Jahi’s family wants her declared 'alive again’

[K_Z]

I know this isn't really on-topic, but since the situation with the pregnant woman was brought up, I have been wondering something. Was the fetus also brain dead? I think the reporting on that case was very sloppy because the science/medicine wasn't understood by the journalists, and my guess is the doctors thought it was likely but were not sure.

I see so many articles saying the mother was without oxygen for an hour, likely due to a blood clot. If the bloodclot blocked bloodflow to her brain, she could be deprived of oxygen, but the fetus would not be if she was still breathing, right, and the blood was flowing through the umbilical cord? But if it was for an hour, it still seems long enough that the fetus also would have been deprived of oxygen too long. Not sure if it works differently given how a fetus receives oxygen.

Then articles report that the fetus wasn't developing correctly, possibly due to the oxygen deprivation. But is fetal development driven by the brain? It seems the fetus would develop mostly normal physically, but have no chance at survival. The deformities could have been preexisting, but it's just a weird situation and I was wondering how that would work. It seems like maybe no one knew exactly what would result. But it would seem that the fetus was also legally dead, and yet that never really gets mentioned.

I'll just chime in with a brief comment here (lol, am I ever brief?!), since this is off topic. Uteroplacental perfusion pressure is highly dependent on the mother's systolic blood pressure (not mean arterial pressure). Add to that the fact that placental perfusion is not auto regulated, meaning the placental vessels are in a maximally dilated state normally, but ARE responsive to biochemical events and drugs, etc which cause vasoconstriction. So, what all that means is that if mother develops a severe drop in systolic blood pressure, the uteroplacental circuit is woefully underperfused. (And a maternal systolic BP at or below 100 is worrisome.) So, in the case of a trauma patient, or a mother with something like a big pulmonary embolism, who has been "down" for an unknown period of time, yes, the fetus is highly compromised during that interval, even if there is some degree of maternal circulation and respiration.

(It's actually more complex than that, but I want to keep this brief! I won't go into acid/base issues, and the oxyhemoglobin dissociation curve, and the effects of fetal hemoglobin.)

We currently don't have any medical diagnostic mechanism to test for intrauterine fetal brain death, at least not that I'm aware of. And assessing the extent of hypoxic damage in a very immature fetus (the Munoz fetus was about 13 weeks when she collapsed) is just very imprecise. Most fetal monitoring looks at patterns of heart rate, accelerations in response to stimulation, etc. which are indirect measures of placental insufficiency, placental infarcts (dead spots), etc. In a situation like the Munoz case, with arrest and maternal brain death, the fetus would be presumed by most mainstream docs as being tremendously compromised, even if the fetus still had a heartbeat when the maternal circulation was restored. That was an incredibly sad and frustrating case at every level. I hope her husband and son are rebuilding their lives as best they can.

 

[TJL]

She can go back to CA any time she can afford to get Jahi there, presuming she wants to take her along. The crap about hospitals in CA killing Jahi is her own delusion. The cash has run out and she can't afford to transport her.

I think if someone would make a settlement offer, Jahi would be removed from that ventilator very quickly.

Yeah that comment they made about, "So Jahi can come home to CA"...was just an attempt to drum up sympathy to their cause by making less-informed people believe that this whole "battle" with the courts and CHO is somehow blocking their "rights" to bring the body home. Obviously not true at all. It's not like the body was deported or ordered out of CA by anyone or any court decree, or state police have set up some sort of roadblock checkpoint to keep them out of CA.

They can go back to CA anytime they want, just like they never had to abscond with it to NJ. It's like you said, it's all a money thing. They don't have the funds to make such a transfer happen, nor do they likely have any support from a transport company to effect such a move. Also, since NJ is really their only safehaven for conducting experimental research on BD bodies at this point, they have no reason to really want to move it back to CA. It's just a publicity stunt to get more support financially.

Edit: thinking on it more, I can now see the "play" he was attempting to make there. With Jahi being deceased and a death certificate declaring such in CA, no medical transport company is willing to touch this with a 10-foot pole to help them bring the body back to CA. They've probably been told it's in violation of some health codes or some such for them to effect a transport to CA, and that they need to coordinate it with the coroner...which of course they don't want to do. So yea, they can't "come back to CA", not because of some evil force preventing them. It's just again they don't have the financial or private support to do it.

