Family wants to keep life support for girl brain dead after tonsil surgery #4

[Isabelle]

<modsnip>

Not sure about California, but in Louisiana a case must go before a peer review committee (made up of doctors) before a malpractice suit can be filed. The peer review decides if the case is one showing malpractice.

 

[Zuri]

Because of the HIPPA act, it is Federal Law that medical records are private.

Federal Law

Also, as the medical record is incomplete, no disclosure would be made until the chart is considered complete and that can be weeks, depending on what sorts of tests or reports are pending.

CHO does not have the option to release her records, except under court order, and since this a federal law, I assume it would have to go to the Federal Magistrate, not the California courts.

I understand exactly what you are saying. IIRC, that spokesperson for CHO said they had not been given permission by the family to speak so as to clear up any misconceptions. That was what I was referring to

 

[Herat]

One could say that a deceased person has no right to privacy, I guess.

Yeah. For example, if you are found dead lying on the sidewalk and have not had doctor's care recently, your nosy neighbors, your meddling mother in law, your mechanic, the local garbagemen, etc can all get a copy of your autopsy report........by law.

 

[MsSeal]

I wonder how the community of ICU PICU nurses are dealing with this tragedy. Because the public is being told that the nurses let her bleed out and did not step in and try to stop it. And now the hospital is trying to cover it up. I am reading that everywhere.

Without being able to see thet nurses' notes and actually witnessed that day we only have the family version of what happened to go on.

What is the protocol postop care of these procedures. It is plausible that the family is telling the truth and the nurses were nonplussed about her bleeding and said "yeah, it's normal, stop worrying, here's a bucket" and then they just let it happen. To the nurses it was the normal amount of blood so they were not vigilent about checking. It is so hard to believe in a PICU situation where there are so many people who are witnesses and all the documentation that is required that nurses would get away with that. But the grandmother is very firm in her assertion that is what happened that day and she is a nurse. I swear I am missing something because it does not all add up.

Also, if a patient has some kind of bleeding disorder can you tell from the amount of blood loss what is normal and what isn't very quickly.

 

[CHERIE.T]

I'm very happy to hear this! Get her OUT of Children's!!!

Yet Children's is the hospital that's kept her body going!

Her mom needs a good shoulder shaking and a good talking to by someone she trust......someone who can explain brain death and non-recovery in terms she will understand.

 

[Donjeta]

It was reported that she received four blood transfusions so at some point the staff certainly got very worried.

 

[BetteDavisEyes]

Wish I had known sooner that there was an episode of Law & Order: Special Victims Unit on last hour that dealt with life and death issues, parents rights with regard to their child/children, disconnecting life support, etc. The episode isn't listed correctly on my Comcast TV grid, so I didn't know until it started that it was on today. I was doing meal prep and watched/listened to the episode that I've seen numerous times. It's probably available online for anyone whose interested.

Law & Order: Special Victims Unit: Season 5, Episode 10

Shaken (25 Nov. 2003)

 

[LinasK]

I wonder how the community of ICU PICU nurses are dealing with this tragedy. Because the public is being told that the nurses let her bleed out and did not step in and try to stop it. And now the hospital is trying to cover it up. I am reading that everywhere.

Without being able to see thet nurses' notes and actually witnessed that day we only have the family version of what happened to go on.

What is the protocol postop care of these procedures. It is plausible that the family is telling the truth and the nurses were nonplussed about her bleeding and said "yeah, it's normal, stop worrying, here's a bucket" and then they just let it happen. To the nurses it was the normal amount of blood so they were not vigilent about checking. It is so hard to believe in a PICU situation where there are so many people who are witnesses and all the documentation that is required that nurses would get away with that. But the grandmother is very firm in her assertion that is what happened that day and she is a nurse. I swear I am missing something because it does not all add up.

Also, if a patient has some kind of bleeding disorder can you tell from the amount of blood loss what is normal and what isn't very quickly.

And I've personally witnessed in nursing homes in Calif. nurses changing their notes and backdating them to cover their tracks for situations that shouldn't have happened and were their fault! I did report them to DHS!!!

 

[LinasK]

Yet Children's is the hospital that's kept her body going!

Her mom needs a good shoulder shaking and a good talking to by someone she trust......someone who can explain brain death and non-recovery in terms she will understand.

Only by court order, or they would've disconnected her long ago by their choice!! Why can Jahi be allowed to live out the rest of her life, however long that is, elsewhere- even if Vents and G-tubes are required??? Her mother has assumed full responsibility. Children's is in CYA mode in my opinion.

