13 Year old gir declared brain dead has now officially died

[RockAndRollBallerina]

Why on Earth did the family run to the media in regards to their daughter's condition to begin with? It makes no sense to me.

 

[JanaDee]

Why on Earth did the family run to the media in regards to their daughter's condition to begin with? It makes no sense to me.

$$$$ and they were hoping to sway the hospital into doing what the family wanted to avoid bad publicity.

 

[Shelly F - Ohio]

Look at the other case at that hospital where the child had complications from the same surgery. She is not brain dead by will never walk or talk. The family sued the hospital for 4 million and just got awarded their money in Nov. but they did not say how much they got.


That mother has been supportive to the Jahri mom.

What even more scary is the premonition she had that she would not wake up for the surgery. What that already a sign from the man upstairs that he would be summoning her home.

 

[kacaju]

I think the question is, to what end? It is not a "therapeutic" move because technically, she is already dead.

The family, if not now, at some point, will have to examine what they wish to get out of this. Will they want to just keep her body alive? ("Warm", as the mother says?) Practically, this is what they're requesting. And she could languish for years that way.

Additionally, what happens if, say, they place a trach or feeding tube and those surgical sites bleed (or otherwise have complications) when she's at the nursing home. How will they handle that? Will they call 911? What will be her "code status"? Full resuscitation? (Of a dead person?) If they fail to act quickly, what will their liability be? If she "dies" there - wait, can she die there if she's already been declared dead?

Really, it doesn't make a lot of sense. Even without looking at costs.

Lots of medical-legal-ethical questions here.

thanks.. makes sense more to me now.

 

[DLgal]

This case really disturbs me. Mostly because I can't wrap my brain around the parent's response to the situation. Had this girl suddenly and tragically ended up in this state, such as as a result of an accident, I could understand. However, this happened after a surgery that they elected to have their daughter undergo after being made aware that this outcome was a possibility. They signed their consent for the procedure.

My 9 year old underwent adenoid removal surgery this summer. The doctor didn't even use a knife, just a water laser type thing to shave off the tissue. Even still, we had to sign a form that listed ALL the potential complications, from chipped teeth, damage to vocal cords, loss of speaking ability, major bleeding, hemorrhage, cardiac arrest, and death. After we read the form, the doctor went over all the complications again with us and made us verbally confirm that we understood and accepted them before he would let us sign it. His nurse was also in the room as a witness. At the surgery center we signed off again on a similar form related to the anesthesia risks. At no point did I feel the surgery was risk free and if my child had suffered any of those outcomes, I was fully prepared to deal with it.

I honestly think these parents might not have really understood the risks involved.

Was it malpractice? Maybe. But not every complication is the result of error. The body often reacts unexpectedly to trauma. However, if they truly feel someone made a mistake, they are not helping that investigation by keeping her "alive" this way. I understand grief can really mess with peoples rationale but this is way beyond a normal grief response.

 

[StitchesGr8Fan]

I remember reading that the family was hoping for a Christmas miracle. Christmas has come and gone. This is going to sound heartless, but every day that poor girl is kept on life support is another day that she is racking up huge medical bills that insurance is probably not going to cover. So one of 2 things will happen. A) the family will win a malpractice suit, get millions of dollars from the hospital and have her medical bills wiped out, and the cost of her care and the settlement will be passed on in the form of outrageous healthcare costs to other patients B) the family will get the bills, file for bankruptcy, and the cost of her unpaid bills will be passed on in the form of healthcare costs to other patients. No one wins here.

 

[sookie]

I think it is sad that the family does not want to accept the medical opinions given that she is brain dead and will not wake up no matter what. They seem to be under the impression that she is just in a coma and may possibly wake up. I can't believe they are actually going to put her in a long term care facility and keep her on life support. I would never do that to my child. I think that is selfish.

If I am not mistaken they have had 3 different doctors examine her and her records, one just for the court, and all 3 of them recommended removing her from life support.

I don't know of many private insurance companies that would agree to pay for long term care for someone brain dead so I am assuming, possibly wrongly, that they have her on Medicaid. You can probably get by with something so ridiculous with Medicaid.

I can understand possibly wanting to wait a few days before you unplug them just so you can have time to accept what is coming, but to try to go to court to keep the hospital from unplugging her is, as someone else said, just delaying the inevitable.

I have not read the whole thread - so I'm sorry in advance.

