Jahi McMath is brain dead, doctor testifies

[XemaSab]

Source: San Francisco Chronicle

An independent physician appointed by a judge to examine Jahi McMath, the 13-year-old Oakland girl who suffered complications from tonsil-removal surgery, testified Tuesday that she is legally brain dead and cannot recover any brain function.

The doctor, Paul Fisher, chief of neurology at Lucile Packard Children's Hospital at Stanford University, examined Jahi on Monday afternoon at Children's Hospital Oakland, where the girl remains on a breathing machine.

Doctors at the hospital declared the girl brain-dead on Dec. 12, and later sought to discontinue mechanical support. Jahi's family objected and, in an unusual dispute, secured a temporary restraining order that is now set to be in place until Monday.

"Unfortunately," Dr. Fisher told Alameda County Judge Evelio Grillo in an Oakland courtroom, "the medical condition of Jahi is that she meets all the criteria of brain death. She has no brain stem and no cerebral function."

Read more: http://www.sfgate.com/news/article/Jahi-McMath-is-brain-dead-doctor-testifies-5091298.php

[Jesus Malverde]

1. Such a tragic story..nt

[GeorgeGist]

2. Sad

[shenmue]

3. Mercy

[magical thyme]

4. very sad, but sadder still, I think, that the parents refuse to accept and remain in denial...

I read today at work that the surgery was much more complex than a 'simple tonsilectomy,' as was initially reported. The hospital is unable to provide details due to HIPAA laws, although this article gives more information than previously published.

And if you read the linked article, 2 hospital physicians and 3 other independent doctors brought in at the parent's request had already confirmed that she is absolutely brain dead. So this is the 6th doctor examining her.

No miracle from God is going to re-start her brain. They need to accept that they've lost their daughter to God, since that is their belief system.

[lostincalifornia]

6. and there needs to be a full investigation what happened, including the recovery room, where the

parents were told initially that the bleeding was normal

[magical thyme]

8. without a doubt. unfortunately, the parents also have hampered the investigation.

the longer she was on life-support, the more the localized tissues may have either repaired or degenerated.

the investigation into what went wrong should have happened much sooner.

[Gormy Cuss]

24. The parents have been let down by the doctors and their clergy,

the latter by allowing the parents to have prayer vigils for the child rather than helping them to understand that the child is already gone. It's unfortunate that this has led them to hold on to hope where there is none, to think that there is a chance for their daughter to recover.

It's a horrible outcome and I don't blame the parents for being so deeply in denial. I just hope that they are starting to accept that there is nothing more that they can do for her other than to let her body go.

[tblue]

33. I can't imagine giving up

no matter what anyone said, until all hope was gone. And that could well be long after everyone else has given up hope. It's not about stats and calculations, not for the family. I don't blame them for having a hell of a time giving up on their baby girl. She had one life and one set of parents, and they aren't letting her go without a fight, and that takes time. I can only imagine how awful this is for them. I hope they find some comfort in knowing they did everything in their power to save her life. I know I would do the same. Damn this whole thing.

[mercymechap]

5. Such a tragic ending

to such a common surgery.....feel for the parents, but sometimes you just have to accept reality and deal with it.

[Voice for Peace]

7. COMPLICATIONS FROM TONSIL REMOVAL???????????????

[magical thyme]

9. NO. NOT a 'simple tonsillectomy.' that has been a media "meme"

this is the first article I've seen mentioning that significant other tissue inside her nasal passages and elsewhere had to be removed..

They were not just removing tonsils; they were removing tissue that was impairing her breathing and causing sleep apnea.

The hospital has been unable to explain the additional surgery due to HIPAA requirements. This is the first more expansive description I've seen of the actual surgery.

[intaglio]

11. Probably adenoid removal as the 2 surgeries are often performed together. n/t

[magical thyme]

12. plus tissue from her throat and nasal passages.

according to the article it was more than even tonsils plus adenoids.

The thing is that the longer this drags out, the less likely mistakes that should and could have been uncovered will be found. The longer she is on life support, the less accurate the autopsy findings. The mother is suing away any wrongful death suits trying to reverse the irreversible.

[COLGATE4]

14. It appears that her surgery was much moreq

complicated than a 'simple' tonsillectomy. Nonetheless a surgeon friend of mine won't touch a tonsillectomy with a ten foot pole. He says it's a lot trickier than people think and with bleeding you can be in a hell of a mess before you know it.

