Family wants to keep life support for girl brain dead after tonsil surgery #1

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  • #541
Let's just say - that this mystery facility DOES take possession of this child's body as it exists today- without a tracheostomy or gastrostomy tube. (See my earlier post which explains these procedures.)
She would be transported with a standard endotracheal tube (breathing tube inserted in the mouth, down into the lungs) and ng/nj feeding tube (inserted through the nose into the stomach or small bowel).
If the endotracheal (breathing or 'ET') tube becomes dislodged, only a physician (or paramedic in the field) can replace it 99% of the time. If no physician is available (which would be the case 99% of the time at a long-term care facility) - does the facility call 9-1-1 for emergent transport? What ER is going to replace an ET tube in a brain dead patient?
I have NEVER heard of a long-term care facility that would accept a patient with an ET tube. A tracheostomy is required for admission to these facilities for the exact reason that there is usually no in-house MD 24/7.
I don't even know what to think any longer about this case. It is so frustrating to only get information filtered through the family - and not the objective facts.

Excellent post, Nicemaryjean.

To add to your insights, what if Jahi's body develops pneumonia? Will she be re-admitted to an acute care facility? What if her body develops an ileus? Cardiac dysrhythmias? What about when her kidneys fail? Find a facility to place an AV shunt and take her body to hemodialysis 3 days a week? Find a facility to place an abdominal catheter for peritoneal dialysis? Marches and demonstrations for ECMO? A Facebook rally for a march to demand an LVAD? (left ventricular assist device-- partial artificial heart)

Where does it end? What exactly is the end game?

I get that the family is angry and in denial. I get that they're heartbroken. I get that they want to inflict maximum pain and suffering on the hospital, and Dolan in particular.

I see the stages of grief playing out. I just wonder how long, and what it will take, for the family to get to acceptance. And how much multi-layer damage will be done in the time it takes for them to get to acceptance. This is really a psychosocial disaster of vast proportions.

And I'm very concerned that the publicity of this case will create the momentum for similar cases in the near future.

This is not about respecting faith and religious beliefs any longer, IMO. And it is most definitely, IMO, not about civil rights.
 
  • #542
I think he may want Jahi to have hormone replacement therapy. Since there is no perfusion to her brain there is no perfusion to her pituitary gland and her body isn't producing pituitary hormones, one of which is TSH, thyroid stimulating hormone.
I can't imagine any kind of surgery is going to fix her pituitary gland if it's been without perfusion for two weeks.
 
  • #543
I can't imagine that anyone would want the organs of deceased person that has been hooked up to a machine for too long.

No, from what I've read, it's way past the point of her being able to donate any organs. Dr. Byrne's hoopla doesn't seem to apply, IMO in this case because his arguments all seem to surround organ donation and he likes to insinuate that hospitals are rushing to take organs from people that aren't dead. The cases he seems to site are those that have recovered from brain trauma but not brain death.

I'm still upset about his comment about the soul not leaving the body and thinking about all those that have made the difficult decision to remove life support and donate organs.

I don't like this guy......He doesn't believe in donation of any vital organs because he says that is what causes their death, even though they are legally dead on life support when organs are removed.

Ok... I'm drifting O/T

If Byrne knows so much maybe he should perform these procedures himself.
 
  • #544
I think he may want Jahi to have hormone replacement therapy. Since there is no perfusion to her brain there is no perfusion to her pituitary gland and her body isn't producing pituitary hormones, one of which is TSH, thyroid stimulating hormone.

I can't imagine any kind of surgery is going to fix her pituitary gland if it's been without perfusion for two weeks.


Dr. Byrne needs to be the physician that conducts this type of "research" on the patient. No morally correct doctor would even consider it! I just looked on the FDA website for any warning letters that may have been issued to him. Surprisingly, there's none-which leads me to believe he blows a bunch of hot air and has no substantial data to back his claims...only desperate families.
 
  • #545
http://www.lifeguardianfoundation.org

Looks like dr Byrne is only interested in selling his books, which sounds as if it feeds on fears of patients that believe things that aren't true at all. Looks like this family is perfect for him to prey on. He is a neonatologist, what expertise does he have in end of life care, brain death, or thyroid or pituitary repair???


Sent from my iPad using Tapatalk

His opinions are so radical that even most Catholic theologians do not support him, and he claims alliance with Catholic ideology.

And mainstream medicine clearly does not support his ideas.

(I just have to wonder how in the world he ever got a non-religious university appointment?!)
 
  • #546
http://www.contracostatimes.com/new...th-hospital-open-transferring-brain-dead-teen

A call to the Coroner's Office on Friday was not immediately returned, but Dolan said that office had greenlighted a transfer if a facility would accept her.

