Family wants to keep life support for girl brain dead after tonsil surgery #2

[Minette]

I see about 10 fire code violations from two pictures of that wreck.

On the other hand, I'll bet it makes a nice hair salon and real estate office.......

Hey, I found the quote from the founder, BBM!

In a letter to Dolan, Scerri said the facility would accept Jahi into its outpatient center and eventually move her into a planned inpatient facility, now under construction, for long-term care.

"We will be providing Jahi McMath 24-hour licensed nursing staff and licensed respiratory therapists," she wrote. "We are also hiring a pediatrician who will accept her as his patient."

http://www.mercurynews.com/breaking-news/ci_24825721/jahi-mcmath-state-launches-investigation-into-medical-case

So I guess the immediate plan would be to put her in the current house and then move her whenever the inpatient center is built. I wonder if the state of New York is down with this plan?

 

[Elley Mae]

Here's today's article followed by the article which detailed the three conditions. It seems now that the family has found transportation and a facility, the hospital attorney slammed it to a halt.

http://www.npr.org/templates/story/story.php?storyId=258836693

The refusal appeared to reverse the position articulated Monday by a hospital spokesman. He said the hospital would allow a doctor retained by the family to insert a feeding tube and to replace the oral ventilator keeping Jahi's heart beating with a tracheal tube — surgical procedures that would stabilize Jahi if she is moved to a facility willing to keep caring for her.


Monday's agreement to allow outside physician perform the procedures:

But a spokesman for Children's Hospital Oakland, Sam Singer, has said that even if a facility agrees to take the girl in, three conditions must be met. The family must find an outside physician willing to insert breathing and feeding tubes, a way to transport her, and a facility that is willing to accept "a deceased person," he said.

http://www.latimes.com/local/lanow/...cility-20131231,0,4905982.story#ixzz2pC5IcqdK

MyBelle, Thanks for the link. This is not at all directed to you.

From the link.
http://www.latimes.com/local/lanow/...cility-20131231,0,4905982.story#ixzz2pC5IcqdK

It was unclear if the bid to transfer Jahi to New York would actually go through. New Beginnings said in its letter filed with the court that a new facility where she would be housed, called the Brendan House, is only "near completion."

And Singer told reporters Monday that "this hospital has had no substantive conversations" with any of the possible outside facilities.


bbm1,2 Just like we can see in the pictures, nothing has changed since 2011, except now they seem to want to complete renovations.

bbm3 I wonder why new beginnings is not calling and setting this up. I mean geez it's a little phone call, easy peasy. I mean it would seem that the call would set the wheels in motion to get this bus on the road.

bbm, yellow ANY bbm3 This hospital has had NO substantive conversations, with ANY of the POSSIBLE outside facilities.

Why would they not comply with the order from the judge. They know what it will take to get this done, Do It. Stop blaming others, go find a place that will accept her.

 

[Herat]

Actually, it will be an "independent living" home...big difference , imo

http://www.nbli.org/assets/pdfs/brendanHouseFlyer2013.pdf

And which part of Jahi's current state is "independent living"?

I hope the family realizes that, under normal circumstances, insurance will only pay for a stay in the proper kind of licensed facility and that ain't it.

 

[Herat]

Hey, I found the quote from the founder, BBM!



http://www.mercurynews.com/breaking-news/ci_24825721/jahi-mcmath-state-launches-investigation-into-medical-case

So I guess the immediate plan would be to put her in the current house and then move her whenever the inpatient center is built. I wonder if the state of New York is down with this plan?

I have to think the State of New York would serve an injunction on them. If they don't have a proper license for 24/7 care and a proper facility, no amount of "contracts" or oral agreements is going to allow this to happen.

And I'll bet part of the New York statutes about 24/7 care facilities requires the director to be at least an RN.

No amount of gibberish from the woman running this facility can make up for the fact that this is patently unsuitable.

 

[otto]

I have to admit that cases like these are compelling. It makes me wonder if waiting 2-3 days after a declaration of brain death might be prudent. It sounds like Zack woke up within 48 hours of being declared brain dead. Unfortunately it has been much longer than that for Jahi.

Many professionals in this thread have talked about changes in the brain's consistency that inevitably occur with brain death. Is there any way those changes can be detected and shown to the family? I know that if it could be proven to me that my loved one's brain was turning into "mush" that would be very convincing to me that their condition was in fact irreversible.

There was a link yesterday to a case study of a middle aged woman. Brain scans showed that, over time, the brain became a black mass.

 

[kimlynn]

MyBelle, Thanks for the link. This is not at all directed to you.

