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Girl Brain Dead after Tonsillectomy

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EaglesWings21 is a ASN, RN and specializes in Medical Surgical.

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wtbcrna is a MSN, DNP, CRNA and specializes in Anesthesia.

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I don't know that the family is trying to use the daughter as money making scheme, but I think their lawyer is seeing big dollar signs.

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I have come back here to this site after a long time away, just to talk about this topic. I work as a peds nurse on a trach/vent unit. While most of my brain injured patients are comatose and somewhat responsive in some way (posturing, moaning, grimacing), I have had others that appeared to be totally brain dead. They had endured brain injuries either from trauma or in some cases, from being coded for a long time.

These patients were completely 100% unresponsive even did not try to blink to protect their eyes, did not come out of the stiff neuro posturing they were in (very difficult to change diapers!), and many had auto regulation issues such as body temperature, heart rate, and blood pressure. They would eventually probably pass from these auto regulation issues, but many of the families fought all they could to do every intervention, still believing in miracles. I cannot speak to the fact that they were brain dead or not-- but they certainly appeared to be. Of course I can have my own personal opinion about whether or not these patients should have been trached in the first place, it's not my place (thank goodness) to make those decisions. I also know that the ethics board did get involved in some of these cases and the patients were eventually allowed to pass.

It seems that from reading the articles on this girl in the news, her case may be similar to some of the patients I have had. Why would the parents not be able to trach/tube-feed her if they wanted to, as long as her body were to survive with just those interventions? How is it that some hospitals allow this and others are firmly against it?

Also do you think the ethics board might be active in discouraging this girl to be trached/tube-fed, or is it solely the doctors who are declaring her brain dead?

And while she is declared brain dead, I don't believe she is a "dead body" until the heart stops. She could in theory be kept "alive" for a long time. How can anyone declare a person dead- dead until the heart has stopped? My father suffered a massive asthma and heart attack and was on vent support and drips for a couple of days until he was declared brain dead. One full day after he was declared brain dead, he was then taken off the ventilator during surgery to remove organs. That day and time that he was taken off the vent and his heart stopped, is when he was officially declared dead on the death certificate.

Edited by anon456

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NicuGal has 30 years experience as a MSN, RN and specializes in NICU, PICU, PACU.

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I think part of it is that we don't have the full story. The family is making it sound like she is laying there with only the vent but in reality this girl may be on full support with vasopressors, etc. My mom was declared brain dead after she had an aneurysm blow, without the fluid boluses and vasopressors they used to keep her BP up until the organ procurement team arrived she would have been "dead".

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Mommy&RN has 6 years experience as a BSN, RN and specializes in Med/Surg & Hospice & Dialysis.

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The lawyer is out for a payday. If the care she received was so incompetent, why would mom let them do 2 more invasive procedures on her child?

As much as I could not fathom losing my daughter, I also could not selfishly allow her body to endure what lies ahead for Jahi's body. Pressure ulcers, being incontient, contracting, aspiration, just to brush the surface.

No matter what her family hopes and prays for, they are holding on to a warm body. Her personality, soul, everything that made her Jahi is gone.

I find the term "simple tonsillectomy" in this case to be as far from the truth as telling someone "the sky is green". I've read on another site where a mother is canceling her child's tonsillectomy because of this case.

Just as another thought.... If her body is not transferred, I would think the donations for air transport should be returned. It seems that the money was requested prematurely if you don't have an accepting facility.

As has been said we are only allowed part of the story and that part is from an extremely emotional stand point. There are facts that are being "hidden" by the family, because they will not allow the hospital to reply to their accusations.

I hope Jahi is not suffering and her body will be allowed to rest.

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OCNRN63 is a RN and specializes in Oncology; medical specialty website.

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​I looked at the fundraising site this am, and they have + 22K raised.

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ixchel specializes in critical care.

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I have come back here to this site after a long time away' date=' just to talk about this topic. I work as a peds nurse on a trach/vent unit. While most of my brain injured patients are comatose and somewhat responsive in some way (posturing, moaning, grimacing), I have had others that appeared to be totally brain dead. They had endured brain injuries either from trauma or in some cases, from being coded for a long time. These patients were completely 100% unresponsive even did not try to blink to protect their eyes, did not come out of the stiff neuro posturing they were in (very difficult to change diapers!), and many had auto regulation issues such as body temperature, heart rate, and blood pressure. They would eventually probably pass from these auto regulation issues, but many of the families fought all they could to do every intervention, still believing in miracles. I cannot speak to the fact that they were brain dead or not-- but they certainly appeared to be. Of course I can have my own personal opinion about whether or not these patients should have been trached in the first place, it's not my place (thank goodness) to make those decisions. I also know that the ethics board did get involved in some of these cases and the patients were eventually allowed to pass. It seems that from reading the articles on this girl in the news, her case may be similar to some of the patients I have had. Why would the parents not be able to trach/tube-feed her if they wanted to, as long as her body were to survive with just those interventions? How is it that some hospitals allow this and others are firmly against it? Also do you think the ethics board might be active in discouraging this girl to be trached/tube-fed, or is it solely the doctors who are declaring her brain dead? And while she is declared brain dead, I don't believe she is a "dead body" until the heart stops. She could in theory be kept "alive" for a long time. How can anyone declare a person dead- dead until the heart has stopped? My father suffered a massive asthma and heart attack and was on vent support and drips for a couple of days until he was declared brain dead. One full day after he was declared brain dead, he was then taken off the ventilator during surgery to remove organs. That day and time that he was taken off the vent and his heart stopped, is when he was officially declared dead on the death certificate.[/quote']

To answer your question about why some do and some don't, I guarantee it's all about money. Insurance companies won't pay depending on their own criteria of death, probably, so who will pay that bill? Is it fair to expect the hospital will eat the thousands per day for costs? The taxpayer? Can the family afford it?

