Family wants to keep life support for girl brain dead after tonsil surgery #7

[BetteDavisEyes]

Where is this taking a burger and fries into ICU/Jahi's room and secretly feeding the patient coming from? Is that a fact? Is that someone else's personal story?

Social media and comments on news reports.

 

[Leilei]

Families are trained to use suction if the patient has a chronic condition and is expected to go home with an ongoing need for suctioning. Families are never taught to suction to assist staff in caring for an acute, post-op patient. NEVER.
I think you're spot on in your speculation that the family saw the RN use it and decided to use it themselves. If Grandma was or is an RN which I seriously doubt, she certainly wasn't one at that hospital on that patient. If she is, she's liable for the 'care' she provided and allowed her family members to perform.
I'm heading off now to search for some record of Grandma being a licensed RN. I'll let you know what I find.

Grandma is an LVN and works at Kaiser. Someone posted her LVN license info way, way back. She's licensed in Alameda County, I believe? I agree with you and everyone else who believes that nobody in this family should have been suctioning Jahi, but in their own interviews, they admitted to doing it, and even claimed that Jahi was suctioning herself.

 

[Herat]

I cannot fathom anyone taking food with them into a recovery room or PICU.

Especially immediately post-op and if one of the visitors is a nursing professional. Even an LVN should have known you do not even consider bringing food in. These patients are strictly NPO (except for ice chips) by the doctors orders.

Even if you didn't eat, it is not at all proper to be bringing any food for yourself into the PICU.

Even if the rumor is incorrect, someone needs to state this outright.

 

[ItsJustaName]

Bringing food into the ICU is dangerous, Its also rude to the other patients that have to smell it. (My sense of smell is often heightened when I'm sick). Or who may be hungry too.

 

[kaRN]

I understand, but this was ICU. Not recovery. If I understand the timeline.

I'm not sure I completely understand the timeline either but Jahi post-op, would have gone first to recovery which is referred to as the PACU (post anesthesia care unit). Her problems started there and she was moved to the PICU (pediatric intensive care unit). I think there's confusion in the reporting.

For reasons of infection control and patient and staff safety, food brought in for visitors to eat would not be allowed in either unit. Hospitals have cafeterias and even entire food courts for families to dine at. Probably not a McDonalds though :blushing: For good reason as this case illustrates.

 

[BuzzieCat]

If - big IF - they took Jahi out of state, would California's laws still be enforceable at that point? If her heart stops beating in some other state, does the California coroner's office have any authority over what happens next regarding returning the body for autopsy?

 

[Elley Mae]

I'm not sure I completely understand the timeline either but Jahi post-op, would have gone first to recovery which is referred to as the PACU (post anesthesia care unit). Her problems started there and she was moved to the PICU (pediatric intensive care unit). I think there's confusion in the reporting.

For reasons of infection control and patient and staff safety, food brought in for visitors to eat would not be allowed in either unit. Hospitals have cafeterias and even entire food courts for families to dine at. Probably not a McDonalds though :blushing: For good reason as this case illustrates.

bbm, This I did not know. Her problems started in the recovery? I may not understand the way things work all the time, but it would seem if her problems started in recovery (PACU) why move her to the next stage and not back to surgery to fix the problem. IIRC the PICU was scheduled to receive her and not where they would take her if a problem arose. idk maybe im confused. jmo

 

[kaRN]

Grandma is an LVN and works at Kaiser. Someone posted her LVN license info way, way back. She's licensed in Alameda County, I believe? I agree with you and everyone else who believes that nobody in this family should have been suctioning Jahi, but in their own interviews, they admitted to doing it, and even claimed that Jahi was suctioning herself.

Thank you!! Now to research the scope of practice of an LVN. I already know she wasn't sanctioned to suction patients but what the heck. :seeya:

 

[mck16]

I'm not sure I completely understand the timeline either but Jahi post-op, would have gone first to recovery which is referred to as the PACU (post anesthesia care unit). Her problems started there and she was moved to the PICU (pediatric intensive care unit). I think there's confusion in the reporting.

