Jahi McMath's mom clear to take her from hospital

[hue]

Source: SFGate


OAKLAND, Calif. (AP) — A judge says the mother of a 13-year-old girl who was declared brain dead after having tonsil surgery can remove the child from a Northern California hospital as long as she assumes full responsibility for the move.

Jahi McMath has been on a ventilator for nearly a month, and her family has been fighting with medical officials to have her transferred out of Children's Hospital Oakland.

Alameda County Superior Court Judge Evelio Grillo said Friday that Nailah Winkfield can move her daughter under a deal with the hospital that holds the mother accountable for consequences that could include Jahi going into cardiac arrest.

Read more: Linhttp://www.sfgate.com/news/us/article/Jahi-McMath-s-mom-clear-to-take-her-from-hospital-5110347.phpk to source

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There is no way their daughter will be able to "survive" a transfer.

[bigwillq]

1. The mother should be allowed to do what she wishes

even if it means death for her daughter.

This is such a heartbreaking story.

[AtheistCrusader]

3. Her daughter is already dead.

Sad, but well, you see the effects of sugarcoating it right here in the headlines.

[ScreamingMeemie]

26. Agreed.

On all points.

[Scairp]

32. I watched the mother exactly once

On television, and she seemed incredibly hysterical. Now, I've never been in that position, but I'm pretty confident that the last thing I would want to do is stand in front of reporters and cameras for my heartbreak to be spread all over the place. This should have remained a private, family matter. I'm sure they could have had this fight in private just as easily. My guess is that someone in her family has dollar signs in their eyes right now and are egging her on to drag this tragedy out and felt that going public was the best way to make the hospital uncomfortable in the misconception that they will get more money in the eventual malpractice/wrongful death suit. At any rate, it's rather clear she has no one to give her the advise she really needs, which is to accept her daughter is gone, have a service to honor her memory, and to begin to grieve that loss and figure out a way to move on.

[NYC_SKP]

2. Is she going to try to take the child out to the New York hospital without medical support.

How sad.

I guess trying everything includes everything.

Sad sad sad...

[rocktivity]

4. "Judge Grillo...not(ed) the girl could be moved with the ventilator she is now using."

Which I guess means that the hospital is still refusing to insert breathing and feeding tubes on the grounds that she's dead? It sounds like a moot point. And is the January 7 5PM deadline still in effect?


rocktivity

[Wait Wut]

5. I hope she has an attorney.

And that he/she is advising her well. It sounds like the hospital is trying to wash their hands of this girl's 'death' by saying they won't be responsible.

This is just horrible. As a parent, you always dread the worst, but thankfully, most of us never have to experience the loss of a child. To feel her daughter is still warm to the touch, to see her breathe, I can understand why it's difficult to believe she's gone. There is nothing in her head that is speaking rationally to her, at this time. It's heartbreaking.

[Bigmack]

9. TRULY heartbreaking!

I'm glad "they" did not remove the tubes keeping her "alive" at Christmas time - but it does sound as if all rational hope is gone….. How VERY sad. Ms Bigmack

[rocktivity]

6. According to this update, a death certificate has been issued

Last edited Fri Jun 29, 2018, 12:50 PM - Edit history (3)

On Friday (Jan. 13), the Alameda County Coroner issued a death certificate stating that Jahi died on Dec. 12.

Which lets the hospital off the hook, and invites any doctor, facility, lawyer, or judge to gamble their professional credibility on administering to a corpse.

Game, set and match.


rocktivity

[tomp]

22. California must have public health laws....

....governing the disposal of a persons remains, including post-mortem examination in certain cases, which it would seem to me are being violated by this order, but I'm no lawyer. I will speculate that this move only adds to the legal complexities of the case all around.

Also, what is the family supposed to do if the patient suffers "cardiac arrest," resuscitate her? Call 911?

I believe this ruling constitutes legal support for an attack on science, and thoroughly muddies the water.

[rocktivity]

24. The certificate doesn't have a CAUSE of death, of course, because an autopsy hasn't been done

due to the body being on a ventilator. But obviously the coroner is more than satisfied that Jahi meets all their criteria for being legally and medically dead. Which gives the hospital the upper hand: now that Jahi is officially a corpse, anyone who continues to advocate for her is calling his own competence into question.


rocktivity

[tomp]

25. I understand, but....

...it seems as if the court is giving the body of the deceased over to the family to do whatever they want with it, as opposed to following public health law on the disposal of corpses, i.e., allowing the family to determine when the person is dead.