 

[Herat]

I think it's important to remember that the Violation of Privacy / Religious Rights suit filed in Federal Court on Friday is for monetary damages to be awarded to the family, AND for Mr. Dolan's fees to be paid.

Let's not forget the motive for that one.

 

[CHERIE.T]

Only by court order, or they would've disconnected her long ago by their choice!! Why can Jahi be allowed to live out the rest of her life, however long that is, elsewhere- even if Vents and G-tubes are required??? Her mother has assumed full responsibility. Children's is in CYA mode in my opinion.

It's ok that we disagree. I feel that Jahi's family is POSSIBLY in their own CYA mode.

IMOO Jahi's life should have ended shortly after she was declared brain dead. Her mother just cannot accept brain death...that is so horrifyingly sad.

 

[Leilei]

Any comment made to the public concerning the patient is a breach of privacy. That does not include comments to the court. No public comments whatsoever. This does not include the mother, family or their attorney since they are not bound by health privacy laws.

Just some quickie research (google is my best friend, I swear), and the hospital privacy breach cases that I see are from hospital employees accessing and distributing actual medical records. Data breaches, hacking, etc... is out there, but so far, I haven't seen anything that compares to what CHO has said during its pressers.

What it is in the court documents, and that they stated that Jahi is deceased and there is no chance for recovery, I don't see a breach of privacy thus far. My opinion, though.

 

[LinasK]

I think it's important to remember that the Violation of Privacy / Religious Rights suit filed in Federal Court on Friday is for monetary damages to be awarded to the family, AND for Mr. Dolan's fees to be paid.

Let's not forget the motive for that one.

Which they deserve. I fully hope that there is a fat malpractice/wrongful death suit filed against Children's Hospital of Oakland. I for one wouldn't take my child there anytime soon, should she need hospitalization- I'd take her to another hospital locally!!! Children's already didn't have a great reputation before this, and they screwed up another tonsillectomy two years ago and left the little girl brain-damaged.
Just recently in Hawaii, a 3-year-old died because of an incompetent dentist. Lynne Spaulding died in the stairwell of SF General Hospital because noone searched there for her for 3 weeks! Then we have Conrad Murray. Why is it so hard for people to believe that there are bad doctors, nurses, and hospitals???

 

[Herat]

Why can Jahi be allowed to live out the rest of her life, however long that is, elsewhere- even if Vents and G-tubes are required??? Her mother has assumed full responsibility.

1. Jahi is not alive. The lovely happy child that once was does not exist except in the hearts and memories of her friends and loved ones.

2. Anything that happens is only to maintain the physical shell until it deteriorates to the point the family accepts that she is dead.

3. The mother may have agreed to accept full responsibility, but we have yet to see that happen in fact. As she has not accepted responsibility prior to this in the last three weeks, it is a valid question as to whether she will actually fulfill the agreement she made under oath in court.

4. The minute the transport team attaches their own ventilator tubing in PICU, CHO "wins" the skirmish as the maintenance of her physical shell is not longer their responsibility.

 

[belimom]

I think the way I feel may be contrary to popular opinion here. But, I think the parents need some time to process everything and be willing to pull the plug on Jahi. I think they will - or should be gently urged to do so by family/clergy/chaplain - after they absorb that fact that she is not going to recover. The hospital has made her death that much harder.

I also wish they would stop referring to Jahi as "the body". Even on machines, she is still Jahi. I think they're doing that to reiterate the fact that in their opinion she is 'dead' and to drive that point home to the media/family. But that is being very insensitive to her family, IMO.

As for lawsuits, I hope her parents get whatever they ask for. No one should die in that situation, in PICU surrounded by nurses/doctors. Yes, there are trivial lawsuits these days and everyone is wanting their chance at the million-dollar lawsuit (banana-peel man on the elevator comes to mind). But this a bonafide malpractice case. Hands down. Maybe her family is handling it differently than some of us would, but bottom line: I believe that the hospital is responsible for Jahi's death.

Just give her parents time to accept the inevitable and to realize that she is not going to wake up. I could be wrong, but that's what I think they want: just a chance to see if she may wake up and to absorb everything without also arguing with the hospital (which I think has delayed their grief process - they still haven't accepted it yet, I don't think).

 

[otto]

Only by court order, or they would've disconnected her long ago by their choice!! Why can Jahi be allowed to live out the rest of her life, however long that is, elsewhere- even if Vents and G-tubes are required??? Her mother has assumed full responsibility. Children's is in CYA mode in my opinion.

This child stopped breathing almost a month ago and is deceased. Why should deceased people be plugged into machines?

