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

[Harmony 2]

Please stick to the facts of the case. Thanks!

Bumping this post...

Comments in articles are considered rumor... Rumors are not allowed here!!

 

[ItsJustaName]

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?

Is there a blurry ground when the patient is a family member and the LVN is acting as a grandmother not a nurse? I think she was way out of line, but not sure if the law would apply to family member trying to help a grandchild.

 

[Madeleine74]

I think I'll wait until there's some official determination or outcome, if we are privy to it. A case like this is comprised of many small medical details along the way, which can produce a conclusion that is far different than anyone thinks. Given that I don't know the details and this case will be explored as part of a legal fact-finding, I'm not going to assume anything. YMMV.

 

[Karmady]

I don't have rules and I'm not a mod. I made an observation and then I was told that people are really only discussing what's in the court records or things said directly by the family and people really aren't speculating and then right after that there are posts where people are talking about the family taking food into ICU and implying that's exactly what happened in the Jahi case, which sounds like gossip and speculation to me. Do you not agree?

I said *I* prefer not to speculate in cases and that is my right because I don't find speculation a useful tool to understand or lead to facts in a case.

So, where are the facts of what food, if any, were brought into Jahi's room?

I think it's been made clear the basis for the discussion of the possibility of food being brought into the room. There aren't any facts in the form of sworn testimony about it (yet, anyway). If I were following the criteria for discussion in your post, I'd disregard it. jmo

 

[ItsJustaName]

So granny would lose her career. How does the CA nurse licensing board work? Can individuals make complaints or just the employers?

ETA In a civil case brought against the CHO could the hospital file a cross complaint against the grandmother? What a mess.

 

[Karmady]

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.

Can you fathom going to court to have surgical interventions performed on a person who's been declared dead. Or transporting a person with a death certificate to have those procedures performed. Or keeping a person with a death certificate on a vent, and feeding the body for more than a month at an undisclosed location? So, there you go, imo.

eta: I know she hasn't been at the undisclosed location for a month. I meant keeping her body on mechanical support for a month.

 

[kaRN]

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.

Thanks Donjeta. That's very interesting!! It contradicts completely the Families claim the hospital said the surgery was routine then. I wonder if Jahi had sickle cell. Extra precautions are always taken for those patients to prevent complications.

 

[Madeleine74]

And, this case is really divided into 2 parts, only the first part involves the hospital.

What happened to Jahi leading up to, including, and then after surgery is where the hospital has liability. Once Jahi was pronounced brain dead and that was verified by 3 other doctors, she is legally considered deceased. The hospital doesn't have any liability in regards to actions taken by the parents, others, lawyers, etc.

As far as the legal case, the question of medical malpractice is what is germane and what the lawyers will be focusing on. Each detail and event in the sequence from surgery to brain death. We of course won't know what those details are, not from the hospital, as this is a private/civil matter.

 

[Karmady]

Is there a blurry ground when the patient is a family member and the LVN is acting as a grandmother not a nurse? I think she was way out of line, but not sure if the law would apply to family member trying to help a grandchild.

I think the statute would definitely not shield the grandmother from liability. However, the only consequence of that is that she could be liable to the mother. For that to happen, of course, the mother would have to sue her. Unlikely, but it happens -- usually when insurance is available. jmo

 

[ItsJustaName]

Complains against hospitals are public record. Fines assessed are public. The autopsy report will be public record. Any malpractice settlements over 30K are public.

 

[ItsJustaName]

I think the statute would definitely not shield the grandmother from liability. However, the only consequence of that is that she could be liable to the mother. For that to happen, of course, the mother would have to sue her. Unlikely, but it happens -- usually when insurance is available. jmo

Interesting. If she is/was an employee of Kaiser I doubt she would be covered for her actions at another hospital. If she had an umbrella homeowners policy that might kick in, but I doubt her daughter would follow through, unless Dolan thinks that they would just settle.

 

[kaRN]

So granny would lose her career. How does the CA nurse licensing board work? Can individuals make complaints or just the employers?

From http://www.bvnpt.ca.gov/pdf/vnregs.pdf

I believe they can. In Ontario the whole point of licensing Nurses is to protect public safety. In a home care setting, the only witness to incompetence would be the public. The section below suggests they can. I'm still looking for the procedure to follow.

33
2524.1. Consumer Complaint Disclosure.

In reaching a decision on the disclosure of a consumer complaint under the Public Records Act
(Government Code Section 6250 et seq.), the Board shall follow its “Consumer Complaint Disclosure
Policy” which specifies the following:

(a) Public Access to Information – It is the policy of the Board of Vocational Nursing and Psychiatric
Technicians (hereafter “Board”) that information concerning individuals licensed by this agency be
available to members of the public. Among the principal functions of the Board is the investigation of
complaints against its licensees to determine whether there is cause for disciplinary action.
Information regarding actions taken by the Board in the disposition of such complaints is readily
accessible to the consuming public.
(b) Complaint Information System – The Board maintains a system designed to provide information
regarding complaints and disciplinary actions against its licensees and information regarding their
license status.
(c) Information to be Provided Regarding Complaints – In disclosing the existence of a consumer
complaint, the Board will do so in a manner that will not reveal the identity of the complainant. The
Board shall disclose details of a consumer complaint if the complaint is substantiated through
investigation and/or an Accusation or Statement of Issues is filed. The Board shall disclose the
following consumer complaint information to the public, upon written request:
(1) The number of complaints which have been found by the Board to be violations of the
licensing law or regulations; and
(2) With respect to each complaint, the following information:
(A) Its date of receipt;
(B) A summary of the violation(s);
(C) Its disposition, by indicating whether the complaint:
(1) Has been or will be referred to formal disciplinary action.
(2) Has been found to involve a minor violation not in itself meriting disciplinary
action;
(3) Has been disposed of through any action taken, formal or informal.
(3) Comparative data considered by the Board to be informative to consumers, which could
include the average number of complaints received against licensees in a given region,
locality or area of practice.
(4) A general disclaimer, if any, as the Board may deem appropriate.
(d) A consumer complaint may not be disclosed if one of the following conditions exists:
(1) The complaint is deemed without merit.
(2) Board jurisdiction cannot be established.
(3) The complaint is unrelated to professional conduct.
(4) The complaint involves a non-consumer matter.
(5) Disclosure is prohibited by statute or regulation.
(6) Disclosure might endanger or injure the complainant.
(7) Disclosure might compromise the investigation and/or prosecution.
(e) Information to be Provided Regarding Disciplinary Actions – The Board maintains records showing
the disciplinary history of all current license holders and will provide to the public, upon request,
whether a current license holder has ever been disciplined and, if so, when and for what offense. A
copy of documents related to that action including the accusation, proposed decision, stipulation
and/or final decision will be provided to the public upon written request.

Note: Authority cited: Section 2854, Business and Professions Code, Section 6253.4, Government Code: Reference: Sections 2875,
2876, 2878, 2878.1 and 2878.5, Business and Professions Code; and Sections 6252, 6253, 6253.2, 6253.4, 6254, 6255, 6260,
11503, and 11504, Government Code.
History:
1. New Section filed 3-2-06; operative 4-1-06 (Register 2006, No. 9).

 

[kaRN]

Interesting. If she is/was an employee of Kaiser I doubt she would be covered for her actions at another hospital. If she had an umbrella homeowners policy that might kick in, but I doubt her daughter would follow through, unless Dolan thinks that they would just settle.

Can the Hospital initiate a civil suit against her on behalf of their now deceased patient? They have suffered and continue to suffer as a result of her actions.

 

[Harmony 2]

friendly reminder: if you have a problem with a post use the ALERT BUTTON (do not respond)...thanks!

 

[Karmady]

Can the Hospital initiate a civil suit against her on behalf of their now deceased patient? They have suffered and continue to suffer as a result of her actions.

Imo, they probably could name her as a co-defendant if the hospital got sued, but likely wouldn't. If they did, she would argue that the hospital's negligence also caused her and/or allowed her to do what she did. Would only make it worse, imo.

 

[BetteDavisEyes]

When I had a hysterectomy in 1995, I didn't want visitors other than my husband. DD was away at college, and I didn't feel that it was necessary for her to come home for my surgery. I didn't tell my mother, siblings, friends, or neighbors until I was home and doing well. I don't understand the need for the whole fam damily to be at the hospital, but to each his own. :moo:

 

[Nore]

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.

------
Hi KaRN, it's discussed in the earlier pages. She is NOT an RN. She is either an LPN or an NA..check it out. My son was a basilar artery stroke hit part of brain stem, we never suctioned him, Nurse only..They (family) quote suctioning in the beginning. I'm not medical but that thing could well pull off clots, maybe more. :loveyou:

 

[BeginnersLuck]

The hospital released Jahi's body to the coroner, the coroner turned over the body to the mother.

I'm pretty sure that it's in the court order that the body must be returned to the coroner for autopsy. I will go digging through the court papers a little later and see what I can find. I don't think that if she were transported out of state it would change anything and I don't think that she would have to be embalmed when returned, if there is a court order.

When CHO released Jahi, I'm thinking that there was a release of liability that went along with that. My question is how encompassing that release of liability may be.
(again, I'll see what I can find in the court records.)

I had this thought that maybe there was a quiet settlement in court as far as medical malpractice. Even if there was a malpractice settlement, there may still be other lawsuits to come from other angles. Could a settlement be kept under raps if that did happen?

I just don't see how a coroner would be able to obtain a lot of information from autopsy, after so much time has passed. There is no telling what all they are doing with her, other than what has been reported, which includes invasive surgical procedures. Basically, the evidence is/has been tampered with or destroyed so to speak. IMO

 

[Cubby]

Has anyone thought about the PICU nurse? The one the McMath family is saying told them to use the suctioning device? Her job and her license could be on the line. She will spend hours and hours in hearings and depositions. If she did not tell them to use the device, then they are trying to destroy her career to justify their actions.

Is there a link indicating a statement was made that the family was instructed to use the suctioning device by a nurse? I have not read that anywhere.

 

[ItsJustaName]

Its way too early for any malpractice settlement. I'm hoping that the hospital has preserved every atom of evidence.