I have read that not only has she been declared brain dead by several docs with several exams over several days, but the ME would like the body to do an autopsy to find out what went wrong. A child shouldn't die from a tonsillectomy like this. I read one article where the family was told that the child was going to ICU and that this was "normal" after a tonsillectomy. I'm sorry - but that isn't the norm. I guess if you have weird anatomy - maybe. But usually kids go home the same day. Some will stay a night on the floor to make sure the kid is able to drink and has good pain control, and then discharge.

The family and hospital needs to know if there was malpractice or gross negligence in the way the tonsillectomy was performed. The case doesn't seem normal at all from what I have read.

In most cases, even when the brain is "dead", the body will continue to heal if on life support. So even if she had a brain injury that has left her brain dead, body is still alive - but only because of medical intervention. That is why we have organ donors - those people are usually declared brain dead, but the body is still in good shape and those organs are salvageable. Anyway, if the body is allowed to stay in this state, it will continue to heal. In that case, ME won't be able to do a thorough postmortem examination to find out what caused the child to have complications and then die. This is huge because the medical board might need to discipline the doctor, the hospital might need to find out what went wrong on all accounts (medical staff and hospital staff) and the family might feel the need to sue the hospital or doctor. Not allowing the child to be removed is only prolonging the agony of the family and will hinder the postmortem exam.

 

[sookie]

True brain death will begin the breakdown of the body within a certain period of time. May take a little longer with this child because she IS a child.

Very sad situation. I am sure the family needs time to come to grips with it and I admire their faith but I think they're praying for the wrong thing.

From an ethical standpoint, it puts the hospital in a tough position. It is wrong to operate on an effectively dead person.

Sad all around.

Yes, this is true. A bad brain will quickly cause other body systems to go haywire. The major organ systems will begin to fail. But skin / connective tissue from the surgery may progressively heal in the meantime, and may effect the postmortem examination - which is what the ME has expressed concerns about.

I also wanted to comment on another thing - I also read that the child was up and talking and eating after surgery. The grandmother gave an interview where she stated that she alerted the post-op team that the girl was bleeding, and that it seemed to be a LOT. She was then told that the child was going to the ICU and that it was normal. Apparently after arrival, the family asked several times if the amount of bleeding the child was having was normal (she continued to bleed) and they were reassured that yes, it was (within the scope of reason after having a T&A). Then the kid crashed.

The interviews I have read were all from the perspective of the family; they are not medical people at all. So I take a lot of this with a grain of salt. But still - that had to be horrific.

 

[Jessica14]

Look at the other case at that hospital where the child had complications from the same surgery. She is not brain dead by will never walk or talk. The family sued the hospital for 4 million and just got awarded their money in Nov. but they did not say how much they got.


That mother has been supportive to the Jahri mom.

What even more scary is the premonition she had that she would not wake up for the surgery. What that already a sign from the man upstairs that he would be summoning her home.

That is very concerning that this same hospital had a similar outcome from a similar surgery. So many issues here and so much to sort out.

Not really sure that is a premonition though. My DS, 8 at the time, had complicated bone graft surgery in September for his cleft palette. He, too, thought he was going to die. I think that was just fear talking. It could have been different for this girl, but I don't know if it is anything but uncertainty.

 

[sookie]

Thank you! As a nurse who takes care of tonsillectomy patients after surgery I was curious what happened to this girl. What a sad situation. I think the family needs to come to terms and let her go.

I think they need an autopsy. Even though she had some medical problems, the family was advised that the procedure would be very helpful.

Some possibilities: I think that the child possibly had unexpected anatomy (could be anything - placement of vessels, etc); or it is possible that malpractice is at play. But the longer the family waits, the harder it will be for the ME to find out what happened. Everyone needs to know... the family, the hospital, the hospital staff, and the patients who might be going under the knife again.

 

[DisneyJamieCA]

Again I don't want to judge the family because I'm not sure I'd be thinking rationally, but it really bothers me that they are willing to give their side over & over again, but refuse to grant the hospital & doctors the right to do the same.

There is a very good chance that the public (and even the family/doctors) will never know what truly happened. Malpractice is always a possibility, but so is the chance that the family is dealing with their own guilt by implying the hospital is at fault.

As for another surgery going bad, yes it's unfortunate, but 2 bad surgeries out of the how many they do...not a good indicator of fault. Even if the family was awarded money it could have been a settlement, often advised by lawyers, and not a finding of fault. Maybe the hospital was at fault, but I'd think we would be hearing more about that now.

