13 Year old gir declared brain dead has now officially died

[pigletgirl]

It's PICU. There should be someone in the room at all times.

Not accurate. If the nurse had another patient or two they could of been in the other room giving meds, etc. Lots of possibilities here. I would never trust what the family says. They've lost all their credibility, IMO.

 

[sunshinehighway]

That's the point that people are TRYING to make, repeatedly. It's VERY possible for family members to do something. Where's the staff? Um, maybe WORKING? Nurses and medical staff aren't guards, who are there keeping their eyes on ONE patient, constantly, 24/7. The point people are trying to make is that something like the SCENARIO (fact, fiction or rumor) of a family member giving food to a patient who isn't supposed to have any IS POSSIBLE, and it doesn't mean that the staff is negligent if they didn't see it happen.

It's also VERY possible the staff was in some was negligent. For some reason that cant even be suggested though.

 

[LisaR]

I don't frequent hospitals, but the few I've been in always have some kind of monitors at the nurses station. Do those just monitor vital signs or do they actually show the patient in the room?

 

[Pamlur]

I keep trying to remember if I ever saw food brought into an ICU room/cubicle during the times my son was a patient there (but he was an adult, not a child). I brought stuff in for the staff, but I don't know if families of the patients were allowed to have food. With supposed limited visitation hours for ICU units, I can't see the need but that doesn't mean anything.

 

[Pea-n-Me]

Investigation into this incident will not depend solely on autopsy results of Jahi's body. I mean, they already know what type of surgery she had, where it was, that she bled out, that she had a heart attack and that she suffered brain death as a result. There may be some more information to be garnered, but probably not a lot of surprises.

Where the real information is going to come from, as I've said repeatedly here, is the medical records - many of which are electronic today. They tell a tale of exactly when events occurred and who, if anyone, dropped the ball - as well as what was done right.

Let's not forget the CA DPH has already investigated this case. ("Sentinel events" such as this must be reported by the hospital.) The DPH has no doubt already have studied the "paper trail" and has a good understanding of what may have happened. Policies at the hospital may or may not change in the coming weeks, depending on if weaknesses were identified in their systems. This will likely be a hospital-wide initiative if it happens. So we may in fact have some idea in a few weeks if it was a "systems" issue.

One of the easiest things to do as a care giver is to initiate a "code". It requires a simple phone call (usually delegated to a coworker) or in some places, even the touch of an emergency button. Once that system is initiated, a sudden rush of emergency personnel (often who have no connection to the case at all, but are on a "code team") step in and help do whatever needs to be done for the patient. I would have a hard time believing this wasn't done if she was "bleeding out" or having other signs of distress or compromise. Even if Jahi's nurse was busy doing something else (in an ICU setting, especially somewhere like Children's or another big hospital, it is not unheard of to have two or more emergency situations happening simultaneously) other staff would most certainly step in and help as that is just what happens in a place like that.

 

[pigletgirl]

I don't frequent hospitals, but the few I've been in always have some kind of monitors at the nurses station. Do those just monitor vital signs or do they actually show the patient in the room?

They show vitals.

 

[Pea-n-Me]

Aren't there cameras that monitor those rooms?

Not necessarily. Some do, I suppose, but not all.

 

[pigletgirl]

It's also VERY possible the staff was in some was negligent. For some reason that cant even be suggested though.

Well the charting will show this if it's true. I really doubt it though.

 

[DisneyJamieCA]

It's also VERY possible the staff was in some was negligent. For some reason that cant even be suggested though.

Nobody has said that they are 100% sure the hospital is not at fault. On the flip side, you and a few others refuse to acknowledge that the family could have done anything to cause the problems. We all have our beliefs on what may possibly happened and we all fall on sides, but until the family allows the release of ALL pertinent information, we will never know. If you are so sure the hospital is at fault, why wouldn't the family let those records out?

As for the PICU, my daughter spent 4 days in one when she was 16 months old. She was in Oakland, although not CHO. It was a larger room with beds separated by curtains. Parents (preferably one, but they'd allow two) were the only people allowed in. And we had to be buzzed in each time. The only exception they made was my parents made the 4 hour drive down with me (I was pregnant) when she was life-flighted, they allowed them 1 minute (one at a time) to say goodbye - and only because the last time they had seen her she was unresponsive and not breathing. There was always staff in the PICU, but not always in DD's curtained area. I think all PICUs are set up differently, so it's hard to say what the set up at CHO was.

 

[MaryAnnDVC]

It's also VERY possible the staff was in some was negligent. For some reason that cant even be suggested though.

Oh geez. ANYTHING could have happened. Maybe it was the family, MAYBE IT WAS THE HOSPITAL STAFF BEING NEGLIGENT, maybe it was just what was going to happen no matter what. What I was making the point about AGAIN was that IF the family gave her food, that does NOT automatically mean there was negligence on the part of the staff.