[rocktivity]

28. Now that she's "officially" dead, disposing of Jahi properly is all the family CAN do

Last edited Sun Jan 5, 2014, 05:27 PM - Edit history (2)

-- which is why the hospital "suddenly" decided to "negotiate" with them. No self-respecting physician is going to insert life support tubes into a corpse, and no respectable medical facility is going to accept a corpse as a patient, tubes or not.

The judge has said that Jahi's body can be moved without the tubes. But that's meaningless now, because now that Jahi is officially a corpse, there's only one place where she can be moved -- to a place of interment.


rocktivity

[tomp]

37. but that is apparently NOT what the family intends to do.

and in allowing them to take the body for purposes other than interment/disposal, the judge's ruling appears to be in contravention of local public health laws and of the doctor's determination of death. I get all the medical issues. I'm addressing legal ones.

[cosmicone]

7. This means some needy child will be without a ventilator

because the family wants to take the ventilator on a carnival ride.

[840high]

8. The family probably did not

authorize organ harvesting.

[Thor_MN]

11. I hope not, since they still think she is alive...

But not really relevant to the post you responded you. That was about use of the ventilator equipment, not organs.

[kestrel91316]

10. Corpses cannot "survive" anything. Just sayin'.

[Codeine]

12. You mean "clear to take her CORPSE from hospital"

She is an ex-parrot.

[ninjanurse]

13. Stakes are Higher for Schiavo Supporters

I think this grieving mother has been badly served by everyone, but especially her lawyer. The facility that says they can take Jahi does not seem to have the means to follow through. I think the lawyer, New Beginnings and the Schiavo family were not prepared to have to take this dead child on a respirator-- it will be interesting to see what they say now. Did they ever think they would have to deliver on their promises?
It makes sense to release the body to the family to do as they see fit. It will not give them what they want, Jahi back alive. It will only end in sadness.
The mother had a right to get a second opinion that her daughter was really dead. That should have been offered by the hospital right away, and her questions answered and her loss handled with more sensitivity. That might have avoided this awful prolonged denial of what can't be changed.

[kickysnana]

14. I would have agreed with you until Julie our Sr bldg President in 2008

at a bad reaction to a dye study of her kidneys and went into arrest and then multiple organ failure and supposed brain death. The family was told and they said they needed 24 hours to think it over and the next morning she woke up. I bought a Christmas table decoration from her last month and she was sent up some friendly medical advice through my auntie today.

It was a rough road back but she didn't and doesn't yet want to die. So I reserve judgement for this family and whatever information they can get. A post yesterday said that information sharing is sometimes impossible for consultations with hospital software designed to efficiently bill insurance companies and secondarily for care givers and patients. You also have to wonder if this had been a blond blue eyed girl if opinions would be different. This was a tragic outcome to a surgery there is big money and careers at stake and that does enter into decisions which is why the family needs an outside impartial expert who can order their own tests even if necessary to make this decision.

At that exact same time in 2008 my mom was moved to palliative care for COPD of 15+ years. She had been hospitalized about once a year to reset medications but recovered and lived with my Dad and did pretty much everything she felt like doing. They told us she was no where near dying when they sent her to transitional care. She rallied for two days and then took a turn for the worse at noon on a frigid January day and passed away just after the last Grandchild's family got to the facility to say goodbye from half way across the country.

I think to give information is good. To ask questions is good but it does bother me people making black and white decisions on an anonymous message board that the family could some day run across. They deserve better, we should be better than that.

At my age I would not want to be in her position but I would have wanted the chance to come back to live my life if I was only 13. I do hope this family finds peace.

[840high]

17. My total sympathy is with the family. I don't

know what I would do in same situation.

[Scairp]

33. This case is not that

Several neurologists have examined the girl and confirmed there is NO brain activity, none whatsoever. I understand that hospitals might be hasty to disconnect someone they feel is not going to recover and is taking resources from patients who would, but it's rather clear the girl is gone, for all intents and purposes, and her body should be allowed to go where her brain already has, a peaceful death as opposed to a prolonged artificial life. If she where breathing on her own that would be different of course, because that would mean there is brain activity. There is nothing there, she is dead. Let her go.

[Violette_Crime]

43. You also have to wonder if this had been a blond blue eyed girl if opinions would be different.

You may wonder but I don't. Oakland in a predominately AA area in the Bay Area, full of Black people and Black children. Why would you think a Caucasian/Hispanic or Asian child would have been treated any differently? The family is not very honest I believe in many aspects of this case, from her undisclosed medical problems through to the way they handle this case. That is the problem, not because she is not White. BTW I am Black myself.