The mother will not accept responsibility for the body until after it is released from the hospital and the coroner. Today, the deceased is still the responsibility of the hospital.

 

[MsSeal]

And I've personally witnessed in nursing homes in Calif. nurses changing their notes and backdating them to cover their tracks for situations that shouldn't have happened and were their fault! I did report them to DHS!!!

So you think CHO nurses/docs are going to change their notes to cover themselves.

I can you tell of one case where I was working in medical records and a doctor was being sued and he came into to review the chart. A staff member of medical records sat with him to make sure that he did not write anything. He was not allowed to have a pen or pencil and he was witnessed the entire time. He could only review the chart.

Now I don't know about the PICU nurses at CHO. The nurses could have changed notes that day but surely someone would have witnessed just as you did and report them. I guess we will never know. Call me niave I just don't think they would stoop to that.

 

[SwampMama]

BBM
IIRC the family said Jahi had been in the ICU about 30 minutes before they were allowed in to be with her. I would guess it's possible a nurse was with her during that time.

Do we know that she wasn't observed by a nurse in recovery and that there wasn't anyone with her on arrival from recovery? Didn't the family state that when Jahi was transferred to ICU it took some time before the family were allowed in her room?

I have had surgery many times (granted, I am not a child) and when I went from recovery to my room, they would take me up alone and ask my husband (who stayed with me 24/7) to let them settle me in first and then he could come in the room.

The nurses and staff need that settling in time so that they can have unobstructed contact with their patient with a family member trying to answer for the patient, distract them with questions, etc. The nurse and patient both need to have their entire attention upon each other at this time.

They may have also wanted time for Jahi to be quiet since her mom and gram were obviously not following post op protocol, plus they were likely disturbing others in recovery if they were laughing and talking.

I really feel that SOMETHING happened that the family should not have been doing, whether it was encouraging Jahi to talk and laugh, improper suctioning or sneaking her a treat. Mom and gram could have gone and gotten cola, Popsicle, ice cream or something while waiting to go to Jahi in ICU, then brought it up to her. If mom had a drink and let Jahi have some, could a cola or a drink with a straw cause a problem? ( I know people who have a tooth pulled are advised not to use a straw for a few days because of dry socket)

This would make sense because Jahi was asking about a popsicle and I figure that part of her pre-op instructions were to NOT eat anything after midnight so she may have been hungry or not used to going without food and treats.

We already know that her mom let her take go to the store by herself to get snickerdoodle/ice cream as a treat so I imagine that her mom had promised her all the popsicles, ice cream that Jahi wanted as part of reassuring her before surgery. (Most parents do tell their kids they can have all the popsicles, ice cream to help them feel more comfortable about surgery)

 

[Donjeta]

Here's uncle's account. He says we kept asking so was he there too? How many family members were there?

"After the surgery, she (Jahi) was fine. She went into the recovery room. She was alert and talking, and she was asking for a Popsicle because she said her throat hurt. As part of the procedure, she was meant to spend the night in ICU," Sealey said. "When she got moved to ICU, there was a 30-minute wait until any family member could go see her. Upon entry, they saw that there was way too much blood."

"She lost four pints of blood. She had to have four blood transfusions. She had two liters of blood pumped out of her lungs, not including what was in her stomach," Sealey said. "There was an enormous amount of blood, and we kept asking, 'Is this normal?' Some nurses said I don't know and some said yes. There was a lot of uncertainty and a lack of urgency."

http://www.wptv.com/dpp/news/nation...ry--family-says-it-wants-to-keep-life-support

I find it very hard to believe that anyone said that blood loss worth four transfusions and 2 liters of aspirated blood is normal, and what does lack of urgency mean? Does it mean that things weren't getting done or that the nurses appeared too calm? It was a unique emergency for the family but the ICU nurses are dealing with life and death situations every day and can't let panic take over.

 

[LinasK]

So you think CHO nurses/docs are going to change their notes to cover themselves.

I can you tell of one case where I was working in medical records and a doctor was being sued and he came into to review the chart. A staff member of medical records sat with him to make sure that he did not write anything. He was not allowed to have a pen or pencil and he was witnessed the entire time. He could only review the chart.

Now I don't know about the PICU nurses at CHO. The nurses could have changed notes that day but surely someone would have witnessed just as you did and report them. I guess we will never know. Call me niave I just don't think they would stoop to that.

Tell it to DHS and JCAHO. I will be very curious to see what the results of their investigations are- but I've personally witnessed it happening, with the Director Of Nursing's consent/permission, so it is naive to think it doesn't happen!