K_Z
Verified Anesthetist
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- Nov 8, 2010
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It is really sad and frustrating for me to read so many global criticisms of this world class facility characterizing the entire facility and staff as heartless and cruel. “The hospital” is not just a cold, bricks and mortar entity—but a vibrant place, filled with many, many compassionate and caring individuals. Rarely is an entire department or facility “bad” or “incompetent” or “heartless”.
I’d like to point out something to demonstrate how compassionate “the hospital” was to this family, even BEFORE Jahi was unfortunately diagnosed as brain dead. “The hospital” has gone above and beyond for this family, IMO, at pretty much every stage of Jahi’s treatment. At the time when Mrs. Winkfield was witnessing Jahi bleed, she apparently experienced a vaso vagal reaction so severe that she herself needed treatment. She “passed out”. If you think about that for a moment, in addition to the crisis that was occurring with Jahi, the ICU staff now had an additional crisis to attend to—the patient’s mother unconscious, and probably on the floor. That required an additional group of caregivers to assess Mrs. Winkfield urgently, call for assistance, and have her transported to presumably the hospital ER for more assessment and treatment. And that is EXACTLY what appears to have happened—Mrs. Winkfield received treatment AS A PATIENT. Presumably she is satisfied with the care she herself received from the staff, both in the ICU and ER. (Which is another reason I have a hard time interpreting the family statements that they called and called for help, and no one came promptly—in an ICU described as an open bay facility—no walls.)
There is a law called EMTALA (Emergency Treatment and Active Labor Act) that compels hospitals to assess and treat emergencies and patients in active labor, and not divert them, for example, to other county facilities by doing a “wallet biopsy” to see what kind of insurance the patient has.
http://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/index.html
Emergency Medical Treatment and Active Labor Act - Wikipedia, the free encyclopedia
CHO was legally obligated to emergently assess and treat Mrs. Winkfield when she passed out. However, once the situation was stable, Children’s would have been completely within their rights to transfer Mrs. Winkfield to an ADULT facility ER, even if she had not agreed with the plan. Children’s Hospital treats pediatric patients. Despite this, the staff recognized that their patient, Mrs. Winkfield, and their other patient, Jahi McMath, were both experiencing a terrible combined family crisis. They apparently kept Mrs. Winkfield as a patient for a number of hours, either in their ER, or somewhere else, most likely because no one wanted to separate a terrified mother from her child, who was in a terrible crisis in the PICU. They bent, and might even be characterized as “broke” the rules to keep this family, and mother and child, together during their crises. That is not just following the law, but demonstrating compassion at a high level, IMO.
I want to contrast this to what happens today in many small hospitals. When a newborn has difficulties that require transfer to a bigger NICU, in the past, we always sent the moms with the babies in the ambulance or life flight. The moms were inpatients, whether they gave birth by vaginal delivery, or C-section. The rationale was compassion—not separating newborns from their mothers during a crisis, and the moms themselves were still recovering from the birth, and needed care and support. For the past several years (maybe as many as 10 years, I can’t recall), we have been unable to do this in small facilities. The babies are transported alone with the NICU team, and the moms have to be discharged so they can go separately, if they are stable enough for discharge. Insurance will not pay simply to keep moms and babies together—there has to be a medical reason for the MOM to be transferred as an inpatient with the newborn.
So I really question the across-the-board criticisms of this world class facility being crass, heartless, and disparaging toward this family. No one wanted this situation to end happily more than “the hospital”, except Jahi’s family.
I’d like to point out something to demonstrate how compassionate “the hospital” was to this family, even BEFORE Jahi was unfortunately diagnosed as brain dead. “The hospital” has gone above and beyond for this family, IMO, at pretty much every stage of Jahi’s treatment. At the time when Mrs. Winkfield was witnessing Jahi bleed, she apparently experienced a vaso vagal reaction so severe that she herself needed treatment. She “passed out”. If you think about that for a moment, in addition to the crisis that was occurring with Jahi, the ICU staff now had an additional crisis to attend to—the patient’s mother unconscious, and probably on the floor. That required an additional group of caregivers to assess Mrs. Winkfield urgently, call for assistance, and have her transported to presumably the hospital ER for more assessment and treatment. And that is EXACTLY what appears to have happened—Mrs. Winkfield received treatment AS A PATIENT. Presumably she is satisfied with the care she herself received from the staff, both in the ICU and ER. (Which is another reason I have a hard time interpreting the family statements that they called and called for help, and no one came promptly—in an ICU described as an open bay facility—no walls.)
There is a law called EMTALA (Emergency Treatment and Active Labor Act) that compels hospitals to assess and treat emergencies and patients in active labor, and not divert them, for example, to other county facilities by doing a “wallet biopsy” to see what kind of insurance the patient has.
http://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/index.html
Emergency Medical Treatment and Active Labor Act - Wikipedia, the free encyclopedia
CHO was legally obligated to emergently assess and treat Mrs. Winkfield when she passed out. However, once the situation was stable, Children’s would have been completely within their rights to transfer Mrs. Winkfield to an ADULT facility ER, even if she had not agreed with the plan. Children’s Hospital treats pediatric patients. Despite this, the staff recognized that their patient, Mrs. Winkfield, and their other patient, Jahi McMath, were both experiencing a terrible combined family crisis. They apparently kept Mrs. Winkfield as a patient for a number of hours, either in their ER, or somewhere else, most likely because no one wanted to separate a terrified mother from her child, who was in a terrible crisis in the PICU. They bent, and might even be characterized as “broke” the rules to keep this family, and mother and child, together during their crises. That is not just following the law, but demonstrating compassion at a high level, IMO.
I want to contrast this to what happens today in many small hospitals. When a newborn has difficulties that require transfer to a bigger NICU, in the past, we always sent the moms with the babies in the ambulance or life flight. The moms were inpatients, whether they gave birth by vaginal delivery, or C-section. The rationale was compassion—not separating newborns from their mothers during a crisis, and the moms themselves were still recovering from the birth, and needed care and support. For the past several years (maybe as many as 10 years, I can’t recall), we have been unable to do this in small facilities. The babies are transported alone with the NICU team, and the moms have to be discharged so they can go separately, if they are stable enough for discharge. Insurance will not pay simply to keep moms and babies together—there has to be a medical reason for the MOM to be transferred as an inpatient with the newborn.
So I really question the across-the-board criticisms of this world class facility being crass, heartless, and disparaging toward this family. No one wanted this situation to end happily more than “the hospital”, except Jahi’s family.
