Family wants to keep life support for girl brain dead after tonsil surgery #5

[Herat]

IMO there is an "attitude" present, which may spill over to the NB facility, assuming transfer there. When this child does not make progress, but continues to decompose, will NB be at fault? Will they be sued due to lack of care? Defense in a lawsuit could cost them plenty.

I'm confused as to the financial status of NB because apparently they will be adding an in-patient building, yet they are soliticing money for an automatic door, which it sounds like they don't have the money to pay for.

On the NB webpage, note quite a bit of fundraising:

http://www.nbli.org/news/

Yes. They are asking for funds for a $5000 automatic door, yet they claim there is a building project that will be opening as an inpatient care facility.

 

[Santa]

http://media.nbcbayarea.com/document...cted+Rpt_1.pdf

Above link posted in earlier thread by Poirotry in Motion is neuro exam by Dr. Fisher. Jahi was removed from the vent for 9 minutes during this exam!

But he didn't examine her, he is not a Dr in California and has no privileges at CHO. He is also a neonatologist and not a neurologist. He was only allowed to "see" her.

 

[mck16]

How sick for the mother to subject this to her other children.

I can imagine the other siblings would be questioning why their sister is not waking up.

I can't imagine living in that two bedroom apartment and seeing a dead corpse being hooked up to a ventilator.

it's extremely morbid and grotesque.

IMo

I totally agree and posted the same a day back and received quite the lecture from someone. I think it is horrible. jmo

 

[NevadaMom]

I wondered in the back of my mind how other patients and families were dealing with this circus. Surely the staff were exhausted from it all. But I wonder if anyone will come forward and give accounts from the observer position.

Sent from my HTC Flyer P510e using Tapatalk HD

I'd seen in a comment on a page, don't remember which one because there are so many, that someone had a friend with a child that was in PICU there for a week and said that the family was quite disrespectful and noisy the whole time they were there. I'll see if I can't find it later, but I'm not going to hold my breath. Googling the keywords "noisy" and "disorderly" in conjunction with "Jahi McMath PICU family" comes up with just about every article. :findinglink:

 

[BetteDavisEyes]

I don't think family went through all this court trouble just so they can unplug her at home.
I am guessing they are planning to do surgeries on her (feeding tube insertion) so she can be transferred to a facility.

I can't fathom a reliable facility/physician wanting to do the surgery on a brain-dead individual. Do you think that the procedures might be done in the family home if that's where Jahi is at this time?

 

[Herat]

But to me, it looks like Uncle is enjoying his rise to "fame" on the back of this poor dead child. He will not fade away quietly. :notgood:

I think Dolan will have to muzzle Uncle O. I don't see him as the kind of guy who can hold on for delayed gratification (financial settlement) for a long time.......

 

[Karmady]

But he didn't examine her, he is not a Dr in California and has no privileges at CHO. He is also a neonatologist and not a neurologist. He was only allowed to "see" her.

I can't open the link, but you're talking about Byrne, not Fisher. Iirc, Fisher is the doc from Stanford who was appointed by the Court to do the third (at least) brain death confirmation examination. jmo

 

[popsicle]

I think Dolan will have to muzzle Uncle O. I don't see him as the kind of guy who can hold on for delayed gratification (financial settlement) for a long time.......

I think Dolan needs to muzzle himself.

 

[Isabelle]

That link doesn't work for me. Anyone?

http://media.nbcbayarea.com/documents/Fisher+-+Redacted+Rpt_1.pdf

Reopened from prior thread and copied from browser. Hope it works.

 

[belimom]

But he didn't examine her, he is not a Dr in California and has no privileges at CHO. He is also a neonatologist and not a neurologist. He was only allowed to "see" her.

I hope the reports are wrong, then, that he examined her and unplugged her for nine minutes. If he did, then... :no:

 

[SwampMama]

I was curious as to whether 9 minutes off of ventilatory assist is the norm. If a person was not brain dead, but did not have spontaneous respiration, the lack of oxygen for 9 minutes would ensure brain death. If I remember my biology correctly, the brain cannot live beyond 6 minutes without oxygen.

