Family wants to keep life support for girl brain dead after tonsil surgery #3

[Herat]

I hate to keep repeating this, but I still don't understand why it hasn't been approached that they take her home, like these few other cases that have been shown in the media.

Her heart will eventually stop and I would think that the family would want her right there with them daily.

They have received a lot of donations and will continue to receive more. Plus these other organizations should be able to help get her set up at home.

It seems like a simpler answer than going this other route, but there must be reasons why they aren't considering it.

I wrote post about some reasons why they wouldn't want to bring her home.

But then I got to thinking. If the Terri Shaivo Foundation wants to help her, why are they promoting going to this unqualified place in New York. Why aren't they promoting taking her home, instead? They could certainly facilitate the funds and the staffing to have Jahi at home. This would appear to be within their mission. This would certainly be compassionate care.

Why advocate having her 3,000 miles away from regular family contact in a sub-par facility?

So why isn't the family asking for this kind of help?

 

[Isabelle]

Re: taking Jahi home.

Pretend there are two options - 1) fight the hospital in court (when they are apparently already treating the family poorly per the family AND the family has no trust in CHO) or 2) take her home. (I realize there's a #3 of remove the vent but I'm leaving that out of this one).

Given these two options, I'd take my child home.

On the precious page up thread the question about taking her home was posed and one comment was made that it's about money. If the family takes her home, a lawsuit against CHO may not be as effective. BUT aren't her chances at life better at home where there isn't a deadline to pull the plug? (I KNOW she's legally brain dead- I'm talking as if I'm her mom). Why wouldn't her mom want to take her home and keep her on a vent there? Can you do that?

I'm just saying that option 1 may mean more money in a lawsuit but seemingly LESS of a chance at being on the vent and "living" longer.

Option 2 may mean less money in a lawsuit but MORE of a chance at her "recovering" (again, playing Jahi's mom here).

So why are they choosing option 1? Is it HONESTLY about money? I know money talks but I was really hoping the first priority was wanting to "keep her alive" not make the most money. Thoughts?

All IMO, speculative, and just partly playing devils advocate.

I agree with taking Jahi home with a referral to hospice. However, it would be mandatory that Jahi have a tracheostomy which is a more secure airway and one that family can be educated to care for. Liability would be out of this world if she were sent home without a tracheostomy and on a ventilator (there is major risk for further injury and death if an endotracheal tube is displaced or plugged). I understand that it has been determined that Jahi has no brain function and risk of death is a moot point, but if she were sent home it should be done with consideration for her safety and with an optimal situation that would allow family to safely care for her. A feeding tube would be a plus but with a trach she could be fed via nasogastric tube. Considering feedings, I would wonder if she suffered damage to the GI system due to major blood loss. This case is very difficult but I think efforts should be made to encourage the family to have interaction with hospice.

 

[Herat]

I've read anything and everything I can about sweet Jahi and have not seen a request from her family to bring her home. At first they just wanted to have her through the holidays. As a mother I completely understood this and thought it good the hospital was allowing Jahi to stay with her family during that time. Now I'm left to wonder; was it too much? I just don't know.

The family cannot accept that Jahi is no longer with us. IMO they don't want to bring her home to die; they want to send her somewhere she can heal. It saddens me to say I don't believe she will ever get better.

So long as Jahi's family cannot accept her death, they'll hold unto hope that she can heal. I say prayers every night for everyone from Jahi's family to CHO. I wouldn't want to be in any of their shoes.

The family doesn't want any responsibility, do they? They don't want to turn off the ventilator, they don't want to bring her home. They want someone else to do all the work, but they want to be able to dictate the terms.

 

[Herat]

I agree with taking Jahi home with a referral to hospice. However, it would be mandatory that Jahi have a tracheostomy which is a more secure airway and one that family can be educated to care for. Liability would be out of this world if she were sent home without a tracheostomy and on a ventilator (there is major risk for further injury and death if an endotracheal tube is displaced or plugged). I understand that it has been determined that Jahi has no brain function and risk of death is a moot point, but if she were sent home it should be done with consideration for her safety and with an optimal situation that would allow family to safely care for her. A feeding tube would be a plus but with a trach she could be fed via nasogastric tube. Considering feedings, I would wonder if she suffered damage to the GI system due to major blood loss. This case is very difficult but I think efforts should be made to encourage the family to have interaction with hospice.

I read upthread that hospice would not take someone declared legally dead.

 

[fruity]

If it was normal bleeding, can you explain how and why the patient went from popsicle to brain dead in an ICU in a matter of minutes? Is that considered "normal" in California?

She didn't. You need to brush up on the times given by the family in MSM.

(after surgery) she appeared alert, was talking and even ate a Popsicle afterward.

But about a half-hour later, shortly after the girl was taken to the intensive care unit, she began bleeding from her mouth and nose despite efforts by hospital staff and her family.