I keep seeing people say a child should die during a tonsil removal - and I agree, people should never die during surgery. But guess what, surgery - ALL surgery - routine or not, has inherent risks. Death, unfortunately, is always a risk and you sign papers to that affect. Routine does not equal risk free. Wasn't it Kanye West's mom who died from complications from plastic surgery.

As I stated earlier, when my grandmother had her feeding tube placed, they were very worried about whether she would survive it, an extremely routine surgery, given her health history (bad heart and having to come off blood thinners because she would have bled out.) If she had passed during the surgery, and we as the family refused to give info or let the hospital do so it would be reported as somebody dying during a routine procedure. As it was, she passed away a week later from a stoke caused by going off the blood thinners. Was that the hospital's fault? No, she knew the risks, was there in the first place because of a stroke and chose to have it anyway. We all hope those risks don't apply to us or somebody we love, but they tell you then because they do happen.

My heart does go out to this family and for their sake I hope they can move past this denial phase in their grief and can stop blaming themselves. And I get it, most people want answers, want somebody to blame and right now the doctors/ hospital is the easiest for them. Maybe the hospital is at fault. Maybe not. I hope they get the answers they need.

 

[Coonhound]

After thinking more about this I feel it's just too macabre and gruesome.
So the child has a death certificate with a "time of death'" on it, and the coroner must give permission for "the body" to be moved.
So they are just...using machines to pump air in and out of the lungs, making them rise and fall as if there is breath...but it's being done inside of a dead body? Realizing that is just...horrific.
Before, I was thinking of it as "letting her go" etc but now I'm realizing this isn't even about letting her die, this is about the decision to stop keeping a dead body warm and pushing air through it. these parents need a grief counselor NOW and they need to be helped to realize what they are holding onto is not their daughter but simply a deceased body. This is more horrific than I can imagine and I really, really hope that someone makes them realized this. The whole thing is just awful and gruesome and they need to realize that their child is gone, that body laying there is not their child.

 

[JanaDee]

After thinking more about this I feel it's just too macabre and gruesome.
So the child has a death certificate with a "time of death'" on it, and the coroner must give permission for "the body" to be moved.
So they are just...using machines to pump air in and out of the lungs, making them rise and fall as if there is breath...but it's being done inside of a dead body? Realizing that is just...horrific.
Before, I was thinking of it as "letting her go" etc but now I'm realizing this isn't even about letting her die, this is about the decision to stop keeping a dead body warm and pushing air through it. these parents need a grief counselor NOW and they need to be helped to realize what they are holding onto is not their daughter but simply a deceased body. This is more horrific than I can imagine and I really, really hope that someone makes them realized this. The whole thing is just awful and gruesome and they need to realize that their child is gone, that body laying there is not their child.

Her mother was quoted as saying as long as her heart is still beating, she is alive.

 

[DisneyJamieCA]

After thinking more about this I feel it's just too macabre and gruesome. So the child has a death certificate with a "time of death'" on it, and the coroner must give permission for "the body" to be moved. So they are just...using machines to pump air in and out of the lungs, making them rise and fall as if there is breath...but it's being done inside of a dead body? Realizing that is just...horrific. Before, I was thinking of it as "letting her go" etc but now I'm realizing this isn't even about letting her die, this is about the decision to stop keeping a dead body warm and pushing air through it. these parents need a grief counselor NOW and they need to be helped to realize what they are holding onto is not their daughter but simply a deceased body. This is more horrific than I can imagine and I really, really hope that someone makes them realized this. The whole thing is just awful and gruesome and they need to realize that their child is gone, that body laying there is not their child.

Yes, what you have described is what happening. The vent is pushing air into her lungs, forcing her to breath. Without it, she would not breath on her own.

I just saw on our local news brief that there is one remaining place willing to take her, but again, she would need the surgeries beforehand (which the hospital is still unwilling to do). And not to what you said, but I've also been thinking, and i know it's been said on here already, this family has already threatened the doctors & hospital with lawsuits. Who in their right mind, even if it weren't on somebody who already died, would continue to perform surgeries on this person at this point? Minus the ethical portion, would their malpractice insurance even allow a doctor to continue once threatened with a lawsuit?

 

[DLgal]

Her mother was quoted as saying as long as her heart is still beating, she is alive.

That is just sad because that is not the definition of "alive" at all. Seriously, I really feel like this mother is not capable of rational thought at this point.