For reasons of infection control and patient and staff safety, food brought in for visitors to eat would not be allowed in either unit. Hospitals have cafeterias and even entire food courts for families to dine at. Probably not a McDonalds though :blushing: For good reason as this case illustrates.

One thing that is not being discussed either is that at some point Jahi was taken back to surgery. Correct?? How long did this last and where did she go next. Is this when they put her on the vent? I am thinking she went back to PICU. Still so many gaps in when everything took place. jmo

 

[popsicle]

Personally, I think it doesn't matter what the grandmothers scope of practice is or where she works. She was not Jahi's nurse and therefor should not have been doing any medical treatments on her. imo

 

[Softail]

Just noticed that Harmony made a sticky for media and medical facts!

Jahi McMath: media/medical facts - Websleuths Crime Sleuthing Community

Thanks Harmony! :loveyou:

 

[Donjeta]

I'm not sure I completely understand the timeline either but Jahi post-op, would have gone first to recovery which is referred to as the PACU (post anesthesia care unit). Her problems started there and she was moved to the PICU (pediatric intensive care unit). I think there's confusion in the reporting.

For reasons of infection control and patient and staff safety, food brought in for visitors to eat would not be allowed in either unit. Hospitals have cafeterias and even entire food courts for families to dine at. Probably not a McDonalds though :blushing: For good reason as this case illustrates.

The timeline is not clear at all but IIRC both the family and the hospital have said that the transfer to the PICU was planned beforehand so it is not necessarily a sign that anything had seemed amiss before the transfer. What we've been told is that Jahi seemed fine at first.

 

[Madeleine74]

Soooo... things are getting discussed that have nothing to do with the official court documents, including comments at the end of media reports, comments which are not official nor have they been vetted for accuracy and could be rumor. Got it.

 

[kaRN]

bbm, This I did not know. Her problems started in the recovery? I may not understand the way things work all the time, but it would seem if her problems started in recovery (PACU) why move her to the next stage and not back to surgery to fix the problem. IIRC the PICU was scheduled to receive her and not where they would take her if a problem arose. idk maybe im confused. jmo

They would have taken her back to the OR which is why the PACU is located just outside. She would be sent to the PACU to recover from the anesthetic and then moved to her room on whatever unit in an ideal situation.
We're missing crucial details here because we only have the families version of events. The PICU is reserved for children requiring life support or 1/1 Nursing care. A child would be scheduled to be taken from the PACU to the PICU if they'd had for example, open heart surgery. Most routine surgical patients return to their regular unit from the PACU.

 

[kaRN]

http://www.bvnpt.ca.gov/pdf/vnregs.pdf
Grannie was completely outside her scope of practice in suctioning or counseling someone else to do so.

2860. Unauthorized Practices.

This chapter confers no authority to practice medicine or surgery or to undertake the prevention,
treatment or cure of disease, pain, injury, deformity, or mental or physical condition in violation of any
provision of law. (Added by Stats. 1951, Ch. 1689.)

2860.5. Permissible Practices.

A licensed vocational nurse when directed by a physician and surgeon may do all of the following:

(a) Administer medications by hypodermic injection.
(b) Withdraw blood from a patient, if prior thereto such nurse has been instructed by a physician
and surgeon and has demonstrated competence to such physician and surgeon in the proper procedure
to be employed when withdrawing blood, or has satisfactorily completed a prescribed course of
instruction approved by the board, or has demonstrated competence to the satisfaction of the board.
(c) Start and superimpose intravenous fluids if all of the following additional conditions exist:
(1) The nurse has satisfactorily completed a prescribed course of instruction approved by
the board or has demonstrated competence to the satisfaction of the board.
(2) The procedure is performed in an organized health care system in accordance with
the written standardized procedures adopted by the organized health care system as
formulated by a committee which includes representatives of the medical, nursing, and
administrative staffs. "Organized health care system," as used in this section, includes
facilities licensed pursuant to Section 1250 of the Health and Safety Code, clinics, home
health agencies, physicians' offices, and public or community health services.
Standardized procedures so adopted will be reproduced in writing and made available to
total medical and nursing staffs. (Amended by Stats. 1974, Ch. 1084.)