[grantcart]

23. Surgery for obesity related sleep apnea.

The real tragedy is that the underlying problem of her obesity was never successfully treated leading to this surgery and the terrible outcome.

[VA_Jill]

25. What you're missing

is that the problem is more complicated than that. Structural conditions causing sleep apnea actually can lead to obesity rather than the other way round, in many cases, and often in children. Don't be so judgmental.

[grantcart]

27. In a case where the whole family is obese would it be logical that the obesity was not treated

or that there were structural conditions that were present in both the maternal and paternal sides of the family?

In any case the point was that people were jumping to the conclusion that it was a simple tonsillitis gone wrong when it was related to a more complex operation related to sleep apnea and obesity. Whatever the cause of the obesity it is the real tragedy that it would lead to a fatal result in such a young child.

[VA_Jill]

30. It's quite possible

that others in the family may also have sleep apnea, just not to the extent that this poor child had it. The whole thing is a tragedy, but the post-op course also seems to have been mismanaged. (I'm saying that from what I read and from my experience as a retired RN with considerable ICU experience)

[grantcart]

31. Agree 100% Terrible tragedy.

The family seems to be more open to religious feelings than scientific fact.


We don't know what the underlying condition was, of course, but if it was obesity by itself then it becomes even more so, which is not as judgmental as it seems because as someone who battles weight control I know how difficult it can be to address.

[question everything]

10. Really sad. From tonsilectomy (nt)

[Warpy]

26. Every surgical procedure out there has considerable risk attached to it.

Most surgeons operate only when non surgical treatment is unavailable or ineffective.

[question everything]

28. I know. I am always warned that each surgery carries risk

(had a few in the past years) but a generation or two ago, tonsilectomy was almost routine..

[Warpy]

29. Just because it's routine doesn't mean there is no risk

Remember Murphy's Law, "nature always sides with the hidden flaw." I wonder if this kid had some sort of exotic clotting disorder that isn't routinely tested for.

The whole thing is just very sad. I do think it's a good thing that the parents won't have to remember Xmas as the day their daughter died. Likely they will give permission to shut the machines off within the next day or two.

[Drunken Irishman]

13. Awful news. :( But at first, I read that as John McCain.

[davidpdx]

15. Very sad

Time to let the child go. Her brain may be dead, but her spirit is still alive.

[Ken Burch]

16. That hospital deserves one hell of a malpractice suit for this.

I've never even heard of someone having an incapacitating hemorrhage following a routine tonsillectomy. That young woman has been lost for no reason.

[VA_Jill]

19. Actually

post T&A bleeds are not as uncommon as we would like to believe. That said, the operative word here is "incapacitating". However, the tissue in the area is pretty vascular and there is always a danger, particularly if the surgery is a little more extensive than *just* tonsillar and adenoidal removal, which may have been the case due to her sleep apnea. I have cared for several kids/young people who had post T&A bleeds, and oddly, all of the white kids were redheads, and every one (4) of the African-American kids had sickle cell trait. There may have been some other factors at work here along with *possible* malpractice….but you can't just scream "malpractice" without knowing all the facts. I tend to think someone screwed up, but we know only what the family is telling us at this point. Tonsillectomy is not "routine" surgery as you would like to think it, not any more, and it becomes even less so the older a child is.

[tomp]

17. I think we have to stop using the term "brain dead."

I think the idea that there is a difference between brain dead and dead is confusing to a lot of people. My understanding is that brain dead=dead. Anyone have a different understanding?

[Codeine]

18. People do indeed seem to conflate braindeath with being comatose.

I think more education about what brain death actually entails and what distinguishes it from a coma state would be helpful to families in this situation. Too many myths and misunderstandings about the subject lead to Terry Shiavos.

[Ken Burch]

20. I thought "brain death" meant that the brain itself had ceased to function, but respiration went on.

The old practice was that someone who had lost brain function would be kept alive on respirators as long as the heart could still pump, IIRC.

Unfortunately, the body and the brain don't always stop living at the same time.

[LisaL]

21. Brain dead person can not breathe.

Ventillator is doing it for them. Once the venitillator is turned off, the breathing stops and heart will stop beating.

[tomp]

22. and the heart beat will run on automatic...

...for a short time, then stop.

[tblue]

32. What a fricking nightmare.

My heart goes out to her loved ones. I wish there was something I could do. Poor little girl!!!!