While the bleeding continued, Jahi wrote her mother notes. In one, the girl asked to have her nose wiped because she felt it running. Her mother said she didn't want to scare her daughter by saying it was blood.

http://www.huffingtonpost.com/2013/12/21/jahi-mcmath-life-support_n_4485119.html

With her family and hospital staff trying to help and comfort her, Jahi kept bleeding profusely for the next few hours then went into cardiac arrest, her mother said.

http://www.nydailynews.com/news/nat...nlife-support-article-1.1554532#ixzz2pDdfwYiH

This all began on Dec. 9, when McMath went into Children’s Hospital for a tonsillectomy. After the surgery, she began suffering severe complications. Three days later, she was declared brain dead.

http://www.nbcbayarea.com/news/loca...my-Asks-Hospital-for-More-Time-236652191.html

It clearly was not a "matter of minutes". Personally I believe she died at the time of cardiac arrest and that her brain death would have been clear on tests if they had been conducted at that time. However, the tests weren't done for 3 days, and none of us can prove that she was brain dead on the day of the surgery.

Editing to ask if anyone has seen a time given in MSM for how long Jahi was in recovery before being moved to ICU? From memory my son was in there for 30 minutes after very minor oral surgery so I imagine it would have been longer than this? My memories of recovery are very fuzzy. I remember giving the surgeon a thumbs up and asking for roast chicken because I was so hungry, but it could have been 5 minutes or 5 hours for all I knew.

Time isn't really the issue here. Hospitals say that patients can bleed out after a tonsillectomy for days afterwards. I think the danger period is 3 days but will have to check for a link.

 

[al66pine]

Snipped from column written by fam atty Dolan pub'ed Jan 1 =
http://www.sfexaminer.com/sanfrancisco/behind-the-scenes-of-fight-over-jahi-mcmaths-life/Content?oid=2663281
"Hospital PR man Sam Singer, a self-declared “fixer,” had previously said if we got a physician to do the tracheotomy,
we could do it at Children’s. Then he changed that, saying no way...." BBM SBM

Has anyone read or heard this directly from CHO or hosp spokesman
(that if fam got a dr to do trach that CHO would allow them to do that at CHO)?
Link, pls.
Anyone?

Did fam atty Dolan use a bit of literary license in attributing that stmt to Singer?

As other folks here (and I) said earlier --
does not seem like CHO can just let any old, random, non-CHO creditentialed (or non-CHO affiliated?) dr
stroll into CHO OR and perform surgeries, without possible repercussions to CHO
from st-licensing bd or nationwide Jt Comm/Hosp (DK exact name).

IIRC fam atty Dolan's app for TRO asked ct to order CHO et al to perform surgeries to insert breathing & feeding tubes.
CHO objected. Ct did not order CHO to perform surg's.

JM2cts and I maybe wrong. :seeya:

 

[Disguiseduser0308]

The family doesn't want any responsibility, do they? They don't want to turn off the ventilator, they don't want to bring her home. They want someone else to do all the work, but they want to be able to dictate the terms.

I hadn't thought of it that way. Someone mentioned in the earlier thread that perhaps Jahi's family is just now caught up in the fighting the fight (sorry, poster, I can't remember your name). I guess that could be. The fight has become bigger than what's really in the best interest of Jahi and her family.

 

[Isabelle]

Well, keeping her "alive" is the way to establish the wrongful death lawsuit. It will sure be a lot more work to have her at home and they would have to directly confront the deterioration that will follow, as she won't have anywhere near the continuous nursing care and attention to skin care, bowel and urine hygiene, ventilator care. It's a helluva lot of work and it will be a great deal of physical work, as she literally is dead weight. Complicated and messy. You'll be too tired for media blitzes. And the media will gradually fade away.

Who will pay for the equipment? The insurance company will not be renting a ventilator and hospital bed for them. They won't be able to get equipment the quality of what the CHO ICU has.

I don't think they really want to take her home.

I do think Jahi could be cared for in home under hospice and that would cover any equipment and meds necessary for care related to her condition.

If a certificate of death has not been issued, she cannot be considered to be deceased. I am not certain but I would wonder if a death certificate has ever been issued for person who is brain dead and continues to have cardio-respiratory even if a ventilator is in use.

 

[Isabelle]

This case will surely be historical and am sure it will be a topic in many university ethics classes.

 

[vlpate]

I do think Jahi could be cared for in home under hospice and that would cover any equipment and meds necessary for care related to her condition.

If a certificate of death has not been issued, she cannot be considered to be deceased. I am not certain but I would wonder if a death certificate has ever been issued for person who is brain dead and continues to have cardio-respiratory even if a ventilator is in use.

I wonder how much they train for this type of situation.

 

[fruity]

Since CHO is considering her legally dead, and the judge did agree she was brain dead, then how could they possibly be required to perform "life saving" measures?

This is on a tangent, but there is a really good explanation here with regards to next of kin and life sustaining measures.