Tracheotomies and the insertion of gastric tubes are procedures done largely to ease the task of providers, Holmes said, and are common for patients discharged to long-term facilities. However, a patient could be moved without those procedures being done, he said.

snip

The position of Children's Hospital Oakland is what would be expected from any other facility, Zitter and Holmes said.

"Generally, when someone is determined to be dead, all remaining interventions are halted," Holmes said, adding Jahi's case is unique in that a judge intervened extending her time hooked to life support machines until Monday evening.

"I think the whole case is dangerous in terms of precedent. I think that's probably a concern for the hospital," Holmes said. "We're able to do so much in medicine, and there are times when maybe we shouldn't do as much."
 
  • #547
No, from what I've read, it's way past the point of her being able to donate any organs. Dr. Byrne's hoopla doesn't seem to apply, IMO in this case because his arguments all seem to surround organ donation and he likes to insinuate that hospitals are rushing to take organs from people that aren't dead. The cases he seems to site are those that have recovered from brain trauma but not brain death.

I'm still upset about his comment about the soul not leaving the body and thinking about all those that have made the difficult decision to remove life support and donate organs.

I don't like this guy......He doesn't believe in donation of any vital organs because he says that is what causes their death, even though they are legally dead on life support when organs are removed.

Ok... I drifting O/T

If Byrne knows so much maybe he should perform these procedures himself.

This story should be buried. The more attention it gets, the more crazies crawling out of the woodwork looking for fifteen minutes of fame and a cut of the winfall.
 
  • #548
This website of Dr. Byrne's talks about Jahi...

"......Maybe it is only a few "pro-lfers" who are willing to protect the life of Jahi. Even a few count, but I know there are many more, if they knew the truth. A slave is someone who is kept from the truth."

http://www.renewamerica.com/columns/byrne

WOW.....
 
  • #549
My POV, fwiw:

The longer this goes on, the more the public is finding the family's case objectionable if not worse. The family is doing itself NO favors in the court of public opinion by prolonging it.

I am so sad that not ONE of the mother's extended family has understood the medical facts and been able to help Mrs Winkfield do the same. Or, a pastor as cited in a similar case upthread, who got it after several drs concurred and then helped the family with acceptance thru their immense loss.

I do not trust the uncle nor the lawyer at this point. They lost my listening ears days ago. I also feel strongly that they have set back public understanding of the real issues at-stake by not being truthful. Hopefully in the end, this case will serve the public by being educational at least. I've seen a lot of minds changed in net comments, the more that information is posted on sites such as WS.

Also, I'm glad to see the word precedent used in today's discussions, for it has surely been on my mind all along. I can only imagine the ramifications. Thank goodness CHO took a stronger stance today, and I hope it continues.

There is law governing the determination of death. An orderly society has legislation in-place for good reason, with protocols to respect such law. True, the law may need clarification or revision, but I doubt such changes will be those the family would like to see strengthened.

It's time to end this and allow Jahi to rest in peace.

Despite all of the above, my heart and sympathies still go out to her family.

~Not my most articulate post...I'm tired after reading all day. All of the above is jmo~
 
  • #550
  • #551
http://www.sfgate.com/health/article/Family-seeks-hospital-s-help-to-transfer-5097409.php

But attorney Christopher Dolan said transferring Jahi McMath to the Southern California facility would require Children's Hospital Oakland to agree to insert a tracheal tube and leave it in place for five to seven days. That would mean she would have to be connected beyond Monday's scheduled expiration of a judge's order to keep her connected to a respirator.

If the hospital refuses, Dolan said, he will return to Alameda County Superior Court to seek an extension of the order and also file a federal court suit on the family's behalf.

snip

But the lawyer said he located another subacute-care facility, with a religious affiliation, in Southern California, whose head of operations and admissions has preliminarily agreed to a transfer, pending final approval by the medical director.
 
  • #552
At this point, Dr. Byrne needs to put HIS medical license and financial future on the line and step up to bring Jahi under his care in a facility that will accept an artificially animated corpse or he needs to shut up and stop trying to speak for God.

In my opinion.
 
  • #553
Dr. Byrne needs to be the physician that conducts this type of "research" on the patient. No morally correct doctor would even consider it! I just looked on the FDA website for any warning letters that may have been issued to him. Surprisingly, there's none-which leads me to believe he blows a bunch of hot air and has no substantial data to back his claims...only desperate families.

I get the impression he has never really done a lot of clinical work. His main purpose appears to be furthering his particular brand of ideology.
 
  • #554
This website of Dr. Byrne's talks about Jahi...

"......Maybe it is only a few "pro-lfers" who are willing to protect the life of Jahi. Even a few count, but I know there are many more, if they knew the truth. A slave is someone who is kept from the truth."

http://www.renewamerica.com/columns/byrne

WOW.....