 

[bcla]

I keep trying to remember if I ever saw food brought into an ICU room/cubicle during the times my son was a patient there (but he was an adult, not a child). I brought stuff in for the staff, but I don't know if families of the patients were allowed to have food. With supposed limited visitation hours for ICU units, I can't see the need but that doesn't mean anything.

I remember once visiting my father in an ICU. Certainly no outside food. It was a large room. There were curtains, but most of them weren't drawn. We originally thought we'd be able to bring our kid there (we weren't up on protocol) but apparently they had a max two visitors per patient and children weren't allowed on the floor unless maybe a child of the patient. As soon as they saw us leave the elevator with a kid in the stroller we were told that one of us would have to wait with our kid downstairs.

He'd actually fallen off the roof and broke his shoulder. I didn't think it was life-threatening per se, but his doctor recommended the ICU. He was a Kaiser Permanente patient, but they had no suitable ICU beds at Kaiser Oakland or Richmond, and was sent (of all places) to John Muir Hospital in Walnut Creek, California. As soon as Kaiser had an ICU bed available in Oakland they moved him.

And from that experience, I noticed that ICU beds must be hard to come by. Every bed was occupied and as soon as they had another option they moved him out so another patient could fill that bed. I imagine pediatric ICUs must be even harder to come by. There are only three specialty children's hospitals in the Bay Area. CHO only has 13 beds (as reported). UC San Francisco Benioff only has 16. Stanford's Lucille Packard Children's Hospital now has 18.

http://www.ucsfbenioffchildrens.org/clinics/intensive_care_unit/
http://pedcriticalcare.stanford.edu/patient-care/

 

[sunshinehighway]

Nobody has said that they are 100% sure the hospital is not at fault. On the flip side, you and a few others refuse to acknowledge that the family could have done anything to cause the problems. We all have our beliefs on what may possibly happened and we all fall on sides, but until the family allows the release of ALL pertinent information, we will never know. If you are so sure the hospital is at fault, why wouldn't the family let those records out?

As for the PICU, my daughter spent 4 days in one when she was 16 months old. She was in Oakland, although not CHO. It was a larger room with beds separated by curtains. Parents (preferably one, but they'd allow two) were the only people allowed in. And we had to be buzzed in each time. The only exception they made was my parents made the 4 hour drive down with me (I was pregnant) when she was life-flighted, they allowed them 1 minute (one at a time) to say goodbye - and only because the last time they had seen her she was unresponsive and not breathing. There was always staff in the PICU, but not always in DD's curtained area. I think all PICUs are set up differently, so it's hard to say what the set up at CHO was.

I'm not refusing to acknowledge they could have done something. I just don't understand why is ok to speculation on all the things the family could have done wrong and not what the hospital could have done wrong. Anything that had questioned the care she was receiving is outright dismissed as unlikely.

It's just as likely that someone dropped the ball as it is her family snuck in a hamburger and one bite caused her to bleed out.

 

[Lorelei Lee]

Hospital beds of all types are generally in high demand. My father has spent many nights in the ER waiting for a bed to open up on the cardiac care floor.

A number of years ago I had pneumonia. I was very dehydrated, which caused my heart to start racing. I initially went to my doctor's office, and he sent me to the ER. My doctor misdiagnosed the tachycardia as a real heart problem, so that when I arrived in the ER I was placed on a heart monitor, etc.

As soon as I was hooked up to the IV and my fluid level returned to normal, they realized I wasn't having a cardiac issue.

While I was waiting for them to find me a bed in a regular room, which was a problem, they moved my stretcher to the hallway near the nurses' station because they needed the heart monitor for the next patient -- a four year old drowning victim.

 

[LisaR]

Investigation into this incident will not depend solely on autopsy results of Jahi's body. I mean, they already know what type of surgery she had, where it was, that she bled out, that she had a heart attack and that she suffered brain death as a result. There may be some more information to be garnered, but probably not a lot of surprises.

Where the real information is going to come from, as I've said repeatedly here, is the medical records - many of which are electronic today. They tell a tale of exactly when events occurred and who, if anyone, dropped the ball - as well as what was done right.

Let's not forget the CA DPH has already investigated this case. ("Sentinel events" such as this must be reported by the hospital.) The DPH has no doubt already have studied the "paper trail" and has a good understanding of what may have happened. Policies at the hospital may or may not change in the coming weeks, depending on if weaknesses were identified in their systems. This will likely be a hospital-wide initiative if it happens. So we may in fact have some idea in a few weeks if it was a "systems" issue.

