Girl Brain Dead after Tonsillectomy

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    http://abcnews.go.com/Health/wireStory/california-mother-tells-tonsil-surgery-tragedy-21293017

    T
    his is such a tragic story and breaks my heart to hear of this, but shouldn't the people caring for this girl realized that she was hemorrhaging and that amount of blood was NOT normal? I mean I am not even a nurse yet but I realize that hemorrhaging after surgery is a HUGE risk and nurses need to assess and act quickly if it happens.

    What are your opinions on this situation and what you would have done different had you been caring for this girl?
    SeattleJess and vintagemother like this.
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    My thoughts are that it's impossible to judge with only 1 side of the story. The saying is that there are 3 sides to every story: his, hers, and the truth.

    Furthermore, the article on CNN a few days mentioned preop plans for the girl to go to ICU postoperatively. Now, most kids getting their tonsils out go home the same day. So what else was going on with this girl that there were plans to keep her in ICU even before the surgery occurred?
    SeattleJess, DizzyLizzyNurse, sdl11b, and 24 others like this.
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    IMO she should have been brought back to the OR immediately when the bleeding was noted. There is a lot more to this story than what is being reported....
    SeattleJess, sdl11b, RunBabyRN, and 3 others like this.
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    Our ENT docs routinely reserve a PICU bed for their tonsillectomies that are being done for severe sleep apnea WITH obesity.

    This poor child had multiple co-morbidities (per the family's report) - but I hesitate to judge when all information is being filtered through the family's lens.

    Reminds me, in a way, of the lung transplant girl in Philly (or was it Pittsburgh?) a few months back- family controlled the release of all information and put their own 'spin' on it. The press reported such as cold, hard medical facts.
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    OSA is common diagnosis for tonsillectomy. I didn't see any other mention of co-morbidities in the report, but I may have missed it. Post-tonsillectomy hemorrhage is probably around 2-3%, which is about what I have seen in my practice. Prevalence of Post-tonsillectomy Bleeding as Day-case Surgery with Combination Method; Cold Dissection Tonsillectomy and Bipolar Diathermy Hemostasis
    sapphire18 and NRSKarenRN like this.
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    moved to nursing news for best response.

    I am sure there is more to this story....how sad for everyone involved. My prayers to the family and staff.
  9. 19
    Quote from J.A.B.,SN
    California Girl to Be Kept on Life Support - ABC Newshis is such a tragic story and breaks my heart to hear of this, but shouldn't the people caring for this girl realized that she was hemorrhaging and that amount of blood was NOT normal? I mean I am not even a nurse yet but I realize that hemorrhaging after surgery is a HUGE risk and nurses need to assess and act quickly if it happens.

    What are your opinions on this situation and what you would have done different had you been caring for this girl?
    The article says the girl was being given blood transfusions. Why they didn't take her back to the OR, only the surgeons know. I doubt that there's anything different I could have/would have done as a nurse. I agree with the others, this case has to be more complicated than we know. A T&A is usually an outpatient procedure.

    The child is brain dead and the family thinks she can recover. Brain death is determinant of death in all 50 states and, the hospital is right, consent is not needed to withdraw support from a dead person nor are they obligated to continue to provide medical care to her. The hospital cannot discuss specific details of the case because of HIPAA yet the family goes running to the media with their side of the story:
    Family of Jahi McMath, Teen Declared Brain Dead After Tonsillectomy, Asks Hospital for More Time | NBC Bay Area

    Honestly, where do you draw the line? The family is now asking for a feeding tube. The child is dead. And the family thinks it's "ridiculous" that the hospital won't allow an "independent doctor" to come in and examine her. I've never known a hospital to allow a doctor who didn't have privileges there to come in, examine a patient and then base their care of her off his recommendations.
    Oakland family: Children's Hospital calls 13-year-old Jahi McMath 'dead' | abc7news.com

    I feel bad for the family. Losing a child is terrible but subjecting a dead child to further interventions is unreasonable.
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    I have known of isolated cases where a completely neutral consultant physician has been permitted to assess a patient in similar condition. I know of NO cases where the neutral third party disagreed with the primary assessment. It is indeed sad that this girl has had this outcome, but as has been said before, brain death is death. Maintaining this girl on life support does no good for any one.
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    'Brain dead' patient found to be alive - UPI.com people are declared brain and still are alive...it is incredibly rare and I don't think that is the case here, but it does happen.
    SeattleJess and Esme12 like this.
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    I can not even fathom losing a child or having to take my child off of life support. My heart breaks for that family. The child did have severe sleep apnea and was over weight. Maybe that played a part. Maybe when the mother repeatedly asked about the "strange" looking blood her child had coming up and the nurses shrugged her off part. I'm not placing blame I'm merely pointing out there is more than meets the eye here.
    SeattleJess likes this.


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