Oakland 13 Y. O. to Remain on Life Support Another Week, Per Court Order
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If you google the words: stories from the trauma bay, the writer of the blog is a trauma surgeon and has written at intervals very cogent summaries of this case since the incident happened. These are informative and written so that even non-medical people can understand.
The lawyer for this poor child’s family is really something, too. In an article in The Mercury News, he is quoted as saying he feels that the doctors/hospital involved are popping corks out of champagne bottles in celebration at the news of the death of this girl’s body. I can’t imagine any doctor or other healthcare provider celebrating such a thing. He should be ashamed.
"According to court documents, McMath was admitted to Children's Hospital Oakland on December 9, 2013, for an adenotonsillectomy, uvulopalatopharyngoplasty and submucous resection of bilateral inferior turbinates.
It was hoped these procedures would provide improved airflow during her sleep at night. The hospital described these procedures as complicated. The family described the surgery as a routine tonsillectomy in media reports."
As operating on severely obese people is generally very risky I wonder if they told the family of the increased risk. It might have spurred them to help this girl lose weight.
If I recall correctly, there were witnesses that saw her family feeding her pieces of a hamburger against doctor's orders, which, undoubtedly, dislodged a clot and started the bleeding.
I can't imagine how they are planning on getting around this very incriminating fact if there is a trial.
I was a pediatric nurse and have experienced parents doing harmful (though often, well-intentioned) things first hand. If there was a bad outcome from their actions it was always the nurse or hospital's fault. Did the nurse explain the potential hazard of feeding their child? Did the family confirm their understanding (preferably in writing)? Was the instruction given in a way that respected their level of health literacy? Were all barriers to learning addressed before the education was given - was the family under stress? hungry? distracted by financial worries?
Sadly, it can rarely be proven that the actions of the family were at fault and the hospital always settles these sorts of claims.
"According to court documents, McMath was admitted to Children's Hospital Oakland on December 9, 2013, for an adenotonsillectomy, uvulopalatopharyngoplasty and submucous resection of bilateral inferior turbinates.
It was hoped these procedures would provide improved airflow during her sleep at night. The hospital described these procedures as complicated. The family described the surgery as a routine tonsillectomy in media reports."
As operating on severely obese people is generally very risky I wonder if they told the family of the increased risk. It might have spurred them to help this girl lose weight.
It is highly unlikely that there were not efforts to get Jahi to lose weight before offering surgery.
Since the family fed her immediately postop, what is likely is that the family was part of the problem with her weight.
Every consent for surgery I have ever seen includes statements about the risks, including risk of death.
Quote:
Originally Posted by pinetreelover
I was a pediatric nurse and have experienced parents doing harmful (though often, well-intentioned) things first hand. If there was a bad outcome from their actions it was always the nurse or hospital's fault. Did the nurse explain the potential hazard of feeding their child? Did the family confirm their understanding (preferably in writing)? Was the instruction given in a way that respected their level of health literacy? Were all barriers to learning addressed before the education was given - was the family under stress? hungry? distracted by financial worries?
Sadly, it can rarely be proven that the actions of the family were at fault and the hospital always settles these sorts of claims.
In this case, the actions of the family seem to be well documented.
It is highly unlikely that there were not efforts to get Jahi to lose weight before offering surgery.
Since the family fed her immediately postop, what is likely is that the family was part of the problem with her weight.
Every consent for surgery I have ever seen includes statements about the risks, including risk of death.
In this case, the actions of the family seem to be well documented.
I think it is abundantly clear that the family knew, or should have know, that their daughter was in critical condition after the surgery, and that they should not have placed anything in her mouth without the express permission of a physician or nurse. I would wager that there was a sign on the door to her room (and possibly at her bedside) to remind everyone that she was not to have food. Her grandmother is reportedly a nurse. Of all the family members, she should have know that feeding the child was a very bad idea. If this malpractice case were to go to trial, I think the evidence would lead a reasonable person to conclude that one or more of her family members is/are to blame for her death. If this were to happen, I have to wonder if the State of California might become interested in filing Negligent Homicide charges against one or more individuals. If I were the one who fed her the hamburger, and if I were placed under oath and asked whether or not I did so in a Court of lawn, I would probably invoke my 5th amendment rights, and refuse to answer the question.