But if Dolan hadn't donated $75,000.00 cash to the "Yes on 46" campaign, that would probably cover every dime necessary for the transport. But this is HIS money, and not the Winkfields...so he can do whatever he wants with it.

 

[K_Z]

I agree with that TJL, because now Jahi's body has been discharged from a hospital, so I'm not at all certain that if there was a problem with the ventilator, or trach, or a pneumonia, or cardiac dysrhythmia, that the NJ law would compel a NJ hospital to admit her body for care. Maybe they would? Who knows. The NJ law has never been tested in this way, according to bioethicist Arthur Caplan, at NYU.

I'm not even sure if a paramedic service would transport. It's a sticky situation. I think the family is in the same position now in NJ, that they would be in CA. Home care, and possibly hospice care, are their best options. I don't think an acute care facility would want to touch this situation anymore, now that her body has been discharged from St. Peter's. IMO, the family is running out of options for institutional care. Maybe a nursing home would take her as a hospice status charity case. IDK. If and when something happens, I don't think there are going to be any further extraordinary measures.

 

[SwampMama]

She can go back to CA any time she can afford to get Jahi there, presuming she wants to take her along. The crap about hospitals in CA killing Jahi is her own delusion. The cash has run out and she can't afford to transport her.

I think if someone would make a settlement offer, Jahi would be removed from that ventilator very quickly.

Odd that NW claims that a hospital in CA could "kill" Jahi. Jahi is legally dead and you cannot be charged with killing the dead. It's not like any hospital would accept her anyway given the fact that she is dead, has no insurance or funds and knowing how very difficult her family is to deal with.

The family has kinda painted themselves into a corner. They refuse to admit Jahi is dead so I don;t think they would ever acknowledge that she is indeed dead and pull the plug. Perhaps they might do it quietly and just announce that Jahi "died" on her own terms, or that the God took her home, but I don't think that they would never say that they have accepted that she is dead and pulled the plug.

I would say that the funds and support have indeed dried up. Spending $1000 a month on "vitamins and supplements" is a lot of money to be spending on a lost cause, especially when no one in the family is working (except for possibly Jahi's stepfather). They are probably struggling in NJ and what to go back to the good life in California, but they need another round of fundraising to do so. But life goes on and people are really no longer interested in supporting this lost cause.

 

[TJL]

I agree with that TJL, because now Jahi's body has been discharged from a hospital, so I'm not at all certain that if there was a problem with the ventilator, or trach, or a pneumonia, or cardiac dysrhythmia, that the NJ law would compel a NJ hospital to admit her body for care. Maybe they would? Who knows. The NJ law has never been tested in this way, according to bioethicist Arthur Caplan, at NYU.

I'm not even sure if a paramedic service would transport. It's a sticky situation. I think the family is in the same position now in NJ, that they would be in CA. Home care, and possibly hospice care, are their best options. I don't think an acute care facility would want to touch this situation anymore, now that her body has been discharged from St. Peter's. IMO, the family is running out of options for institutional care. Maybe a nursing home would take her as a hospice status charity case. IDK. If and when something happens, I don't think there are going to be any further extraordinary measures.

Ooooh very good insight, I hadn't thought of the NJ-admissions angle. THANK YOU! I love your input here...I learn so much from you. Makes total sense. She was admitted to a NJ hospital under the credentials of Dr. Fellus (who works for IBRF), who lost his license and was fired along with losing his credentials there. He was, in essence, the only doctor willing to take responsibility for this case in NJ. Of course the hospital wouldn't just "kick the body to the curb" with Fellus' dismissal, but I'm sure they were told that there's nothing more they could do at the hospital and urged them to move into home care.

Not wanting to risk a legal battle in NJ where they had the exact same problems in CA, the Winkfields quietly took the "out" they were given, and the body was discharged. Readmission would have to be for some, like you put it, further extraordinary measures, which likely nobody (with privileges) in NJ feels can or should be done.

So they're stuck in their NJ apartment.

*phew* Did I digest and understand you correctly? I know I added a few thoughts of my own there...

 

[TJL]

Odd that NW claims that a hospital in CA could "kill" Jahi.

It just reminds me of another of her on-camera interviews where she quoted herself telling Jahi, "They tryin' to kill you again!"

I always thought that was ironic how she used the word, "again." Sort of another Freudian Slip admitting she knew and understood Jahi had died.