From the link.
http://www.latimes.com/local/lanow/...cility-20131231,0,4905982.story#ixzz2pC5IcqdK

It was unclear if the bid to transfer Jahi to New York would actually go through. New Beginnings said in its letter filed with the court that a new facility where she would be housed, called the Brendan House, is only "near completion."

And Singer told reporters Monday that "this hospital has had no substantive conversations" with any of the possible outside facilities.


bbm1,2 Just like we can see in the pictures, nothing has changed since 2011, except now they seem to want to complete renovations.

bbm3 I wonder why new beginnings is not calling and setting this up. I mean geez it's a little phone call, easy peasy. I mean it would seem that the call would set the wheels in motion to get this bus on the road.

bbm, yellow ANY bbm3 This hospital has had NO substantive conversations, with ANY of the POSSIBLE outside facilities.

Why would they not comply with the order from the judge. They know what it will take to get this done, Do It. Stop blaming others, go find a place that will accept her.

There was a video posted yesterday of Dolan and Singer having words and Dolan asked for a time and date to have a meeting.
No response from Singer and Dolan asked more than once.
Not sure why the lack of communication between the parties.
IMO

 

[momrids6]

I swear I thought I read somewhere that it was one day planned to become an inpatient facility, but you are probably right. In either case, right now it is in no way, shape, or form a fit place to house someone who is wholly dependent on a ventilator, whether you believe Jahi is dead or not. As others have said, it is a construction site. HOW could any medical professional consider this an ethical or even a humane situation for Jahi to be in? I think the people who are behind this facility probably have their hearts in the right place, but this should not even be in consideration as a last resort, IMO.

Please know Minette, I am agreeing with you in terms of it not being an option for Jahi; I was referencing their own material that it is not even an "inpatient facility" per se.

http://www.nbli.org/assets/pdfs/bren...eFlyer2013.pdf

 

[Elley Mae]

There was a video posted yesterday of Dolan and Singer having words and Dolan asked for a time and date to have a meeting.
No response from Singer and Dolan asked more than once.
Not sure why the lack of communication between the parties.
IMO

A public forum (press conference) would not seem to be a proper/professional place to decide on a medical institution to take a deceased person. I would not have respronded either. jmo

 

[BeginnersLuck]

Just for comparisons sake here is the policy of different facilities, in a different state, as it applies to brain death.

http://hhcethics.org/documents/HHC_Corporate_Brain_Death_Policy.pdf

2. If there is an objection by the Legally Authorized Representative to a brain death
determination that is on a religious or moral basis, reasonable efforts to accommodate
the objection shall be undertaken.
a. Reasonable accommodation after the determination of death includes the
continued provision of ventilator support and routine nursing care for a reasonable
period (generally not to exceed 72 hours from the time of pronouncement).
Treatment for an indefinite period of time after the determination of death is not
required.
b. Reasonable accommodation after the determination of death does not require
performance of any diagnostic or therapeutic procedures, including (but not limited
to): blood tests, radiologic tests, physiologic monitoring, administration of
medications for any purpose, nutrition or hydration support, cardio-pulmonary
resuscitation (notwithstanding absence of a DNR order), or treatment in a critical
care unit.

Also:

5. The time of death is recorded as the time brain death is determined.

 

[kimlynn]

A public forum (press conference) would not seem to be a proper/professional place to decide on a medical institution to take a deceased person. I would not have respronded either. jmo

I found it interesting that there wasn't any response at all from Singer as to a meeting to resolve issues yet he did seem willing to take the time to hurl a few insults at the attorney. Childish.
None of this is helping anyone move along. IMO

ETA Dolan asked for a time and place to discuss issues which seems reasonable to me.

 

[momrids6]

There was a video posted yesterday of Dolan and Singer having words and Dolan asked for a time and date to have a meeting.
No response from Singer and Dolan asked more than once.
Not sure why the lack of communication between the parties.
IMO

Dolan is the family's attorney- not a facility owner, facility attorney , nor a facilty rep...

 

[jjenny]

And which part of Jahi's current state is "independent living"?

I hope the family realizes that, under normal circumstances, insurance will only pay for a stay in the proper kind of licensed facility and that ain't it.

I don't think insurance is going to pay since the patient is considered legally dead.

 

[MyBelle]

MyBelle, Thanks for the link. This is not at all directed to you.

From the link.
http://www.latimes.com/local/lanow/...cility-20131231,0,4905982.story#ixzz2pC5IcqdK

It was unclear if the bid to transfer Jahi to New York would actually go through. New Beginnings said in its letter filed with the court that a new facility where she would be housed, called the Brendan House, is only "near completion."