[Nonhlanhla]

15. Here's an interesting post on the case

Last edited Sat Jan 4, 2014, 12:58 AM - Edit history (1)

This poor child is dead, and she has been dead for 3 weeks. No one has ever recovered from brain death. This is not suspected brain death, and it is not a coma or vegetative state - it is proven brain death. She has been tested and tested and tested. She is dead and despite the ventilators her body has slowly been decomposing for 3 weeks.

Here is a very informative post about this case.
http://sprocket-trials.blogspot.com/2014/01/jahis-legacy.html

[Butterbean]

18. That is an excellent blog post, thank you for sharing that. n/t

[Hekate]

21. Terrific blog post. That was no "simple tonsillectomy" as the MSM describes it over and over....

http://sprocket-trials.blogspot.com/2014/01/jahis-legacy.html

This:

From CHO’s attorney’s response court filings on December 20, we learned that Jahi had not had a simple tonsillectomy, but actually several invasive procedures to open up her upper airway. She’d undergone an adenotonsillectomy, uvulopalatopharyngoplasty, and submucous resection of bilateral inferior turbinates. In laymen’s terms, her tonsils and adenoids had been surgically removed from the back of her throat, her uvula (that thing hanging down at the back of your throat) and soft palate removed or remodeled, and excess soft tissue removed from the back of her nose. These tissues are very fragile and highly vascular, meaning they can bleed a lot, as anyone who has had a nosebleed can testify to. We learned via local media that the teen had recently been given the privilege of taking the bus to nearby Berkeley to get her favorite treat from an ice cream shop: a snickerdoodle ice cream sandwich with vanilla ice cream, despite weight being a huge factor in obstructive sleep apnea.

And this:

Via messages left on SFGate’s message board, commenters claimed that the family did not follow the physician’s post-op instructions. Because of HIPAA laws, the hospital and staff are not allowed to talk, but civilians visiting the hospital are not bound to silence. Numerous posts claimed that the family marched extended family to Jahi’s bedside, talking to her and encouraging her to talk back. Doctors and nurses instructed the parents to keep the teen quiet.

There has also been chatter on message boards regarding co-morbidities. While it is true that anything on the Internet needs to be read with suspicion, sometimes the truth ekes out. Posts were made stating that she had Type 2 diabetes and asthma. Posts were made claiming that Bay Area physicians, when asked by parents about tonsillectomy risks, replied that the word in the medical community was that Jahi’s family failed to disclose a familial predisposition to bleeding. Because of HIPAA laws, the hospital is not allowed to discuss the case at all, and is only allowed to say that Jahi is in the facility and that her condition has not changed.

Things are starting to look like this was family noncompliance, not physician error or nurse negligence. Talking is a no-no in the immediate post-op period after any sort of upper airway surgery. Failing to disclose something as serious as a potential bleeding disorder may well have been fatal.

The family are starting to look like idiots, with all due respect to their grief. (Even idiots grieve deeply -- but if they do things like bring in a stream of visitors and tell the kid to talk when they've been specifically instructed to not do anything of the sort, it is not the hospital's fault.)

And this, for the benefit of the MSM and others who can't tell the difference between irreversible brain death and a coma:

In the early-morning hours of December 11, signs of brain swelling were noted. That pressure, combined with a lack of blood flow, effectively killed her cerebral cortex and brain stem. How is it known her brain stem is dead? Because she is unable to breathe on her own without the ventilator, and has no swallow or gag reflex. How do we know her cerebral cortex—the seed of our consciousness and individuality—is dead? She is unconscious because there is no blood flowing through her brain and there is no electrical activity.

Her heart beats because the heart does not need messages from the brain to beat....

The whole thing is horrifying. Several years ago I read a worst-case scenario about a mother who kept the corpse of her child ventilated and fed at home for nearly a year. It took that long for all the cells to finally die. A couple of times she rushed the youngster to the ER because of airway obstruction -- the medical professionals tried to tell her the "obstruction" was actually decay, but there was no getting through her denial. I hope to God Jahi doesn't end up like that.

[Gormy Cuss]

29. The writer believes shite in the SFGate message board comments?

Sorry, but I'd place even odds that the "helpful" rumors pointing to family noncompliances are an intentional distraction from whatever when wrong in her medical care. The Oakland Tribune in an early report described one of the family members present, her grandmother, as a veteran nurse for Kaiser Permanente.

What is a fact is that CHO hired a PR expert to manage its image after the family took the story public.

In this case, the family lawyered up early and took their case public. Then the hospital hired a consultant, whose website calls him "the fixer," to manage the media fallout. That has led to a public battle with each side demonizing the other.

http://www.latimes.com/local/la-me-0104-banks-jahi-mcmath-20140104,0,6691480.column#ixzz2pXrsStLa

and that CHO settled a lawsuit only weeks before over a case of another child who suffered serious brain damage after a adenotonsillectomy two years ago, also performed to alleviate sleep apnea.