P.S. your comment about finally giving in and announcing "Jahi has died." I've always thought the same thing. They'll NEVER admit that Jahi died in December, because that would open up thousands of new legal battles, including possible criminal charges for fraud, mail and wire fraud (the donation money from crowd-source), defamation, libel, etc.

So they'll just eventually say, "Jahi died peacefully at home on such-and-such date..." and also make sure to throw in some jab about CHO being unwilling to help them with further funding they needed to keep Jahi alive through some "severe infection or other health problem." They will most certainly find an angle to place blame elsewhere for Jahi's "second death."

 

[Donjeta]

http://thaddeuspope.com/images/Request_get_more_evidence.pdf
I'm new at this. Hope this posts ok.

thanks I hadn't read that before...

Dolan writes...

"...Dr Fischer stated that certain tests were not done to his satisfaction or to a standard he indicates is necessary for him to consider that Jahi is brain dead."

Dolan needs a proof reader. This to me means that they're trying to prove to Fisher that Jahi is brain dead and he won't buy it without further testing.

 

[katydid23]

thanks I hadn't read that before...

Dolan writes...

"...Dr Fischer stated that certain tests were not done to his satisfaction or to a standard he indicates is necessary for him to consider that Jahi is brain dead."

Dolan needs a proof reader. This to me means that they're trying to prove to Fisher that Jahi is brain dead and he won't buy it without further testing.

Wait, you mean they r trying to prove she is NOT brain dead..right? :waitasec:

 

[TJL]

thanks I hadn't read that before...

Dolan writes...

"...Dr Fischer stated that certain tests were not done to his satisfaction or to a standard he indicates is necessary for him to consider that Jahi is brain dead."

Dolan needs a proof reader. This to me means that they're trying to prove to Fisher that Jahi is brain dead and he won't buy it without further testing.

Most everything that comes out of his office are painful to read. Just think about the CV of Machado that was in Comic Sans font. Not one intern there thought to change it to TNR or other professionally-accepted font? With the size of his law firm, I doubt any of the court documents (or press releases) are even written by Dolan personally, and are just thrown together by interns. Like one of the first filings that kept referring to Jahi as, "he." That was indicative it was a cut-and-paste job from other cases, or that they used one of those common legal document programs which "fill in the blanks" based on drop-down menu choices, etc.

 

[joypath]

http://www.mercurynews.com/ci_24861233/how-brain-death-is-affecting-jahi-mcmaths-body

This article was in the new news section of a google search but it's an old article, just updated two days ago for some reason.

Anyway, we had been wondering if she was receiving hormones and there's this quote:

"To support the body that they fought so hard to save, Jahi's family has authorized some nutritional support, including potassium, minerals and hormones. She's also getting antibiotics to combat a possible infection. "


BBM:
After re-reading this......WHO is prescribing the antibiotics?? WHAT ones??? Is this prescribing healthcare provider the same one who would serve as the "admitting" provider IF/SHOULD a 911 call be made? It's my bet that the medical history presented to EMS is "edited" to just indicate a NW defined disability of cerebral damage vs full brain death!
Can't you just "see" the nightmare of arriving @ XYZ Hospital with an ALS unit, a "vent" patient without a DNR or a medical chart and a "forced" admission to ER/ED service.

 

[Frigga]

^ That is a frightening thought.

 

[Nore]

Hi, this bothers me. If she is fed by G~tube why does she need supplements? This has been in my craw a while. I know that soon after her move to N.J. I read an article in the paper, with Dolan and Omrai or whoever .Supposedly they removed the G~tube as (in my words) it wasn't functioning right. She still had the trach.. I know a person cannot remain on IV fluids for a great length of time as it is not proper nutrition, a couple weeks at the most. I searched could never find the article again. Should they try to bring her back to CA. How? they'd need a private plane. Commercial would want her in a casket and place her in the cargo section. I don't see them moving her. They must have a "sort of" Doctor for her ~script for antibiotic. She has drop foot, hands are in splints. I just cannot fathom how they are pulling this all off! Early up it sounded like she is leaving the N.J. hospital she has been in, are they (hosp.) asking them to move her? This situation is beginning to seem a bit ghoulish to me. God forgive me I don't mean that the wrong way but you gotta admit it's not Kosher. If anyone can help me with some of these thoughts I would appreciate it. If not thank you for reading.:loveyou:

 

[Hiandmighty]

This scene with Jahi wearing the sunglasses and all reminds me of how wakes are becoming popular in the Deep South: fashion the deceased as they were in life. Here is an example of one socialite who attended her own wake while "sitting" on an iron bench....
http://theadvocate.com/news/neworleans/neworleansnews/8975606-123/socialite-mickey-easterling-goes-out

 

[K_Z]

Can't you just "see" the nightmare of arriving @ XYZ Hospital with an ALS unit, a "vent" patient without a DNR or a medical chart and a "forced" admission to ER/ED service.

Respectfully snipped.

Yes, gently, and without hurting your brain, try to wrap your head around a discussion as to whether a legally brain dead patient "needs" a DNR. Or whether a legally brain dead patient is a "full code." Or a "partial code." (I personally refuse to even entertain what it would be like to write policies and procedures for those situations. That'll give me nightmares.)

Anyway, let's all hope that NW realizes that Jahi will never "need" to be in a hospital, or an ER, ever again. Because that just would be a very bad situation all around, for Jahi, her mother, the transport staff, the ER staff, the hospital admin, hospital attorneys, etc. I don't wish that situation on anyone. Not even attorneys.

 

[I Object!]

NW has already assumed ALL liability for Jahi's body. It was a condition of the agreement allowing her to take the body. It was an agreement Dolan negotiated for her. Nothing that happens or doesn't happen since she took custody of the body can be blamed on anyone or any entity.

As an aside... I have been in San Francisco since Thursday and passed by dolan's office many times while riding the Muni. Not a great area, but not a surprise.

 

[TJL]

NW has already assumed ALL liability for Jahi's body. It was a condition of the agreement allowing her to take the body. It was an agreement Dolan negotiated for her. Nothing that happens or doesn't happen since she took custody of the body can be blamed on anyone or any entity.

*grin* We are talking about an ambulance chaser attorney and a family who has done everything imaginable to try to blame this whole fiasco on everyone except the people ultimately responsible: themselves. Heck, they even tried to say 6 doctors were wrong in their BD determination because those 6 doctors didn't have ALL the right evidence 10 months ago. And then tried to blame CHO and Dr. Fischer for Dolan needing 4 more weeks to prepare his new case.

Or how about this one: blaming their need to go into hiding because they get death threats. C'mon...that just sounds so much like yet another typical excuse that they figure most people would buy into because it's one that creates fear...something they know many people are irrationally prone to these days. Create a sense of fear, and it naturally deflects away from the true reasons for doing something. Now I won't doubt that they likely got a few messages or tweets or IG's from crazy people who made threats. But if that did happen, all it would take is contacting law enforcement to track those people down and do something about it. But this excuse for hiding just makes a better headline than the truth.

Dolan's a pretty typical, slimy ambulance chaser attorney. And he's good at what he does for a living: placing blame on anyone with deep pockets and getting them to pay up just to make Dolan go away. Maybe that's why he thinks this has been the most difficult case of his career: he's not yet found a way to get CHO to fork over lots of money, and that frustrates him?

But even accepting liability and responsibility does not relieve 3rd parties from being held responsible for deliberate and/or gross negligence. I'm sure Dolan would be frothing at the mouth if he could pin that on someone or some business. Yet another reason nobody else or no place else wants to get involved in the care of Jahi's body.

 

[TJL]

Hi, this bothers me. If she is fed by G~tube why does she need supplements? This has been in my craw a while. I know that soon after her move to N.J. I read an article in the paper, with Dolan and Omrai or whoever .Supposedly they removed the G~tube as (in my words) it wasn't functioning right. She still had the trach.. I know a person cannot remain on IV fluids for a great length of time as it is not proper nutrition, a couple weeks at the most. I searched could never find the article again. Should they try to bring her back to CA. How? they'd need a private plane. Commercial would want her in a casket and place her in the cargo section. I don't see them moving her. They must have a "sort of" Doctor for her ~script for antibiotic. She has drop foot, hands are in splints. I just cannot fathom how they are pulling this all off! Early up it sounded like she is leaving the N.J. hospital she has been in, are they (hosp.) asking them to move her? This situation is beginning to seem a bit ghoulish to me. God forgive me I don't mean that the wrong way but you gotta admit it's not Kosher. If anyone can help me with some of these thoughts I would appreciate it. If not thank you for reading.:loveyou:

Who knows how they're getting scripts for anything (if they are actually getting stuff that requires scripts.) As was suggested before, they could be pulling something that a lot of celebrities do: have doctors write scripts under an alias to protect their identity. It's a frowned upon practice, but I believe it's also one that has passed certain "smell tests" with authorities because it protects people's privacy.