Any argument that Ms. McMath’s mother has a right to participate in decision-making here is based on a fundamental misapprehension. The next of kin has a right to participate in decisions regarding life-sustaining treatment. Children’s’s own procedures acknowledgement this fundamental right. However, there is simply no life-sustaining treatment that can be administered to a deceased person. Because Ms. McMath is dead, practically and legally, there is no course of medical treatment to continue or discontinue; there is nothing to which the family’s consent is applicable.

http://www.sfgate.com/file/704/704-ChildrensHospitalP&A.pdf

 

[jjenny]

Why are you insisting it is an "unqualified place"? You seem to be on a campaign to destroy the resting place of this family.

Again, there inpatient facility hasn't been completed. They can only take her into their outpatient facility. She is brain dead and on ventillator. How can she be an outpatient? Do they have a license to have someone like her in their outpatient facility?

 

[Isabelle]

I read upthread that hospice would not take someone declared legally dead.

I understand but without a death certificate is she legally deceased? I know this is splitting hairs.Wonder if the coroner has been asked or offered to issue a death certificate and what requirements are necessary to issue one.

 

[MyBelle]

And nothing of this pertains to Jahi.

It just serves to harass the physicians and hospital

Nothing pertains to Jahi? Seriously?

 

[momrids6]

When a person is pronounced brain dead, the death certificate for the individual is issued for the time and date when brain death is declared, not when they are removed from the ventilator.

http://www.cdc.gov/nchs/data/misc/hb_me.pdf

 

[popsicle]

http://thaddeuspope.com/images/McMath_EXHIBITS_1_of_2.pdf

Starting on page 12 (according to the top of the pages it is page 14) the details from the family's side are at times, just not believable. imo

 

[fruity]

Why are you insisting it is an "unqualified place"? You seem to be on a campaign to destroy the resting place of this family.

Can you provide proof that the place is qualified to take Jahi?

What do you mean by "resting place" of the family? I'm not American, and "resting place" is a colloqualism here for cemetery or burial place.

 

[vlpate]

She didn't. You need to brush up on the times given by the family in MSM.
snipped for brevity
It clearly was not a "matter of minutes". Personally I believe she died at the time of cardiac arrest and that her brain death would have been clear on tests if they had been conducted at that time. However, the tests weren't done for 3 days, and none of us can prove that she was brain dead on the day of the surgery.

But about a half-hour later, shortly after the girl was taken to the intensive care unit, she began bleeding from her mouth and nose despite efforts by hospital staff and her family.

While the bleeding continued, Jahi wrote her mother notes. In one, the girl asked to have her nose wiped because she felt it running. Her mother said she didn't want to scare her daughter by saying it was blood.

If she was bleeding profusely, it seems the daughter would have seen the blood when she lowered her head to write the note...the natural instinct is to wipe with hand if it's "running".. she'd have seen it on her hand. This sounds like the mother dealing, rather than accurately relaying the events.

When the large amts of blood and clots started coming, Jahi had to be horrified...blood scares children period...imagine her mother's horror to see her daughter's fear.

She has to be tortured, and I'm sure she's not the first mother to experience such horror...I hope she is seeing someone that might help her make the right decision for the right reasons.

 

[MyBelle]

She didn't. You need to brush up on the times given by the family in MSM.



http://www.huffingtonpost.com/2013/12/21/jahi-mcmath-life-support_n_4485119.html



http://www.nydailynews.com/news/nat...nlife-support-article-1.1554532#ixzz2pDdfwYiH



http://www.nbcbayarea.com/news/loca...my-Asks-Hospital-for-More-Time-236652191.html

It clearly was not a "matter of minutes". Personally I believe she died at the time of cardiac arrest and that her brain death would have been clear on tests if they had been conducted at that time. However, the tests weren't done for 3 days, and none of us can prove that she was brain dead on the day of the surgery.

Editing to ask if anyone has seen a time given in MSM for how long Jahi was in recovery before being moved to ICU? From memory my son was in there for 30 minutes after very minor oral surgery so I imagine it would have been longer than this? My memories of recovery are very fuzzy. I remember giving the surgeon a thumbs up and asking for roast chicken because I was so hungry, but it could have been 5 minutes or 5 hours for all I knew.

Time isn't really the issue here. Hospitals say that patients can bleed out after a tonsillectomy for days afterwards. I think the danger period is 3 days but will have to check for a link.

I don't need to "brush up" on anything. Jahi's organs will not be sold to the highest bidder. Anyone who wishes to believe Children's hospital actually cares about Jahi is still free to do so....but I doubt anyone believes the hospital.

 

[MyBelle]

I wrote post about some reasons why they wouldn't want to bring her home.

But then I got to thinking. If the Terri Shaivo Foundation wants to help her, why are they promoting going to this unqualified place in New York. Why aren't they promoting taking her home, instead? They could certainly facilitate the funds and the staffing to have Jahi at home. This would appear to be within their mission. This would certainly be compassionate care.

Why advocate having her 3,000 miles away from regular family contact in a sub-par facility?

So why isn't the family asking for this kind of help?

As far as I can tell, only you are insisting it is an "unqualified place."