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Such a sad story, and the truth is not a single one of us knows when death occurs.
I heard on the news this morning that her death certificate has been made.
Hi Dale,
It was hard for me to hear about a death certificate being completed but not issued yet. With the date of death listed as 12/12/2013, I don't mean to sound like the focus is money, as it isn't. Still, CHOP has to be paid for ICU care for what is roughly 25 days since then. I don't know if any third payer be it private insurance or Medical is required to pay for "treatment of a brain dead patient."
There are a lot of secondary questions that have arisen from this case.
While the Coroner's Office has specific duties, I was surprised they released that information. I am positive the Coroner has to follow specific protocols per CA laws. The only reason I could think of, for announcing a Death Certificate had been completed, but not issued, is CHOP was very clear they would have to have approval of the Coroner's office to even consider letting the teen ' s body be moved to NY when that outpatient facility was being named as the designated facility to receive the teen.
Saying the above differently, I wonder if the Coroner's office was sending a message without becoming more involved.
A lot will be learned from this tragic situation. Policies or laws may even be changed. The saddest part to me, is none of those decisions can return this child's life or focus on the memory of that child, as they grieve her.
I think its wrong for us to opine at this point about the merit (or lack thereof) of a potential lawsuit against the hospital and the doctor in this case. The legal system can sort that out.
However, you are completely right on the issues of brain death. I understand that the coroner has even issued a death certificate for this girl. I would think from a legal standpoint that would eliminate any issue about whether she is dead or not.
I absolutely agree. How could any of us have the information necessary to say whether or not a mistake was made?
We do not have the benefit of medical records; surgical records, etc. We were not in the operating room or the recovery room.
The family may make allegations but we all understand that they are just allegations at this point.
Are medical mistakes sometimes made? You betcha.
Are allegations of mistakes sometimes made with no factual information to back them up? Yes as well.
The saddest part is that Jahi's organs could have been used to give someone else or multiple people the gift of life ... now that is no longer possible.
I wonder, how does the judge get away with all these absurdly ridiculous rulings? How does he sleep at night knowing that he is furthering one of the saddest spectacles I have ever heard of?
Welcome WIHS2006.
I wonder the same questions as you. Not being an attorney, I don't know how one "lower court judge" can make a ruling and instead of following his own ruling, instead issuing another ruling for another week. It's back in the excellent court documents some have been gracious enough to add to this thread. I could be wrong, but I thought the Judge originally stated the opinion of the Stanford Pediatric Neurologist would be what the court followed.
One thing that appears clearer, at least to me, is the Higher Courts do NOT plan to be involved, sending the case back to the lower court.
I appreciate your post and hope you'll continue to comment when you can. It scares me to think perhaps how uneducated this judge was about brain death and his inability to follow his own earlier rulings.
People live and people die. Yes, it is something that happens. No, NO one thinks they aren't going to see their child again when they go into surgery. But it happens and it's happened in my extended family. We didn't sue. Just because you don't expect it doesn't mean it won't happen. That's why families give informed consent before a surgery.
I know she had other health problems because they were mentioned in the media. She was having surgery because of some of those problems, most notably sleep apnea. She was clearly very overweight, as we can tell from pictures of her. Anyone who has any medical knowledge knows that her sleep apnea could be (most like WAS) due to her weight. There are increased risks of surgery when someone is that overweight. I'm sure the surgeon asked for and received cardiac clearance before performing the surgery. Does that make it their fault that she died after the procedure? No. They did everything they should have done and still she died.
I was sympathetic toward the family in the beginning, but they have carried this too far. As I have said before, at this point I think they are either ignorant (don't understand medical things, and the fact that she is dead and not coming back) or looking for a payout, or both. They have come out slandering the hospital and surgeon while at the same time not allowing the hospital/surgeon to tell their side of the story. You know, if it were a family member of mine, I wouldn't WANT the money because the money wouldn't bring my family member back. And unless the surgeon or anesthesiologist were grossly negligent (which I don't believe happened in this case), I wouldn't sue or expect any kind of payout.
Maybe it's because you've been in the industry and you subsequently become deconditioned that you can simply say that it "just happens." I'm sorry, but I don't feel that way. Also, I haven't read anything in the media that details any other supposed health problems. What was mentioned was sleep apnea (and yes, I know that being overweight had contribute to this condition). If the girl was so overweight as to pose a liability, the doctor wouldn't have done it (especially on a child), clearance or no clearance. It would be nice, though, to have a doctor weigh in on this because I freely admit that I am not a healthcare professional.
I'm not playing the blame on the hospital. I *know* that hospital staff put their all on the line when it comes to patient care, especially that of a child. I don't particularly agree with how all of this has played out and I also don't agree that this child should be put through any more indignity. This child is a corpse on display whose heart is being kept beating artificially, who can't control any functions in her body because the "mainframe" is shut down.... I wish that the family opens up to the counseling it needs to heal and do the right thing and let this poor child rest in peace. At the same time, I do not agree with the attacks on the family, particularly the mother. I don't think there is any greater pain that can be inflicted upon her than the death of her child. When it's all said and done, the money is just that -- money. You can't hug it, kiss it, or do anything with it. Their loss is far greater than any supposed payout. If anything, they are probably being given advice to make the hospital pay. I don't know who is at fault here, all I know is the result.