One of the easiest things to do as a care giver is to initiate a "code". It requires a simple phone call (usually delegated to a coworker) or in some places, even the touch of an emergency button. Once that system is initiated, a sudden rush of emergency personnel (often who have no connection to the case at all, but are on a "code team") step in and help do whatever needs to be done for the patient. I would have a hard time believing this wasn't done if she was "bleeding out" or having other signs of distress or compromise. Even if Jahi's nurse was busy doing something else (in an ICU setting, especially somewhere like Children's or another big hospital, it is not unheard of to have two or more emergency situations happening simultaneously) other staff would most certainly step in and help as that is just what happens in a place like that.

Can't medical records be altered or information left off?

DH had rotator cuff surgery and a torn bicep repaired on Oct. 28th. The surgery center (rated #1 in our county) tried to give him Tylenol multiple times even though he is allergic. I wanted to speak to the doctor about the mistakes so I requested the records. There wasn't any mention of the mistakes. It shows what he was given instead, but no mention is made of the drug he was almost given. The nurse had to sign that medicine out. I don't know what she would do with the unused medication, but it was not mentioned in DH's records. Maybe she didn't have to record it in his chart since she didn't end up giving it to him, but I think that is walking the line of shady.

The doctor wrote out a prescription for Tylenol with Codeine. When the discharge nurse handed it to me, I pointed out yet another mistake. The nurse wrote on the RX, "Wife refused." I don't think so! I made her write, "Wife refused because husband is allergic." In my opinion, she was trying to make me look like the difficult person instead of putting in writing the obvious mistake.

I recognize that DH's situation is WAY different than Jahi's case. Hospitals, nurses, staff, and parents make mistakes. I'm not sure everyone openly admits to their mistakes even if it is required. Some things are harder than others to cover up, though.

 

[Lorelei Lee]

An investigation into what happened here is going to involve a review of the medical records and witness statements. While an autopsy would have been very helpful, the lack of one doesn't mean the investigators won't be able to determine what caused her death.

After all, how do you prove medical malpractice when the patient survives?

 

[U2_rocks!]

It would certainly be guilt in my books. They would have a need to blame someone rather than themselves and would not accept their own responsibility.

I would like to add though, that in my daughters case, they WANTED her to sit up (albeit propped up), eat and drink, and talk. You have to eat to prevent the wounds scabbing and becoming infected. A hamburger would just have made her sick if anything? You have to eat scratchy foods and be able to keep them down before they will discharge you over here after that kind of operation.

Here you have to eat solid stuff before you leave the hospital. My friend's DD just had a tonsillectomy on Dec 12 (coincidentally) and she had to eat toast before she could be discharged. It was hard for her, but there were reasons for it.

 

[LisaR]

An investigation into what happened here is going to involve a review of the medical records and witness statements. While an autopsy would have been very helpful, the lack of one doesn't mean the investigators won't be able to determine what caused her death.

After all, how do you prove medical malpractice when the patient survives?

That's a very good point!

 

[skylizard]

Since we haven't heard anything in a few days, I wonder if they've finally come to terms with her death. ??

 

[StitchesGr8Fan]

Since we haven't heard anything in a few days, I wonder if they've finally come to terms with her death. ??

CNN just had an article that they want privacy. I'm reading between the lines, but I think things are going downhill, and they don't know what to do.

 

[dakcp2001]

Someone who may or may not have been at the hospital that day, on a comment on an internet site reports that they saw what looked like a family member offering her a bite. Not a lot to go on, and lots of possibilities from the family having permission, to Jahi refusing the bite, to someone who is confused about what they saw, to an outright lie by someone seeking attention in an anonymous forum.

It's PICU. There should be someone in the room at all times.[/QUOTE]

That is completely false. You think healthcare is expensive now? Just imagine how much 1 on 1 care would cost. In my hospital picu nurse can have up to 3 patients. They always have 2. And even if care was 1 on 1, you would still need to leave the room to get meds, blankets, read the orders, talk to doctors, go pee. And there are some cameras in the hospital but they are in main hallways not in patients rooms where baths and bathroom functions are taking place.

Seriously if I had a nickel for every time family went against doctors orders I would never have to work again. A lot of adult patients say I am going to eat if I want too, and we cancel their surgery. When we say nothing by mouth, we mean NOTHING by mouth.

At the start of this I would have said the idea of the family sneaking a hamburger is a bit ridiculous but after seeing how this family has behaved, nothing would surprise me.

The hospital probably already has a good idea of what happened and why they are not allowed to speak or defend themselves. If the family really did try to bring in 16 family members to the PICU when only 1 is allowed, I can see it taking the whole staff to get them out. What a circus. Complete disrespect for other patients. This family and the circus they have created took away from the care of other patients on that ward for way too long now. I feel very sorry for the staff that had to deal with this. And I also feel sad for the other families going through their own tragedy while in the pica and having to witness this mess.