Jahi's body was apparently taken out of the NJ hospital months ago and moved into a private apartment used by the family there, also in NJ. I guess they've just been using 24/7 home-care nursing to keep up with the maintenance of the body. And as far as the delivery of supplements, caloric intake, medicines, hormones, etc. They haven't really elaborated on that much, and I think they do this intentionally to keep as much obscurity and cloudiness to their story as possible. The less the public knows, the better. Kind of like how the mother keeps saying Jahi maintains her own body temperature, yet we see in numerous photos and videos of the body which is covered in several layers of blankets, woolen beanies, etc and a machine in the room which has a set purpose of circulating heated water through hoses over the body, in order to help keep body temperature up.

What they say and what they do are two different things, and carefully orchestrated to tell the story they only WANT people to hear or see.

P.S. also, thank YOU for your input and opinions on this topic I'm so glad we have this place to openly discuss and explore everyone's thoughts on it!

 

[TJL]

"To support the body that they fought so hard to save, Jahi's family has authorized some nutritional support, including potassium, minerals and hormones. She's also getting antibiotics to combat a possible infection. "


BBM:
After re-reading this......WHO is prescribing the antibiotics?? WHAT ones??? Is this prescribing healthcare provider the same one who would serve as the "admitting" provider IF/SHOULD a 911 call be made? It's my bet that the medical history presented to EMS is "edited" to just indicate a NW defined disability of cerebral damage vs full brain death!
Can't you just "see" the nightmare of arriving @ XYZ Hospital with an ALS unit, a "vent" patient without a DNR or a medical chart and a "forced" admission to ER/ED service.

I'm sure THAT phone call to 911 would be extremely cryptic! "My child's heart stopped beating, please send an ambulance!"

 

[La Louve]

Most everything that comes out of his office are painful to read. Just think about the CV of Machado that was in Comic Sans font. Not one intern there thought to change it to TNR or other professionally-accepted font? With the size of his law firm, I doubt any of the court documents (or press releases) are even written by Dolan personally, and are just thrown together by interns. Like one of the first filings that kept referring to Jahi as, "he." That was indicative it was a cut-and-paste job from other cases, or that they used one of those common legal document programs which "fill in the blanks" based on drop-down menu choices, etc.

Interns in a law office generally will do research, not prepare documents for court. I can't believe Dolan doesn't have any paralegals on staff.

I worked as a paralegal for 20+ years and I would never have let docs go out the way his office did. Some judges would have laughed him right out of their courtrooms, or worse, for such sloppy work.

 

[SwampMama]

I'm sure THAT phone call to 911 would be extremely cryptic! "My child's heart stopped beating, please send an ambulance!"

That would be a weird call to go on as a first responder. I have worked as a first responder and have seen some weird things but being called to save the "life" of a legally dead person would be unbelievable. There is little chance that any first responder does not know the name and story of Jahi. If I were a first responder on the scene I would let her go. I could not bring myself to try to make her heart beat again, even if it meant losing a job. But Jahi is dead anyway so it is not like anyone could be sued for "killing her" or "refusing to save her life".

I've been to calls where we knew that we were not going to save the patient (for example an elderly man who was dealing with advanced cancer and multiple other problems) but we did CPR and administered drugs nevertheless. It was more for the wife of the man so she knew that we did try everything. We did it by the book.

Seriously this case has sailed so far down the river of denial. Her family may wish to treat her as i she is alive and recovering because of their beliefs but the rest of us have our own set of beliefs and for me, to be in a situation like Jahi is stuck in is horrific. Let her go!

I think back to the interview that NW gave and she said that Jahi was shy and would not like all this attention at all. How does she think Jahi would feel about her mother announcing to the world that she got her period, or that strangers are changing her diapers and tending to her private parts. Any normal teen would be mortified. I cannot understand why the family is putting Jahi thru this. Admit she is dead and let her go.