Family wants to keep life support for girl brain dead after tonsil surgery #6

[otto]

This article discusses pediatric sleep apnea and betwetting. I didn't research outcomes of improvement of bedwetting with T&A, UPPP, and turbinate resection, but I'm assuming they are out there somewhere.

http://www.entnet.org/HealthInformation/Could-Child-Have-Sleep-Apnea.cfm

Thanks. I didn't know that there was a connection. Given that there is sometimes a connection, I still doubt that a doctor would ever claim that a child would be cured of anything through surgery. I don't have much experience with it, but my limited experience is that the doctor says that the surgery will hopefully improve the situation. It's always a "hope for the best, prepare for the worst" scenario.

 

[katydid23]

Im just going to day it simply as a person who assisted physicians assessing brain dead patients....ALL brain dead means is LACK or deficient Brain electrical activity...So If you dont wish to believe LACK of Oxygen causes Brain damage FIne..BUT it does...from my experience..Take it for what its worth...

The only reason Jahi suffered that lack of Oxygen is because ICU staff werent monitoring nor assisting her..left her family to deal with her bleed out..Sudden Blood loss..does cause such injuries...

Unless you have some sort of link to suggest any difference..i will agree to disagree on your premise..:seeya:

We do not know what actually happened in the aftermath. In some ways they are giving conflicting versions of the events. They say 'no one helped', but then also describe nurses being in the room helping them, but saying ' not enough nurses' were helping. So which is it?


And I do not think you can blame CHO for brain damage if she had a heart attack/stroke and suffered brain damage as a result. Sometimes these things happen in spite of being cared for competently.

 

[Quester]

My daughter recently had 4 wisdom teeth removed in outpatient surgery. One was impacted and there was a lot of bleeding. I took care of her the first night, and the nurse said "ABSOLUTELY, NO SUCKING" on anything. She could have popsicles but must lick them or cut into small bites. But NO SUCKING nor using a straw to drink for a few days. Doing so could cause further bleeding.

Yes - after wisdom teeth removal, my understanding is that any sucking action could cause blood clots to dislodge which could result in bleeding and possible dry socket issues.

 

[Linda7NJ]

It was probably necessary. I think that "elective" surgery often gives the wrong idea, suggesting that it is optional or not really necessary. When my son had neurosurgery, I was surprised that "elective" was written on the chart. It's true, I had to make the decision whether he had the surgery or not. Without the surgery, he would be severely brain damaged. With the surgery, he's a great guy. It was impossible to say prior to the surgery whether it was absolutely necessary, but immediately after the surgery the neurosurgeon found me and told that I made the right call ... that it was necessary.

I am glad you had a choice and I'm thrilled your choice was the correct one.




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[Melanie]

That's not lighting. I think that is the loss of skin elasticity, amongst other things.

That's the first thing I saw - loss of skin elasticity (especially compared to her sisters hand).

MOO

 

[Disguiseduser0308]

Of course the hospital hasnt made it clea..claiming HIPPA...So Story's can very..BUT FACTual things..Jahi was sitting up in her bed when family entered..and she suddenly started initially to seep blood from nose and mouth...and whomever handed the K-basin suggested..this is normal..Then within a short period..Bleeds out..Why should this family be required to clean up that blood..Why should this family ever have to do anything?? Who was (medically) actually in attendence??..Did they ever call for Medical emergency help ( nurse attendent)?? When was Code called?? AFter she bleed out??

ICU bedside nursing understand how deteriorations..bleeding outs or crashings of vital signs work..You dont wait for Cardiac arrest before ya call for help..And Im talking way back.....Im truly qustioning this so called ICU care at CHO??? :scared:

Re: Bold part -- Ya know, this struck a cord with me because I did a lot for my son when he was horribly ill with a double kidney infection from a source that took three/four days to grow in a culture. I did everything in my power to help the nurses care for my son (with their permission). Most parents who stay with their children in hospital are there to be a method of support and care for their children. They don't have to. They want to.

 

[BeginnersLuck]

I am not a medical professional, and somebody may have answered this before me. I have two friends who have been on TPN for different reasons. Because their body is still alive, their digestive system somewhat shuts down, but doesn't start to fall apart as Jahi's has. They had to slowly wean off of the TPI, and eat special diets, and in both of the cases, there were setbacks where they had to go back on to TPN for a while.