2860.7. Skin Tests and Immunizations.

(a) A licensed vocational nurse, acting under the direction of a physician may perform: (1)
tuberculin skin tests, coccidioidin skin tests, and histoplasmin skin tests, providing such administration is
within the course of a tuberculosis control program, and (2) immunization techniques, providing such
administration is upon standing orders of a supervising physician, or pursuant to written guidelines
adopted by a hospital or medical group with whom the supervising physician is associated.
(b) The supervising physician under whose direction the licensed vocational nurse is acting
pursuant to subdivision (a) shall require such nurse to:
(1) Satisfactorily demonstrate competence in the administration of immunizing agents,
including knowledge of all indications and contraindications for the administration of such
agents, and in the recognition and treatment of any emergency reactions to such agents
which constitute a danger to the health or life of the person receiving the immunization;
and
(2) Possess such medications and equipment as required, in the medical judgment of the
supervising physician and surgeon, to treat any emergency conditions and reactions
caused by the immunizing agents and which constitute a danger to the health or life of
the person receiving the immunization, and to demonstrate the ability to administer such
medications and to utilize such equipment as necessary.
(c) Nothing in this section shall be construed to require physical presence of a directing or
supervising physician, or the examination by a physician of persons to be tested or immunized. (Added by
Stats. 1974, Ch. 837.)

This is where I got confused-

2861.5. Liability for Emergency Care.

A person licensed under this chapter who in good faith renders emergency care at the scene of
an emergency which occurs outside both the place and the course of his employment shall not be liable
for any civil damages as the result of acts or omissions in rendering the emergency care. This section
shall not be construed to grant immunity from civil damage to any person whose conduct in rendering
emergency care is grossly negligent. (Added by Stats. 1974, Ch. 824.)

IMO this refers to emergencies taking place where no Doctor or Supervising RN is available to provide care competently. Like a nursing home in the middle of the night, or on the bus. Grannies job was to alert the staff of the emergency and back off in this situation. Would our lawyers agree?

 

[Karmady]

One thing that is not being discussed either is that at some point Jahi was taken back to surgery. Correct?? How long did this last and where did she go next. Is this when they put her on the vent? I am thinking she went back to PICU. Still so many gaps in when everything took place. jmo

It's not being discussed because, as far as we know, it didn't happen. As I understand it, from the family's various versions, she had some bleeding which increased over some period of time. A doc, or more than one doc intervened and gave her IV meds and afrin(like) tx. Then everything went to heck in a handcart and she coded in the PICU while the grandmother was present. The mom heard the code, rushed to the room, saw what was happening, passed out and was admitted herself. While being treated herself, she learned that Jahi was in a "coma."

jmo

eta: links to all of the above, including the multiple docs who intervened, have been posted before.

 

[Elley Mae]

The surgery was uneventful, the family thought, and a relieved Jahi awoke from sedation and asked for a Popsicle.

Nurses took her to the ICU where she was supposed to spend the night, but staff would not let Winkfield in, Winkfield said.

http://www.mercurynews.com/breaking-news/ci_24775261/jahi-her-mom-and-13-days-at-childrens

“After the surgery, she (Jahi) was fine. She went into the recovery room. She was alert and talking, and she was asking for a Popsicle because she said her throat hurt. As part of the procedure, she was meant to spend the night in ICU,” Sealey said. “When she got moved to ICU, there was a 30-minute wait until any family member could go see her. Upon entry, they saw that there was way too much blood.”

http://wqad.com/2013/12/17/girl-predicts-devastating-outcome-of-her-own-tonsillectomy/

 

[threecrazykids]

Soooo... things are getting discussed that have nothing to do with the official court documents, including comments at the end of media reports, comments which are not official nor have they been vetted for accuracy and could be rumor. Got it.

Yes, and that also includes the family's version of what happened. :seeya:

 

[Harmony 2]

Just noticed that Harmony made a sticky for media and medical facts!