I don't even think "mainstream pro-lifers" align their ideology with his.
 
  • #555
Since one of Jahi's family members is said to be a registered nurse, I don't exactly know how that person can be in denial about the medical facts.

I have two personal examples to share with you. One involves my father. I am also a nurse, and had worked with and knew his ICU nurses years before. When I arrived at the hospital, my dad was in ICU, not on a ventilator, just with an IV, O2 and of course, heart monitor. He had a massive GI bleed of undetermined origin at home that AM and almost died. He was also a chronic heart and renal failure patient by that point. His age was advanced. He had outlived most of his friends.

The ICU nurses grabbed me as soon as I had seen my father. They showed me his lab values for BUN, Creatinine, and serum potassium. They were incompatible with life, and he was receiving a medication which lowers potassium- nasty stuff.
It was clear to me in less than 1 minute that my father's labs were incompatible with life, or a good quality of life.

I asked them if he was a Code Blue, because most ICUs will not accept DNR patients for good reason. They said " Yes, that's why we wanted to talk to you". I wasn't a bit upset except that my daddy was so sick, I was exceptionally pleased that they understood that I would not want my dad resuscitated in the presence of chronic organ dysfunction/ impending failure.
I talked to my mother that night and she asked the doctor many questions the next AM. They decided upon a DBR status for him, and he was moved to a reg. hospital room. He died peacefully several months later after being at home, alert and happy, for the entire summer. He lived a good life, he had a good death.

Next, I want to share with you something that happened to me as a nurse in Florida. It is true that some parts of Florida are saturated with elderly people. Some are in nursing homes, of course. I worked on a surgical floor, and most of the pre-surgical patients were elderly patients who needed multiple workups before surgery. Then, our hospital got a laser and a new eye surgeon to do the modern cataract removal surgeries in 1983.
I noticed that all of the inpatient cataract patients we had were from nursing homes.. and none of them could talk, roll over, feed themselves- in other words, their quality of life was end stage. They were close to natural deaths. However, this eye surgeon was finding cataracts in these peoples' eyes and removing them surgically and charging Medicare.

To this day, I do not understand how what he die was ethical or justifiable. Not because a dying person with no family shouldn't have the right to see, but because ALL surgeries have risks. And because it seemed that he was using these first " discarded" elderly people as learning experiences.

Ethics is not one thing for one person and another thing for another person when the conditions are the same. It is the practice of applying the same standards according to the criteria.

Long story short, this is ALL about money. Just like the eye surgeries on people too elderly to even understand that they were in a hospital and who had no family to see what was going on profited the hospital and the eye surgeon, every day that this little girl is allowed to stay in a bed instead of a casket in the ground, the more money her family will collect for their own emotional pain and suffering as well as the injuries to the child.
As for the earlier comments about how her surgical wounds might heal and not be obvious to a coroner. big deal. The MEDICAL RECORD tells the story of what happened, what was done when, and the facts of the Code Blue. The Medical Record of this child is the smoking gun. The family knows this because there is a nurse in the immediate family, just as I know it for the same reason.

The insurance company is not getting involved because they have deeper pockets than the surgeon, the hospital, etc. I ran into the same problem when I worked in Utilization Management. No one except at Medicaid would take the responsibility to deny treatment if the denial would result in certain death.
 
  • #556
Reading these my heart is actually breaking for this poor woman.

I don't think she actually understands that her daughter is dead. I mean let's put it this way, the woman works at Home Depot to support 4(?) children, I don't think she's gone through higher education and I REALLY doubt she has much is any medical knowledge.

I have a feeling that her lawyer and this quack doctor keep telling her that she's alive and the hospital is lying to them. I'm not going to turn this into a race thing but people who are in the racial minority are often used to "Big Brother" lying to them (Tuskegee Experiment, anyone?) and honestly start to expect it. I think that Dr. Bryne is filling this family's head full of lies and false hopes.
 
  • #557
Older commentary "Treating the Brain Dead for the Benefit of the Family"

I thought there was some good ethical discussion in this article.

http://web.utk.edu/~jhardwig/BrainDead.pdf

Bumping this link, as it is just such a thoughtful and thorough debate and discussion about the role of the family's needs vs the role of the patient's needs, IMO.

Thank you, BeginnersLuck, for finding it. Highly recommended reading.
 
  • #558
  • #559
  • #560
Family finds facility to take 'brain-dead' girl

The new facility is in Southern California, said the family's lawyer, Christopher Dolan, but he wouldn't provide its name.

"We're afraid they'll be inundated with press" and decide to back out as well, he said.


Is he implying this as a reason that the facility in the Bay Area declined? smh

~jmo~
 
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