Welcome to WS's Wolfie!!

Thanks for joining the discussion!!

 

[Karmady]

I am willing to bet my next 10 years of paychecks that there is no reportt, pre-op signature, or ANY such form this family will be able to produce where they signed a document stating that these procedures would "CURE" overactive bladder - let alone CURE anything else for that matter.

The uncle can "report" anything he wants!:banghead: That doesn't make it TRUE.

Am I reading this right? You don't believe that anyone in this family is capable of lying or would have motive to do so?

They also purport to believe that she's going to benefit from being fed and will recover, although she's been dead for a month. I'm not shocked they would also purport to have thought that surgery would cure pretty much whatever was wrong with Jahi to begin with. jmo

 

[K_Z]

I would bet it was predicted it would cure her sleep apnea and as a result improve the urination problem.


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I disagree. There is no way ANY ENT doc would present this collection of procedures as a "cure" for anything. It was a strongly recommended set of procedures to attempt to address a set of symptoms, as part of a multimodal approach to treating all of Jahi's underlying issues (whatever they were).

ENT, in my experience, doesn't "like" doing these kind of procedures. They don't do a lot of them, and they do months of interdisciplinary evaluation before they recommend them. They recommend them and do them when the potential benefit clearly outweighs the reasonably anticipated risks. And it is still only ONE part of the whole person treatment.

 

[Linda7NJ]

I am willing to bet my next 10 years of paychecks that there is no reportt, pre-op signature, or ANY such form this family will be able to produce where they signed a document stating that these procedures would "CURE" overactive bladder - let alone CURE anything else for that matter.



The uncle can "report" anything he wants!:banghead: That doesn't make it TRUE.



Am I reading this right? You don't believe that anyone in this family is capable of lying or would have motive to do so?

There is no reason in the world anyone would elect to have this surgery unless they believed it would solve their sleep apnea issue. They wouldn't believe it would benefit them unless a doctor told them so.

Iirc I read this mother got a second opinion after the first recommended this surgery. Her mother brought her to this hospital. A well known and respected children's hospital.




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[threecrazykids]

The autopsy will be an important part of the investigation.

IMO - The longer this is drawn out the less likely any autopsy findings will be "in favor" of Jahi and her family.

But of course with the conspiracy and all, I am certain any COD other than: "bleeding out due to medical negligence following routine tonsillectomy" will just be completely unacceptable by the family.

 

[Herat]

It was probably necessary. I think that "elective" surgery often gives the wrong idea, suggesting that it is optional or not really necessary. When my son had neurosurgery, I was surprised that "elective" was written on the chart. It's true, I had to make the decision whether he had the surgery or not. Without the surgery, he would be severely brain damaged. With the surgery, he's a great guy. It was impossible to say prior to the surgery whether it was absolutely necessary, but immediately after the surgery the neurosurgeon found me and told that I made the right call ... that it was necessary.

There are basically two options for surgery: emergency or elective.

This is for the scheduling in the OR. If it is emergency, it must be done within a certain time for preservation of life or limb and will bump other non-emergency cases.

An "elective" case just means that it is not a life-or limb threatening emergency and can get put on a schedule with all the other cases in the OR's that day. It gives no value as to whether it is necessary or not. Just not emergently.

There are many surgeries that are elective, but really need to get done: biopsies, mastectomies, colon cancer surgeries, prostate surgeries, chronic disc pain surgeries, total joint replacements.......etc. etc. etc.

 

[Isabelle]

Support Children's Hospital: https://www.facebook.com/pages/Support-Childrens-Hospital/1436701536560002

Don't know who set up that page but I don't think Children's did. They need to be clued in and have it taken down!

 

[Linda7NJ]

IMO - The longer this is drawn out the less likely any autopsy findings will be "in favor" of Jahi and her family.



But of course with the conspiracy and all, I am certain any COD other than: "bleeding out due to medical negligence following routine tonsillectomy" will just be completely unacceptable by the family.

It will be decided by a jury if the family elects to go to trial.
Unless the hospital offers a settlement that acceptable to the family.
IMO


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[otto]

BBM. This unfortunate teen did not have a "normal airway". If she did have a normal airway, she would not have been scheduled to have extensive remodeling of that airway for what the family describes as "severe" obstructive sleep apnea.

