally cartilage removal.... when it comes to children, they seem to be more aware and hesitant in their (doctor) approach.

It took my Nikel 8 months before they would approve him for surgery. (Another 4 before it finally happened) The tests were exhaustive as a parent... but I thank them for that. On the other hand, not the same, since mine wasn't breathing related, I was in surgery in less then two months.

I think tests should be more elaborate with children. So much can go wrong when they are that little.

 

[MaybeNotToday]

As ppl have noted, this particular legal procedure by Jahi's mom to force the hosp to keep Jahi on vent, etc. could end w. ---
--ct. order to hosp to keep her on vent indefinitely, and Jahi may 'die' (per mom's definition) while still on vent in hosp, in days, weeks, or perhaps months or yrs; or
-- ct order allowing hosp disconnect vent, and Jahi would 'die' (per mom's definition) in a matter of a few minutes or perhaps hours.

Either outcome for Jahi, mom, family, et al is tragic, whether that 'death' (per mom's definition) is sooner or later.

If the ct allows hosp to follow the CA statute and disconnect vent, I wonder how that will effect future behavior of--
-- patients,
-- parents & other family members,
-- other persons named by patient as H/C surrogate,
-- GALs,
-- attys considering rep'ing pt or fam for brain death situations.

IIRC before TRO action was filed, CHO spokewoman said there was "no policy' on brain-death situation and each is handled case by case.

IIRC someone posted link to a CA hosp policy stating that once brain death had bn determined, the vent
(and maybe other devices?) would be disconnected after a given period of time - 12 hours or 36 hours(?).

I wonder if CHO spoikeswoman's 'no policy' stmt was accurate.
If CHO actually had a 12 or 36 hr disconnect policy in place, I wonder if it was not disclosed to Jahi's fam,
in the hope that Jahi's mom would come to grips w her dau's brain-death as death.

Healing thoughts to all involved: Jahi, mom, other fam, the drs and other med care providers, hosp employees,
the other CHO patients and fams exposed to this sad situation.

JM2cts.

Yes, I'm thinking healing thoughts for her mother but sending up a special prayer for her lawyer as well. I believe this guy knows exactly what he's doing and what his motives are- and for that I will pray extra hard for his conscience.

 

[joypath]

A question has risen regarding a autopsy and its ability to pinpoint the situation/medical condition at the time of crisis. While it is extremely accurate that time has changed the physiological condition of Jahi, there MAYBE some histological clues that the OCME will coordinate with the empirical data contained with the medical record (pre & post surgery) & from forensic interviews.
There is a probability (strong) that the surgical site(s) have healed thus clouding the etiology of the initial claims of overwhelming spontaneous blood loss, this "healing" will be identifiable BUT will not be a differentiating point.

This case will be a challenge, the longer the external forces prolong to eventual resolution the more difficult pinpointing a MOD.

For a interesting autopsy evaluation, here's a case from Fla. while the decedent was NOT a brain death case but had spent time "supported" and my point is to provide a comprehensive autopsy report that reflects the efforts involved. http://www.blogsforterri.com/archives/5050439_autopsy report and supporting documents.pdf

Also, here's an excellent site for a quick education of/on pathology from a very personable & intelligent physician!
http://www.pathguy.com/autopsy.htm

 

[meanmaryjean]

For those posters with medical backgrounds, a question about preoperative testing: are the tests that are done the same for adults and children, or are there certain tests that are done for adult patients (e.g., pregnancy, etc.) but not for children? If different tests are done for children, is it based strictly on age?
Thanks!

Lab testing would likely be the same for adults and children: CBC (blood count with hemoglobin and hematocrit), basic chemistry profile (electrolytes, kidney function) and likely coagulation studies (PT, PTT/ INR). Her sleep study would also be considered part of her pre-operative testing.

I cannot think of a test that would be done on a child that would NOT also be done on an adult.

 

[gngr~snap]

I'm not sure, but in regards to bleeding and obesity, would a fatty liver (or a highly stressed one) have anything to do with it?
I know there is a relation between liver disease and bleeding.
IF that were the case- I am not saying it is...
Wouldn't that still show up at autopsy regardless of time?
Could a fatty liver repair itself in time?
I know pre-op bloodwork is done.
I also know that bloodwork is pretty normal until there is significant liver damage.
SGOT, SGPT? -from memory only.
I need to go back to school.
Moo
Sent from my SGH-T679 using Tapatalk 2

 

[meanmaryjean]

A chemistry profile would include some liver enzymes- fatty liver is not often seen in children without some other pathology. Obesity (body fat) does not mean liver fat. Separate process. You can be 6 feet tall and 120# and still have a fatty liver!

 

[momrids6]

I think it will be extended again, too. Just too much going on in the courts with different judges and different items. I think this is a very weak argument, but linking her to the ADA as disabled may be take a longer time to discuss and review in court.

Now this is distrupting the lives of people who were planning on having their own court cases heard in these jurisdictions.

I have no idea how being legally deceased qualifies as disabled

 

[joypath]

For those posters with medical backgrounds, a question about preoperative testing: are the tests that are done the same for adults and children, or are there certain tests that are done for adult patients (e.g., pregnancy, etc.) but not for children? If different tests are done for children, is it based strictly on age?
Thanks!

Making a generalized statement here: pre-op testing is ordered by the healthcare providers directly involved in the procedure, he/she uses criteria that he/she chooses AND is within the guidelines of the standards of practice of the agency.

In some facilities, each & every invasive procedure may have specific laboratory procedures done before a scheduled procedure is done...for example the tertiary care hospital where I had an adult tonsillectomy required full chemical profile (chem 24), complete blood count (CBC) & hemostasis work-up (PT & PTT) (they skipped pregnancy testing due to AGE! ) and a "type & hold" (that's a precautionary measure in case units of blood are needed STAT & the HCP can transfuse "type to type")

 

[Roxye]

I've been trying to be nice but, I just don't get some things.