 

[DisneyJamieCA]

This is the latest news article. It says there is a place in NY willing to take her but that Children's has not heard from them and that the coroner would have to sign off on the transfer if it is out of state. The two CA places who were originally willing to take her are no longer. Also, Children's has said they will help with the transfer IF an outside doctor will place the feeding tube & trach - so far, no doctor has stepped us as wiling to do so. I http://www.ktvu.com/news/news/local/time-short-find-new-facility-jahi-mcmath/ncXm2/

ETA: I just read on our local ABC site that the family does not have insurance as they previously claimed.

 

[NewmanFamily6]

NBC News Update...

Childrens Hospital Oakland continues to support the family of Jahi McMath in this time of grief and loss over her death. We continue to do so despite their lawyers criticizing the very hospital that all along has been working hard to be accommodating to this grieving family."

We have been waiting since Friday 12/27--when we were first told by the family lawyer of a potential facility that might accept the body of Jahi--for a call from a physician to discuss with our medical staff what may be necessary to transfer the deceased. Our physicians have yet to receive a single call or message from the facility under consideration.

The letter/email below was sent to Chris Dolan, the McMath family lawyer, at approximately noon today, Dec. 29, by Childrens Hospital Oaklands attorney Douglas Straus:

Chris,

I learned from your statements to the media that the Southern California sub-acute facility will not accept Jahi McMaths body because the physicians there do not want to treat a dead body. Childrens Hospital understands that this is a very difficult time for Jahis family. Childrens will continue to do what it can do to support the family. In that regard, Childrens position has been consistent:

1. Childrens will be pleased to communicate directly with a physician at any facility that is considering accepting Jahis body to make sure Childrens understands the requirements set by that facility for accepting the body and to ensure that the facility understands the current condition of the dead body and what is being done to maintain it under Judge Grillos temporary restraining order. Of course, the familys representatives can observe that communication.

2. Childrens needs to be assured that there is a lawful transportation plan to any facility to which transfer is proposed.

3. If the proposed facility is out-of-state, Childrens needs written assurances from the Coroner that their office will allow the transfer.

To date, there has been no communication from any facility named by you regarding a transfer or requirements for transfer with any of the medical professionals at Childrens. The family has not identified any facility with which Childrens can have this dialogue. Nor have we been provided with a transportation plan or coroner authorization.

As your email and your statements about the facility in the Los Angeles area acknowledge, discussion about performing medical procedures upon a dead body presents unusual and complicated questions. Until there is a definite commitment by a facility to accept Jahis body upon specified terms, I dont think I can tackle those issues. Please let me know if the family is able to identify a facility.

Doug Straus

 

[bittybabygrower]

This just gets more and more horrible. This family can bash/ say whatever they want but will not allow the hospital to speak out. I feel badly for the staff there. As a nurse I am sorry for this family....but we have only heard their side of the story and my heart hurts more for the nurses taking care of this shell .

I have my doubts they are going to find anyone truly willing to do the surgeries in fear of this girl dying "again" on their table and setting themselves up to be named by the money hungry lawyers. And no facility is going to take her without a stable airway and a means to feed her. And what if she decides to die yet again em route to this other facility and who is paying for this and for her family to go to her?? The lawyers are probably fronting money on the assumption of a payout from the malpractice. And if they are awarded, it goes to a trust for her care. When that money runs out then what?

This is just so unethical and cruel it makes my stomach hurt.

 

[JanaDee]

This just gets more and more horrible. This family can bash/ say whatever they want but will not allow the hospital to speak out. I feel badly for the staff there. As a nurse I am sorry for this family....but we have only heard their side of the story and my heart hurts more for the nurses taking care of this shell .

I have my doubts they are going to find anyone truly willing to do the surgeries in fear of this girl dying "again" on their table and setting themselves up to be named by the money hungry lawyers. And no facility is going to take her without a stable airway and a means to feed her. And what if she decides to die yet again em route to this other facility and who is paying for this and for her family to go to her?? The lawyers are probably fronting money on the assumption of a payout from the malpractice. And if they are awarded, it goes to a trust for her care. When that money runs out then what?

This is just so unethical and cruel it makes my stomach hurt.

I read earlier today they were talking to a facility in New York, but they refused to name who.

 

[ronandannette]

Is there anyone with medical expertise on the thread that can answer this question?

The "dead body" (as the hospital's communication in P#157 refers to her) has presumably been without nutrition since the incident as we know that no feeding tube has been inserted. Should the courts rule against forcing the tube (and, not that it matters but I hope that this procedure does not occur) how long before the heart will stop beating from this cause? Can a body in this state even metabolize nutrition?