A root cause analysis of the problem is vital in cases such as this. I agree with observations that others have made. It is clear that the family was enabling an eating disorder, and that their failure to mitigate the child's food intake led to the need for this very complex, high risk surgical procedure. This fact was made clear by the family's inability to refrain from feeding her, when doing so could kill her instantly. Sadly, even if the surgery had been successful, it would not have affected her morbid obesity. The family would have perceived the successful surgery as a "green light" to continue to enable her eating disorder,and she probably would have gained even more weight as a result. If left untreated, she might not have lived long enough to see her own children grow up.
I was a pediatric nurse and have experienced parents doing harmful (though often, well-intentioned) things first hand. If there was a bad outcome from their actions it was always the nurse or hospital's fault. Did the nurse explain the potential hazard of feeding their child? Did the family confirm their understanding (preferably in writing)? Was the instruction given in a way that respected their level of health literacy? Were all barriers to learning addressed before the education was given - was the family under stress? hungry? distracted by financial worries?
Sadly, it can rarely be proven that the actions of the family were at fault and the hospital always settles these sorts of claims.
"Because of the extent of the surgery, the pt was not allowed to talk and was given a white board for communication. The pt wrote "I'm hungry" The Grandmother brought in and fed her a hamburger. The pt bled immediately and the grandmother who is an LPN, was belligerent, used a Yankauer suction despite being told to not to do so and threatened the PICU nurse. The pt hemorrhaged and and code blue was called. It was a difficult prolonged and traumatic intubation."
#210:
"Grandma was very vocal initially until other patient families started speaking about what they witnessed in the picu first hand (talking, feeding, suctioning, berating staff, belligerent family). I heard the grandmother has retired her LVN license."
LVNs do the duties that are now provided by people referred to as nursing aides. Suctioning a patient would not typically be one of those.
"According to court documents, McMath was admitted to Children's Hospital Oakland on December 9, 2013, for an adenotonsillectomy, uvulopalatopharyngoplasty and submucous resection of bilateral inferior turbinates.
It was hoped these procedures would provide improved airflow during her sleep at night. The hospital described these procedures as complicated. The family described the surgery as a routine tonsillectomy in media reports."
As operating on severely obese people is generally very risky I wonder if they told the family of the increased risk. It might have spurred them to help this girl lose weight.
The child was obese and had sleep apnea, snoring, and restricted breathing when she slept
The complex invasive surgery was to increase air flow. It worked.. Then according to reports the family fed her solid food and the kid blew out her stitches
But as you suggested, simply losing weight would’ve solved this whole problem. Sadly, no doubt the child would’ve continued a sedentary lifestyle with junk food had she survived the surgery.
"According to court documents, McMath was admitted to Children's Hospital Oakland on December 9, 2013, for an adenotonsillectomy, uvulopalatopharyngoplasty and submucous resection of bilateral inferior turbinates.
It was hoped these procedures would provide improved airflow during her sleep at night. The hospital described these procedures as complicated. The family described the surgery as a routine tonsillectomy in media reports."
As operating on severely obese people is generally very risky I wonder if they told the family of the increased risk. It might have spurred them to help this girl lose weight.
This is a reasonable question. I've encountered situations where someone died following surgery and when I read the medical records, I sometimes find myself questioning the decision to operate. For example, what if the patient is sixty-nine years old, has a history of high blood pressure, high cholesterol, is overweight (not obese) and has diabetes? Let's further state that the patient had back pain and radiculopathy in his extremities. The surgery is spinal disc surgery designed to remove a ruptured disc impinging on a nerve in his lumbar spine. The argument is that all surgery contains risk and the question is whether the benefits of surgery outweigh the risk. However, the in the case I just mentioned, surgery was not a life/death matter. What it was about was treating a condition of pain and numbness that was bothering the patient a great deal. Patient had all the risks disclosed to him and signed an Informed Consent form.
Patients can sign an Informed Consent form, yet I still think there should be some point where the surgeon refuses to operate, despite the willingness of the patient to consent.
Ultimately, I think it becomes a question of just how much risk there is and the surgeon's ability evaluate that risk and make a decision. I think most people would be reluctant to second guess that decision.
In this case, we don't know what the outcome would have been if surgery hadn't been performed. Sleep apnea can be life-threatening in extreme situations. The fact that the girl had reached the point she had with her weight tells me the family either wouldn't or couldn't do anything about her problem.
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