To be clear, I don't think this child is still alive in any meaningful way and I hope that her body gives out soon. I just think that CHO has a lot of explaining to do.

[Nonhlanhla]

31. True, but...

It is true that one should not place too much stock on online rumors. What makes that bog post helpful is that it describes the complexity of the surgery that this child had, which was not quite the "routine tonsillectomy" that the family keeps mentioning. It also clarifies her current condition, about which there has clearly been some public misunderstanding.

Excessive bleeding after this kind of operation is unfortunately not an unheard-of complication, and it could have been triggered by talking etc. If in fact the family encouraged her to talk etc., they likely contributed to the problem. But of course, as you point out, that might just be rumors. It might also just be rumors that the family failed to disclose a bleeding disorder in the family, and that the child had diabetes and asthma (as a matter of fact, those do sound like rumors to me - it's just a bit too much.) The hospital will surely have to explain what went down, but right now they cannot. I would not be too quick to jump to blaming the hospital, however. Surgery is risky, and sometimes things just go wrong, even when medical staff do all that they can. An autopsy could give some answers. But ironically at this point an autopsy might no give many answers anymore since her body has been deteriorating so much already.

[JohninPA]

38. You are incorrect

Both Zach Dunlop and Steven Thorpe would disagree with your assertion.

Although some may say that since they are alive, they were not really brain dead. However in both cases their doctors were absolutely sure they were 100% dead. I'm not saying that this case is the same, but doctors can and do make these mistakes.

[Nonhlanhla]

40. They were misdiagnosed

From what I've read, both of those individuals were misdiagnosed. Steven Thorpe, for example, was in a chemically induced coma, and you cannot really declare someone brain dead when they're in a chemically induced coma (why would he even be in a chemically induced coma if he was brain dead?). According to media reports, his CT scans showed "almost irreversible" injury, which is not the same as brain death, since someone can survive an irreversible injury. Also, it does happen occasionally that people recover from traumatic brain injuries (like Steven Thorpe's, which was the result of car accident), but usually not in victims of brain injury due to lack of oxygen or blood flow in the brain (e.g. heart attack victims like Jahi). And no one who has ever met ALL the criteria for brain death (like Jahi does and Steven Thorpe did not) has ever woken up.

[PasadenaTrudy]

16. It's really "organ support", not life support...n/t

[Nonhlanhla]

19. It's not even that

From what I understand (as a lay person) her organs have already deteriorated too much to be viable for transplant. So in a sense this is not even organ support. The heart may be the exception, since the ventilator is keeping it going and it does not need input from the brain to continue, but I don't have enough medical knowledge to say that for certain. But the other organs are slowly starting to decompose.

Either way, this is not life support, nor even organ support. It's just ventilating a corpse. I feel sorry for the family, but this is starting to get macabre.

[PasadenaTrudy]

23. I agree, quite creepy n/t

[awoke_in_2003]

20. Let her go

she is already gone, just get it over with

[Historic NY]

27. To move her from one coast to the other...

won't work unless they have lined up a special medical carrier for transport.

[magical thyme]

30. they have.

They've lined up the carrier (a little under $30,000), but have yet to line up the medical staff to attend her journey, although supposedly an anonymous doctor has volunteered to do it.

They also are looking at another (likely wingnut) facility in Arizona, so New Beginnings is their 2nd choice since they want her body closer to home.

[warrant46]

34. an anonymous doctor has volunteered to do it.

Did they call Mel Brooks ?

[magical thyme]

35. I wouldn't be surprised...

it turns out "their" pediatrician who claims that Jahi is still alive is a pro-lifer wingnut from Ohio who believes (and teaches) that the move to brain-death as a legal pronouncement back in the 60s was a conspiracy to enable evil doctors to harvest organs from still living people for the transplant biz. What's truly frightening is that he really is on a med school faculty, and comes across as really out of it and nuts. He insists that as long as a heart is beating the person is alive, even when it's a machine that is keeping it pumping.

[warrant46]

36. Wow

[Beacool]

39. Heartbreaking case, but the parents should let her go.

The poor child will never recover and the cost of keeping her "alive" could cost millions in the long term. Money that could go to other children who have a better chance of recovery.

[Sheldon Cooper]

41. They are religious people, and I hope that their god will soon help them accept their daughter's

fate. The whole situation is heartbreaking.

[Beacool]

42. Yes, it is.