A line has to be drawn somewhere, and at some point, a group of people with suits and fancy pens decides together their lists of pros and cons, and they decide which list looks better. Brain death may allow for certain body processes to continue, but they're no less dead.

You wouldn't watch a headless chicken run around and decide it's actually alive after all. (I know that comparison is terribly tacky and heartless, but it's the most relatable example that comes to mind.)

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JustBeachyNurse has 10 years experience as a RN and specializes in Complex pediatrics turned LTC/subacute geriatrics.

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Apparently the grandmother is an LVN but is not correcting the attorney and media who assume/ imply that she is an RN. I

It seems there are no willing facilities to take the child's body.

Likely the inquiry was made "can you take a 13-year old vent & GT dependent child requiring long term subacute care? Trach & PEG surgery pending acceptance at your facility ".

Transfer coordinator "we can if you send me the chart & details. I can review it by the clinical & medical director "

Then they find out WHO it is and that it's a legally/ medically brain dead child involved in a legal & media circus.

Yes this happens. I took a potential intake call for a potential transfer more than once when the referring individual only gave sketchy information that did not fully depict the patients condition and needs. Granted it wasn't a high level media case but still. Desperate times call for desperate measures.

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KelRN215 has 10 years experience as a BSN, RN and specializes in Pedi.

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Apparently the grandmother is an LVN but is not correcting the attorney and media who assume/ imply that she is an RN. I

It seems there are no willing facilities to take the child's body.

Likely the inquiry was made "can you take a 13-year old vent & GT dependent child requiring long term subacute care? Trach & PEG surgery pending acceptance at your facility ".

Transfer coordinator "we can if you send me the chart & details. I can review it by the clinical & medical director "

Then they find out WHO it is and that it's a legally/ medically brain dead child involved in a legal & media circus.

Yes this happens. I took a potential intake call for a potential transfer more than once when the referring individual only gave sketchy information that did not fully depict the patients condition and needs. Granted it wasn't a high level media case but still. Desperate times call for desperate measures.

I'm sure that's probably exactly what happened and that's why Children's insisted on communicating with the "accepting" facility themselves.

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7 Articles; 1,142 Posts; 37,824 Profile Views

The lawyer is out for a payday. If the care she received was so incompetent, why would mom let them do 2 more invasive procedures on her child?

As much as I could not fathom losing my daughter, I also could not selfishly allow her body to endure what lies ahead for Jahi's body. Pressure ulcers, being incontient, contracting, aspiration, just to brush the surface.

I agree, and this is about half the patients on my unit. It's not a pretty picture. :-(

I find the term "simple tonsillectomy" in this case to be as far from the truth as telling someone "the sky is green". I've read on another site where a mother is canceling her child's tonsillectomy because of this case.

I had read somewhere that it was not a simple procedure at all-- they also reconstructed her entire soft palate area and created a flap or something. It's a risky procedure.

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7 Articles; 1,142 Posts; 37,824 Profile Views

To answer your question about why some do and some don't, I guarantee it's all about money. Insurance companies won't pay depending on their own criteria of death, probably, so who will pay that bill? Is it fair to expect the hospital will eat the thousands per day for costs? The taxpayer? Can the family afford it?

A line has to be drawn somewhere, and at some point, a group of people with suits and fancy pens decides together their lists of pros and cons, and they decide which list looks better. Brain death may allow for certain body processes to continue, but they're no less dead.

You wouldn't watch a headless chicken run around and decide it's actually alive after all. (I know that comparison is terribly tacky and heartless, but it's the most relatable example that comes to mind.)

I can tell you at least where I work, a great number of the patients who are comatose and trach/vent/tube dependent are being paid for by our state. Many of the families were uninsured in the first place, many are not even legally here, and many of the kids are in CPS custody and don't ever have visitors or people calling to find out how they are doing. We have a few long-term care facilities for such peds patients and they can live there indefinitely and then they come to us when they have an acute infection or something, and then they go back to the facility. It's often a topic of conversation on how much it's costing the state to care for these kids. And while it feels wrong to put a monetary value on someone's life, I know that this can't possibly continue as medical technology advances. The ethics board needs to play a greater role in these situations.

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KelRN215 has 10 years experience as a BSN, RN and specializes in Pedi.

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Finally a new article with some clear cut facts and reality checks for the general public to read..

Clock ticks in Jahi McMath case; experts say court clash went too far - latimes.com

This is the best media coverage I've read of this case yet. And it seems that knowledgeable people are starting to come out of the woods to speak intelligently on this case. An article I read earlier on CNN had far more rationale comments than "the hospital shouldn't play God, there could be a miracle" ones.

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