We do not know if she had a "normal" cardiovascular system and blood clotting ability. We OPTIMIZE patients for elective surgery, we cannot "cure" them of every underlying condition that puts them at risk. We don't know how she responded during surgery. She was high risk, period. You don't reserve a valuable PICU bed for "every" tonsillectomy.

There is a pervasive idea in the general public, and perhaps even among some health care providers that just because something is scheduled as "elective", the patient is "healthy" and the surgery can be argued as "not needed". "Elective" simply means it is not an emergency.

That's what I understood as well. "Elective" meant that the patient would not die without the surgery, but the situation could deteriorate significantly without the surgery. Neglecting to perform "elective" surgery could eventually lead to required surgery. Elective also means that the decision to have surgery is 100% in the hands of the parents. We kind of joked that it was the doctor's way of covering their legal butts.

 

[katydid23]

I still havent been able to view that report Leilei....???



Sudden Bleeds like this..Tonsils or Esophageal Varices Fits what you area describing..massive bleeding from throat (esophagus)....Here's how thats dealt with...have actually experienced that numerous times in ICU and ER's over the years...This link describes intubations to put pressure of lining of throat..

BUt First an foremost..Call for HELP..Dont hand a basin or bucket to family...Be that as it may..Many dont believe that..BUT Fact is..She 9 12 year old) arrested..why? Sudden blood loss..Wasnt she medically cleared prior to surgery..And please Family info doesnt even scratch the surface for Medical clearances....

Below is one scenerio what you asked about Zuri :seeya:



http://www.nlm.nih.gov/medlineplus/ency/article/000268.htm


Treatments for acute bleeding:

•A small lighted tube called an endoscope may be used. The health care provider may inject the varices directly with a clotting medicine, or place a rubber band around the bleeding veins.
•A medication that tightens blood vessels (vasoconstriction) may be used. Examples include octreotide or vasopressin.
•Rarely a tube may be inserted through the nose into the stomach and inflated with air. This produces pressure against the bleeding veins (balloon tamponade).

How do we know that they did not try any of the above treatments? I am under the impression that they did in fact 'work' on her after it became obvious the bleeding was profuse.

 

[Isabelle]

I have a medical question for KZ, Herat and anyone who might know:

When you have a pediatric patient who suddenly starts hemorrhaging from an ENT surgery like this, how do you stop the bleeding? If a patient can bleed out in 3 minutes (180 seconds), what do you do first, providing the bleed is arterial in the back of the throat? I understand the resuscitate efforts like fresh frozen plasma, o neg blood, I've fluids for volume. How do you stop the bleeding in 180 seconds? TIA

As an RN I would think a return to the OR would be necessary. Would like another medical person to chime in as to whether or nor cryoprecipitate is used anymore an whether it can be used for this type of bleeding. (Forgive me if I have the wrong drug)

 

[threecrazykids]

There is no reason in the world anyone would elect to have this surgery unless they believed it would solve their sleep apnea issue. They wouldn't believe it would benefit them unless a doctor told them so.

Iirc I read this mother got a second opinion after the first recommended this surgery. Her mother brought her to this hospital. A well known and respected children's hospital.




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HUH? People have elective surgeries ALL THE TIME in hopes of "curing" them for whatever the ailment they have (real or not). There are also people who believe that surgeries will benefit them even when doctors tell them repeatedly that no surgery will "fix" their issue.

 

[Jacie Estes]

Maybe because surgery isn't just done on perfectly healthy people to begin with.
Perfectly healthy people don't usually even need surgery.

That was not my question, if the amount of meds in the bag seen in this picture at this link is a 'boatload', if she was that unhealthy, why was she cleared?

photo of meds at this link: http://www.cbsnews.com/news/teen-ja...nsil-surgery-court-appointed-doctor-confirms/

post I was responding to: Websleuths Crime Sleuthing Community - View Single Post - Family wants to keep life support for girl brain dead after tonsil surgery #6

 

[popsicle]

Why is anyone under the impression that Jahi was not returned to the OR when she started bleeding? Truth is we do not know what happened or where she died OR/picu. jmo