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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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If it turns out to be DIC resulting from pre-existing conditions combined with the trauma of surgery would it still be medical error/malpractice? This is an honest question not mocking as this appears to be more in your area of expertise as a CRNA. Just curious. If the tragedy is a result of known risk rather than negligence or gross error is it still considered malpractice or provider/facility fault?

I did a lit search and couldn't find one case report of DIC after tonsillectomy, if this was DIC it was likely a late complication, and probably not initially treated appropriately.

If this girl had a known pre-existing condition then the surgeon and anesthesia are still at fault for doing an elective procedure with potentially life-threatining pre-existing condition. It is highly unlikely that there is any incidence where the hospital isn't found liable. IMHO from reading the news reports if the family's lawyer thinks it isn't going in the family's favor he is likely to just request a jury trial which invariably will lead to verdict in the family's favor.

FYI: This is also the second major complication in the last couple of years at this hospital after a tonsillectomy. Twin tonsillectomy tragedies raise questions

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Actually, since this was more than likely a medical error the hospital will be on the hook for medical care for the rest of the child's life.

Even if medical error, medical care for the "rest of the child's life" is done and paid for.

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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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Even if medical error' date=' medical care for the "rest of the child's life" is done and paid for.[/quote']

Exactly. Legally and medically the child's life was over 2 weeks ago (and confirmed a week ago by an independent physician) when brain death was declared and subsequently confirmed.

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Actually, since this was more than likely a medical error the hospital will be on the hook for medical care for the rest of the child's life. There will probably be an undisclosed settlement at some point that will include a court appointed trust fund for future medical care.
As I said, a waste of millions upon millions of dollars that could go toward research or actual therapeutic care rather than sustaining a corpse.

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

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As I said' date=' a waste of millions upon millions of dollars that could go toward research or actual therapeutic care rather than sustaining a corpse.[/quote']

Money that would have never done anything besides sit in insurance companies investments or in the hospitals legal funds....

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Caffeine_IV has 7 years experience and specializes in LTC, med/surg, hospice.

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I am confused a little' date=' someone help me here.. I have seen many many pts declared brain dead, awaiting donation etc BUT of all of those, they were on multiple drips to keep a HR/BP..I have yet to see any one of them not on one drip or several to keep the "body" alive. Am I missing something?? How can this girl go to a skilled facility even if she is trached and PEGed, if her body can not maintain a BP or HR?? After all of this, I wonder what type of RN her grandmother is, she at the very least should understand what is happening or will happen.[/quote']

The grandmother is actually an LVN and I agree.

I don't see the coroner allowing this transport. Eventually someone will have to say enough is enough.

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uRNmyway is a ASN, RN and specializes in Med-Surg.

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Actually, since this was more than likely a medical error the hospital will be on the hook for medical care for the rest of the child's life. There will probably be an undisclosed settlement at some point that will include a court appointed trust fund for future medical care.

But that's kinda the point. The rest of the child's life? She has been declared brain dead. There ya go, financial responsibility for her care over.

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

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But that's kinda the point. The rest of the child's life? She has been declared brain dead. There ya go, financial responsibility for her care over.

Not if the family can get the court to agree to it. Legal and medical logic are not the same.

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Penelope_Pitstop has 13 years experience as a BSN, RN.

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I am confused a little, someone help me here.. I have seen many many pts declared brain dead, awaiting donation etc BUT of all of those, they were on multiple drips to keep a HR/BP..I have yet to see any one of them not on one drip or several to keep the "body" alive. Am I missing something?

That's a good question. I've had a lot of experience with a patient who has suffered a severe anoxic injury but does not progress to brain death/experience herniation and is not on any sort of pressor support. (A lot of times they are my easiest patients!)

My thought is this...When a patient is for organ procurement, certain parameters must be met in regards to vitals & UOP - more strict than your usual patient in the ICU. The MAP goal is much lower, for example.

My other thought is that she IS on pressors. But the family is our source of info and it's possible they don't realize that the drips going into her are pressors. A lot of times family members think pressors are antibiotics or pain meds or maintenance fluids. And a lot of LTACs do take patients on pressor support.

Good question.

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smartnurse1982 has 7 years experience.

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Some of you,just wow!

Anyway,I'm a private duty Peds nurse.

We work with kids like this all the time. Come on,a vent,trach,and feeding tube isn't a death sentence.

Half of my pts are "brain dead". One of my boys doesn't even have waves on the EEG.

In Nj,if the parents don't want to pull the plug,it ain't happening.Medicaid or not,it doesn't matter.

One of the reasons I love Nj

I guess I don't like California's definition of brain death

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LadyFree28 has 10 years experience as a BSN, RN and specializes in Pediatrics, Rehab, Trauma.

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Some of you' date='just wow! Anyway,I'm a private duty Peds nurse. We work with kids like this all the time. Come on,a vent,trach,and feeding tube isn't a death sentence. Half of my pts are "brain dead". One of my boys doesn't even have waves on the EEG. In Nj,if the parents don't want to pull the plug,it ain't happening.Medicaid or not,it doesn't matter. One of the reasons I love Nj I guess I don't like California's definition of brain death[/quote']

There's differing degrees of brain activity; not everyone that you care for may be "brain dead"; that's why there are other tests IN ADDITION to the EEG.

Quality of life is MORE important than having someone CLINICALLY brain dead "sustaining life" when there is no life.

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edmia has 10 years experience as a BSN, RN and specializes in Emergency, ICU.

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There's differing degrees of brain activity; not everyone that you care for may be "brain dead"; that's why there are other tests IN ADDITION to the EEG. Quality of life is MORE important than having someone CLINICALLY brain dead "sustaining life" when there is no life.

Absolutely.

I've been following this thread and story and I am just stunned at this family's ignorance and willingness to subject their loved one to years of torture -- although I guess if she's brain dead she's not feeling or understanding any of this. That's a blessing.

How long until pressure ulcers kick in? How long until limbs fall off after extended vasopressor use? How long until osmotic pressure fails and she's leaking fluid from every pore? How many times will they have to code her before this family accepts and is able to grieve properly?

I feel sad for them.

Sent from my iPhone using allnurses.com

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