Let us also keep in mind that the family is being supported by the Terri Schiavo Life and Hope Network. Who knows, at this point, what all voices are whispering in their ears? Telling them what they want to hear and encouraging them to go down this path.
The decision seems easy to us.
For the family ~ not so much. I hope that no one is giving them false hope and poor advice.
Ringo1,
Welcome to the ongoing discussion. I think your post is a core question many of us have posted earlier. I, too, hope the mom is getting accurate advice. Terri Schiavo. had unfortunate severe brain injury resulting in many neurological and other complications.
Personally, I can see a place for the organization trying to help families with relatives, who have TBI or severe to profound brain injury, an appropriate facility to care for their loved one. But the Oakland Teen is neither.
To be fair, I don't know what the organization received as medical facts vs. observations.
I hope there is a better understanding for all of the difference of brain death vs. Severe Brain Injury given the teen in Oakland.
Twenty years ago my Dad slipped into a coma due to the shutdown of his renal system. The doctors advised that he would not likely recover and that we should prepare for the inevitable. The first thing we decided on as a family was to sign a do-not-resuscitate (DNR) form because we all knew collectively that we could never live with having to take him off life support. And it wasn't any easier because he was an adult, it was among the hardest things I've ever had to do.
But do you want to know what I'm thinking about while tracking this story? Not my father, not about what might be ethically appropriate or medically sensible. No, what I'm thinking about is how much harder the entire ordeal would have been if we had the public weighing in and judging my family, if we had to deal with court rooms and lawyers to do what we felt was right and to be tried in the court of public opinion.
I honestly don't know what's right for this poor girl or her family, I only know that they should try and follow what they truly feel is the proper course of action.
Maybe it's because you've been in the industry and you subsequently become deconditioned that you can simply say that it "just happens." I'm sorry, but I don't feel that way. Also, I haven't read anything in the media that details any other supposed health problems. What was mentioned was sleep apnea (and yes, I know that being overweight had contribute to this condition). If the girl was so overweight as to pose a liability, the doctor wouldn't have done it (especially on a child), clearance or no clearance. It would be nice, though, to have a doctor weigh in on this because I freely admit that I am not a healthcare professional.
I'm not "deconditioned," I'm just realistic. As I said, it happened in my extended family and we didn't put the person on life support or file a lawsuit.
Yes, there were reports of serious health problems and sleep apnea is VERY serious and affects the heart.
Why would a surgeon not do a surgery if there was cardiac clearance? The purpose of obtaining clearance is to have a cardiologist determine whether the patient is a candidate for surgery. I am positive that would have been done in this case, especially with the sleep apnea. I'm sure the family was informed that even though the patient had been cleared for surgery, there are still inherent risks. And knowing those risks, the family decided to proceed. That's the way it works. It was a children's hospital. All they work on is children. So when you say "especially on a child" - I'm sure the hospital is quite accustomed to getting cardiac clearance for surgery on a child. No doctor can predict whether a patient is going to start hemorrhaging and have a heart attack after surgery. So yes, it "just happens" sometimes.
It is also possible that without surgery, the girl's heart could be damaged from sleep apnea or she could have a heart attack and/or die from sleep apnea. It's possible that she was desaturating so much at night that the surgery wasn't elective but was really needed for her sleep apnea. Every time a surgery is done, they weigh the risks versus benefits, present both to the family, and the family makes the decision. There are times when a surgeon simply will not do a surgery and will not offer surgery as an option to the patient/family. Obviously in this case, surgery was indicated.
I'd rather the decision fall on the family instead of the courts and hospital. The hospital's decision is motivated by profit. More money to get another patient. Also, if the hospital made a mistake in surgery, it's cheaper to pay for a death than to pay for a lifetime of treatment. I don't want the government deciding either. Last government to decide people if patients were worth keeping alive was Nazi Germany. They put mental patients, elderly, and disabled to death even before they started on the Jews and gypsies.
Victim of GM,
I agree it is best for a family to decide, when there is a decision to make. A hospital and staff try to work with families as much as possible. A family who won't accept brain death despite all the additional examinations, an outside opinion and repeated testing is NOT a typical family.
Ideally, the family would work with the hospital vs. fighting it, as this family has done. Most families in similar situations don't receive a fraction of what this one has. However, somehow they make the next step and give their child dignity in death.
I don't want courts determining medical decisions either.
Interesting blog posts on Jahi, the second one by a CRNA (certified registered nurse anesthetist)
One excerpt:
"Message board comments have said family court documents reveal that Jahi’s body has diabetes insipidus, which is a known complication of brain death.
There are also remarks that Jahi’s mother, grandmother and stepfather all suctioned her oropharynx when bleeding started, before summoning an ICU nurse. Hearsay, yes, but remember, families and visitors of other patients are not bound to silence by HIPAA. Did they worsen the bleeding by too-aggressive suctioning?"
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Me Too