ETA: did a look up on procedure to determine brain death and patients are left off respiratory support for 8 to 10 minutes or until the CO2 level rises to a cutoff point.

also this BBM: http://surgery.about.com/od/proceduresaz/a/Brain-Death-What-Does-It-Mean.htm

"Apnea Testing

A patient who is sick enough for brain death testing will be on a ventilator. A patient who is truly brain dead cannot breathe without a ventilator. In order to test to see if the breathing reflex is intact or absent, the patient is removed from the ventilator in a procedure called an apnea test. Typically, an ABG is drawn immediately prior to the beginning of the apnea test, when the patient is taken off of the ventilator. Oxygen may be given to the patient during the apnea test, but the ventilator cannot help the patient breathe. "

 

[Santa]

I can't open the link, but you're talking about Byrne, not Fisher. Iirc, Fisher is the doc from Stanford who was appointed by the Court to do the third (at least) brain death confirmation examination. jmo

Yes, Byrne.

 

[Herat]

But he didn't examine her, he is not a Dr in California and has no privileges at CHO. He is also a neonatologist and not a neurologist. He was only allowed to "see" her.[/quote

Dr. Paul Fischer is a California-licensed physician who is the head of Neurology at Stanford University Medical Center. He is also a board certified in pediatrics.

He was the court-appointed neutral physician who did a formal brain death examination. His hand written report about his examination of Jahi has been widely circulated as it was part of the court documents

This information is easily verifiable on google.

 

[Isabelle]

But he didn't examine her, he is not a Dr in California and has no privileges at CHO. He is also a neonatologist and not a neurologist. He was only allowed to "see" her.

This Dr. Paul Fisher noted his California medical license number on the neurologic exam for brain death.

 

[Santa]

That is completely incorrect.

Dr. Paul Fischer is a California-licensed physician who is the head of Neurology at Stanford University Medical Center. He is also a board certified in pediatrics.

His hand written report about his examination of Jahi has been widely circulated as it was part of the court documents.

This information is easily verifiable on google.

Please make sure you have the correct individual.

Oooops! Sorry about that, I didn't read "Fisher" :blushing:

 

[Donjeta]

I was curious as to whether 9 minutes off of ventilatory assist is the norm. If a person was not brain dead, but did not have spontaneous respiration, the lack of oxygen for 9 minutes would ensure brain death. If I remember my biology correctly, the brain cannot live beyond 6 minutes without oxygen.

I wondered about that myself. Ten minutes is the standard but the test is aborted and the patient is connected back to the ventilator if the saturation levels drop too bad.
The patient is pre-oxygenated for a while before the test to make it safer and according to this http://www.surgicalcriticalcare.net/Guidelines/brain_death_determination_2009.pdf
the patient is not kept completely without oxygen during the test.

Apneic diffusion oxygenation is the
procedure most commonly utilized to maintain oxygenation during apnea testing.

But there are complications so it is not something that most physicians would do lightly I think.
See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824942/


http://www.ems1.com/airway-manage b...eic-oxygenation-Everything-you-know-is-wrong/
(Not a scientific article and not about the apnea test but explains what apneic diffusion oxygenation means and how long it takes to desaturate after preoxygenation)

 

[Elley Mae]

I took the 9 minutes to mean that her heart continued for 9 minutes before it showed signs of failing without the assist of the ventilator. idk jmo

 

[Karmady]

also this BBM: http://surgery.about.com/od/proceduresaz/a/Brain-Death-What-Does-It-Mean.htm

"Apnea Testing

A patient who is sick enough for brain death testing will be on a ventilator. A patient who is truly brain dead cannot breathe without a ventilator. In order to test to see if the breathing reflex is intact or absent, the patient is removed from the ventilator in a procedure called an apnea test. Typically, an ABG is drawn immediately prior to the beginning of the apnea test, when the patient is taken off of the ventilator. Oxygen may be given to the patient during the apnea test, but the ventilator cannot help the patient breathe. "

Yes, the notation says 100% O2. I assume that's standard protocol since I'm completely confident that the apnea test would not be administered if it would likely or necessarily result in brain damage itself. Much less that the Stanford doc would have done that and documented it for the court. Kind of goes w/o saying imo.

 

[jjenny]

I was curious as to whether 9 minutes off of ventilatory assist is the norm. If a person was not brain dead, but did not have spontaneous respiration, the lack of oxygen for 9 minutes would ensure brain death. If I remember my biology correctly, the brain cannot live beyond 6 minutes without oxygen.

ETA: did a look up on procedure to determine brain death and patients are left off respiratory support for 8 to 10 minutes or until the CO2 level rises to a cutoff point.

Dr. Fisher is an expert and it sounds like all the tests were done by the book.

 

[mck16]

Surely there is some law against housing a person considered dead being maintaine by artifical means. It simply can't be legal. CPS should be notified and these children checked out. I am sorry but this is more insane than mom's not accepting the situation.

I would like to see pictures of her actually being taken in to the home. I can't believe there aren't any. It may not even be true. jmo