I am having a hard time understanding certain things. (Like why was Jani kept in hospital). My Nikel came home with us SAME DAY! Look up Vanderbilt Children's Hospital! It is a leader in child care. Jahi's hospital claims to be great too! Something is off here if they felt she need to be in PICU! This situation hits home hard for me. I dealt with my own uncertainties, but I knew the doctors, the hospital, and I did my research.

Something other then the duel surgery happened to put this baby in PICU! The scraping of the throat is part of an adenoid/tonsillectomy.

Something else happened here! JMO.

Nikel had some throat bleeding, and they warned us of that. He was tired, and they warned us of that too. I was told, initially, because my son had been deprived of sleep for so long because of his sleep apnea, he may sleep for three days if not a week once he started to recover. YET! THEY SENT HIM HOME THE SAME DAY!

That leads me to believe that Jani's surgery was less then routine. IF Vanderbilt wouldn't keep my 20 plus over weight child overnight, then what is different in her home state other then we aren't hearing the full truth?

 

[MEN3C]

A question has risen regarding a autopsy and its ability to pinpoint the situation/medical condition at the time of crisis. While it is extremely accurate that time has changed the physiological condition of Jahi, there MAYBE some histological clues that the OCME will coordinate with the empirical data contained with the medical record (pre & post surgery) & from forensic interviews.
There is a probability (strong) that the surgical site(s) have healed thus clouding the etiology of the initial claims of overwhelming spontaneous blood loss, this "healing" will be identifiable BUT will not be a differentiating point.

This case will be a challenge, the longer the external forces prolong to eventual resolution the more difficult pinpointing a MOD.

For a interesting autopsy evaluation, here's a case from Fla. while the decedent was NOT a brain death case but had spent time "supported" and my point is to provide a comprehensive autopsy report that reflects the efforts involved. http://www.blogsforterri.com/archives/5050439_autopsy report and supporting documents.pdf

Also, here's an excellent site for a quick education of/on pathology from a very personable & intelligent physician!
http://www.pathguy.com/autopsy.htm

It's very unfortunate if bleeding was the cause, but hemorrhage is a known complication of this surgery. You have to respect the tonsils! I don't know anything about what happened in this specific case, but a bleeding tonsil can make getting an airway extremely difficult (lots of blood). There's a lot of blood supply around there - the tonsils themselves are supplied by multiple branches of the external carotid artery but the internal carotid artery lies only 2-2.5cm posterior (though in a very small percentage of the population, it can actually lie just deep to the superior constrictor muscle!).

 

[meanmaryjean]

I've been trying to be nice but, I just don't get some things.

I am having a hard time understanding certain things. (Like why was Jani kept in hospital). My Nikel came home with us SAME DAY! Look up Vanderbilt Children's Hospital! It is a leader in child care. Jahi's hospital claims to be great too! Something is off here if they felt she need to be in PICU! This situation hits home hard for me. I dealt with my own uncertainties, but I knew the doctors, the hospital, and I did my research.

Something other then the duel surgery happened to put this baby in PICU! The scraping of the throat is part of an adenoid/tonsillectomy.

Something else happened here! JMO.

Nikel had some throat bleeding, and they warned us of that. He was tired, and they warned us of that too. I was told, initially, because my son had been deprived of sleep for so long because of his sleep apnea, he may sleep for three days if not a week once he started to recover. YET! THEY SENT HIM HOME THE SAME DAY!

That leads me to believe that Jani's surgery was less then routine. IF Vanderbilt wouldn't keep my 20 plus over weight child overnight, then what is different in her home state other then we aren't hearing the full truth?

If you go back and read the other threads- you will find this was not EVER routine surgery. Only her FAMILY has stated that it was. The PICU stay was planned from the beginning due to her existing co-morbidities.

 

[joypath]

I'm not sure, but in regards to bleeding and obesity, would a fatty liver (or a highly stressed one) have anything to do with it?
I know there is a relation between liver disease and bleeding.
IF that were the case- I am not saying it is...
Wouldn't that still show up at autopsy regardless of time?
Could a fatty liver repair itself in time?
I know pre-op bloodwork is done.
I also know that bloodwork is pretty normal until there is significant liver damage.
SGOT, SGPT? -from memory only.
I need to go back to school.
Moo
Sent from my SGH-T679 using Tapatalk 2

IMHO one can R/O hepatic reasons for the bleeding UNLESS her SGOT/SGPT (love that you remember, like I do, the older terminology for the transaminases!!) aka AST/ALT were sky high and IF they were the surgery would/should have been cancelled.
Liver damage like a fatty liver would be observable at autopsy via section evaluations, if not gross observation.

 

[Steft50]

I've been thinking this afternoon about that movie Steel Magnolias. The scene that takes place in the cemetary right after the funeral for Julia Roberts when Daryl Hannah approaches Sally Field commenting about how she should feel good that her daughter is in heaven, she will always be young....ect....and Sally Fields response was "that was a nice thought but I guess I am selfish because I would rather have her here with me". I just can't get that one line out of my head.

It may not seem like it, but I have had enormous sympathy with Jahils mother. I've been frustated by some of her comments, but I do feel everything she has said and done have been out of her love for her daughter. That said I just can't get over the feeling that she has gone this far more for herself than what is ultimately best for her daughters body.

I have to say that I have also been hugely upset when I've read in different places how much she loves her daughter so much more to take this difficult path she is taking because I feel it insults all the mothers before her, who loved their children every bit as much, who have made the difficult decision to accept reality by letting their children go with grace (or anger or fear or pick an emotion) whether they have chosen to donate organs or not.