Jahi McMath: media/medical facts - Websleuths Crime Sleuthing Community

Thanks Harmony! :loveyou:

Yes, I started moving some links there... please add relevant links to be referenced. Thanks!

 

[Karmady]

http://www.bvnpt.ca.gov/pdf/vnregs.pdfI need to have one of our lawyers confirm it, but Grannie was completely outside her scope of practice in suctioning or counseling someone else to do so.

2860. Unauthorized Practices.

This chapter confers no authority to practice medicine or surgery or to undertake the prevention,
treatment or cure of disease, pain, injury, deformity, or mental or physical condition in violation of any
provision of law. (Added by Stats. 1951, Ch. 1689.)

2860.5. Permissible Practices.

A licensed vocational nurse when directed by a physician and surgeon may do all of the following:

(a) Administer medications by hypodermic injection.
(b) Withdraw blood from a patient, if prior thereto such nurse has been instructed by a physician
and surgeon and has demonstrated competence to such physician and surgeon in the proper procedure
to be employed when withdrawing blood, or has satisfactorily completed a prescribed course of
instruction approved by the board, or has demonstrated competence to the satisfaction of the board.
(c) Start and superimpose intravenous fluids if all of the following additional conditions exist:
(1) The nurse has satisfactorily completed a prescribed course of instruction approved by
the board or has demonstrated competence to the satisfaction of the board.
(2) The procedure is performed in an organized health care system in accordance with
the written standardized procedures adopted by the organized health care system as
formulated by a committee which includes representatives of the medical, nursing, and
administrative staffs. "Organized health care system," as used in this section, includes
facilities licensed pursuant to Section 1250 of the Health and Safety Code, clinics, home
health agencies, physicians' offices, and public or community health services.
Standardized procedures so adopted will be reproduced in writing and made available to
total medical and nursing staffs. (Amended by Stats. 1974, Ch. 1084.)

2860.7. Skin Tests and Immunizations.

(a) A licensed vocational nurse, acting under the direction of a physician may perform: (1)
tuberculin skin tests, coccidioidin skin tests, and histoplasmin skin tests, providing such administration is
within the course of a tuberculosis control program, and (2) immunization techniques, providing such
administration is upon standing orders of a supervising physician, or pursuant to written guidelines
adopted by a hospital or medical group with whom the supervising physician is associated.
(b) The supervising physician under whose direction the licensed vocational nurse is acting
pursuant to subdivision (a) shall require such nurse to:
(1) Satisfactorily demonstrate competence in the administration of immunizing agents,
including knowledge of all indications and contraindications for the administration of such
agents, and in the recognition and treatment of any emergency reactions to such agents
which constitute a danger to the health or life of the person receiving the immunization;
and
(2) Possess such medications and equipment as required, in the medical judgment of the
supervising physician and surgeon, to treat any emergency conditions and reactions
caused by the immunizing agents and which constitute a danger to the health or life of
the person receiving the immunization, and to demonstrate the ability to administer such
medications and to utilize such equipment as necessary.
(c) Nothing in this section shall be construed to require physical presence of a directing or
supervising physician, or the examination by a physician of persons to be tested or immunized. (Added by
Stats. 1974, Ch. 837.)

This is where I got confused-

2861.5. Liability for Emergency Care.

A person licensed under this chapter who in good faith renders emergency care at the scene of
an emergency which occurs outside both the place and the course of his employment shall not be liable
for any civil damages as the result of acts or omissions in rendering the emergency care. This section
shall not be construed to grant immunity from civil damage to any person whose conduct in rendering
emergency care is grossly negligent. (Added by Stats. 1974, Ch. 824.)

re the bold, when we discussed these provisions before, we noted that they don't apply in hospitals since if something takes place in a hospital, it's not an "emergency" within the meaning of the law -- due to the fact that paid medical staff is on hand. Also, the law doesn't, under ANY circumstances, prevent you from being liable if your negligence in rendering true emergency assistance is not merely negligent, but GROSSLY negligent (per the bold). jmo