And Singer told reporters Monday that "this hospital has had no substantive conversations" with any of the possible outside facilities.


bbm1,2 Just like we can see in the pictures, nothing has changed since 2011, except now they seem to want to complete renovations.

bbm3 I wonder why new beginnings is not calling and setting this up. I mean geez it's a little phone call, easy peasy. I mean it would seem that the call would set the wheels in motion to get this bus on the road.

bbm, yellow ANY bbm3 This hospital has had NO substantive conversations, with ANY of the POSSIBLE outside facilities.

Why would they not comply with the order from the judge. They know what it will take to get this done, Do It. Stop blaming others, go find a place that will accept her.

Actually, from what I've read, that isn't where Jahi will first go. Apparently, the organization has stated in a letter filed with court documents they are willing to provide Jahi 24-care at their out-patient facility, which is a modern building.

The president of New Beginnings Community Center for Traumatic Brain Injury, a nonprofit outpatient rehabilitation center in Medford, said in a letter Sunday to the mother's attorney and filed with the California court that she would be "willing to open our outpatient facility to provide 24-hour care as an inpatient long-term facility for Jahi with the required and appropriate medical staff that she depends upon."


http://www.newsday.com/news/health/...th-moved-to-li-court-documents-show-1.6699484

 

[Steft50]

IIRC, someone posted either on this thread or the previous one, some really good articles on why/how the heart beats regardless of brain death. The vent and the Vasopressin are enabling the heart to continue beating. If you take away the Vasopressin, which is used to help with BP as well as kidney function, chances are Jahi would develop congestive heart failure.

Even if Jahi's heart were to stop, I have read nothing to indicate that she is a DNR. So she is a full code until either the family says otherwise, or despite CPR and resuscitation, her heart does not resume a normal rhythm. JMO

First of all thank you so much for answering all the medical questions I've seen asked. The explainations that you and your DH have provided have been greatly appreciated!

The section I BBM brings up the legality of resusitating what is legally a dead person? Where would her coding fall into the legal/ethical question?

 

[SophieRose]

One brain dead guy supposedly lasted 20 years on a ventillator. So I fail to see how this could possibly be accurate.

Yes, he lived from the age of 4 to 24. There were two other children in the study that lived quite some time, one for two years and another for five years. But that was quite uncommon.

 

[jjenny]

Actually, from what I've read, that isn't where Jahi will first go. Apparently, the organization has stated in a letter filed with court documents they are willing to provide Jahi 24-care at their out-patient facility, which is a modern building.

The president of New Beginnings Community Center for Traumatic Brain Injury, a nonprofit outpatient rehabilitation center in Medford, said in a letter Sunday to the mother's attorney and filed with the California court that she would be "willing to open our outpatient facility to provide 24-hour care as an inpatient long-term facility for Jahi with the required and appropriate medical staff that she depends upon."


http://www.newsday.com/news/health/...th-moved-to-li-court-documents-show-1.6699484

How is the brain dead person on a ventillator going to be an outpatient? Don't they need a license to keep a brain dead person in their outpatient facility?

 

[Cubby]

Family says they couldn't get any nurses attention to help them.Sounds like the bleed out took minutes to happen.
Jahi wrote a note to mom asking if she was okay.She said she was swallowing mucus (probably blood) so of course family tried to help so she wouldn't choke to death on her own blood.
IMO

The family should have never intervened. We don't know what the nurses were doing because the hospital is not able to due to hipaa.

The family has already been proven to be less than honest. I don't have any reason to believe the accuracy of their statements.

 

[kimlynn]

Dolan is the family's attorney- not a facility owner, facility attorney , nor a facilty rep...

I understand but perhaps a meeting could have helped both parties as well as Jahi and family?

 

[jjenny]

Yes, he lived from the age of 4 to 24. There were two other children in the study that lived quite some time, one for two years and another for five years. But that was quite uncommon.

I know living that long isn't common. I was responding to Linda who claimed that brain dead person's heart should stop within a short time even if they are on ventillator. Obvoiusly not true.

 

[krimekat]

There was a video posted yesterday of Dolan and Singer having words and Dolan asked for a time and date to have a meeting.
No response from Singer and Dolan asked more than once.
Not sure why the lack of communication between the parties.
IMO

Singer, I believe, is not an attorney, just the "spokesman". I assume that all essential parties would be necessary to participate & make it a productive meeting.

MOO