This is all just so very sad.

And wins a large settlement. This is a horrendous outcome for a fairly routine procedure.

We read of so many surgeries and procedures that are done unnecessarily.

I hope this wasn't one of those, but it was very tragic in it's outcome in any event.

They had to remove a lot of tissue from inside her sinuses too.

The hospital cannot comment without the parent's permission which of course they're not giving. I wouldn't be so quick to assume it was malpractice when there's no details.

the facility did not respond appropriately when postoperative complications first arose.

For the family they would say the response time was slow, but haven't we all had times where a minute can seem like forever.

The hospital cannot refute statements by the family, since the mother has not given the hospital permission.

The parents note she awoke from surgery and asked for a popsicle. Then all of a sudden started bleeding profusely, causing the brain damage.

http://www.cnn.com/2013/12/30/health/jahi-mcmath-girl-brain-dead/index.html?c=homepage-t&page=0

It's not clear if the hospital could have saved her. If the parents had facts that show the hospital could have saved her, I imagine they would have relayed them by now.

Maybe it just never surfaced until now....Autopsy will show this...and maybe they already did testing now that she had the incident.

But the record and mother's testimony should answer that question. One article said Jahi was spitting blood up into cups, but another said she died 1/2 hour post-op. I think the mother will get only more grief from the course she's on, and would have done better to demand an investigation of the hospital care.

It was removal of the tonsils, adenoids and other throat tissue to address sleep apnea caused by her obesity. There is scant data on the efficacy of this procedure in children, but current figures estimate no more than 50% of children as obese as she was would benefit.

In short, the procedure was almost certainly unnecessary to begin with, the risks likely outweighed the potential benefits, and she would have likely benefitted much more from both an OSA and cardiovascular/diabetic standpoint from weight loss.

But hey, we are a society of quick fixes that is in denial of the risks of obesity.

I don't know much about sleep apnea, but I thought the CPAP machine was normal for that. Could the machine not have been good enough requiring surgery?

It's very difficult to tolerate, more so for kids. I don't know whether Jahi ever attempted it. I have read she underwent a formal sleep study to diagnose her OSA. This is generally done to justify a script for CPAP.

Factor disorders are not routinely tested for pre-op.

Example: Von Willebrand Disease

http://www.childrensmn.org/services/cancer-and-blood-disorders/blood-disorders/teen-hematology-and-gynecology-program/von-willebrand-disease


snip>


What are the symptoms of von Willebrand disease?

Von Willebrand disease can be a mild disorder and often children have very few symptoms. Recurrent nosebleeds are a common complaint in children with vWD. Usually, children with vWD bruise easily, or bleed after tooth extraction, tonsillectomy or other surgery. Females can have increased menstrual bleeding. A person's symptoms may change throughout their life, but the type of vWD does not change.

How is von Willebrand disease diagnosed?

Von Willebrand disease can be difficult to diagnose. This is partly because the results of a person's blood tests can vary day-to-day. For example, the amount of von Willebrand factor can be temporarily increased when a child/teen:

Is under stress.
Has an infection.
Has recently undergone surgery.
Has recently undergone a blood transfusion.

Very sad

Dr. Who testified about something today?

It may be bedtime.

Then WTF is?

As in many other states. 6 physicians have now examined her and declared her to be legally dead. Scans have demonstrated 0 blood flow going to her cortex and brain stem.

She is dead.

Furthermore, she did not have a "tonsillectomy" as is widely reported. She had a much more involved and risky procedure to address sleep apnea. Sleep apnea likely caused largely by her significant obesity, which in-turn almost certainly complicated her operative and post-operative course. 13 year olds do not achieve this level of obesity without the help of their parents.

So, in essence, what you have here is a family that allowed a child to reach levels of obesity that caused a significant side effect (sleep apnea). They then chose an elective surgery to correct the sleep apnea (which has no greater than a 50% success rate for obese children, based on limited studies). Now, after a tragic post-operative course, they are demanding all manner of abuse be done to her corpse. Her ENT docs share blame in this case, but I cannot get over the horrible decisions the parents have made for this child. I have no doubt they loved her, but holy hell, have they made wrong decisions for her at almost every pass.

Had they treated her obesity, the causes thereof, helped her family understand proper nutrition and exercise instead of this procedure, the girl would still be with us.

I saw this over and over with my parents before they died this year. They ate shit and go medicated for their acid reflux and high cholesterol.

I believe both were treatable through diet.

Sad to say. But look what they are up against. There's simply too much money to be made in the food, clothing and diet industries. And it's so tempting to go along with the message that it's perfectly fine to be fat.

for her obesity is really going too far. She is not a two year old who has been force fed. She was a teen who was fully capable of eating too much on her own -- or she could have had a physical condition that made obesity more likely.

They are clearly wrong not to accept her death, but it's pretty heartless to pile on blame for the death when NONE of us knows exactly what went wrong. That surgery should NOT have killed her. Obese children have surgeries every day, and survive.

It sure as hell makes securing an airway in a crashing patient more difficult.

You might look at obesity rates and OSA rates in the pediatric population (hint: direct correlation).

As for her obesity, true, I do not know if she was gainfully employed and capable of purchasing all of her own food. But at 13, I assume she was not, thus her parents share a large part of the responsibility regarding her diet. I do not know if she had a "medical condition" that affected her metabolism (I suspect pediatric metabolic syndrome DUE to her obesity). But I do know that she was unable to violate the 1st law of thermodynamics and that any energy she stored in her adipose tissue began as calories in her mouth.

I refuse to ignore the role her obesity played in this tragedy.

because then you can be certain nothing bad will happen to your loved ones, because you, of course, will never make a mistake like that.

One of our relatives lost his daughter due to an eating disorder. It's much harder to control a child's eating than you are acknowledging, or there wouldn't be deaths from anorexia and bulimia.

it's so hard being a parent, and this mother is dealing with her daughter's death from surgery she set up. All anyone can do is make the best decision possible at the time with what they know.

Sounds like child abuse/neglect by the parents to me. And what doctor in his right mind would have agreed to perform that operation? The adults in her life really failed this child. And they are continuing to do so, basically abusing her corpse.

There is no guarantee that she wouldn't have had apnea even if she weren't obese, though obesity raises the risk.

She needed to lose weight for her health regardless. Why not see if she still had obstructive apnea even after losing weight, then doing the surgery once it is proven necessary.

sooner rather than later -- losing weight can take a while.

I don't know why people here are harping on the parents, though. Some doctors recommended this procedure. Haven't the parents been through enough?

TBH the surgeon involved should be shot; he attempted 3 procedures at once, all of which carry significant risk of bleeding on their own. Then there was the removal or trimming of the turbinates when there was a less risky process - ablation.

Should they be blamed for that, too?

I said nothing about the parents.

But obesity and smoking dramatically increase your chances of getting OSA and emphysema, respectively. And once you have the diseases, obesity and smoking make them worse and harder to treat.

Its sad but why cant people understand when you are brain dead, you are dead?

Everything that makes a person, a personality, is in your brain. Not your arms, legs, etc.


Sure they can keep her lifeless, personality free body going on for years probably but that poor kid is gone forever.

the less they want anyone to meet up with him.

Quacks abound. Thanks for posting.

Sid

So sad!

He's a neonatologist, clinical profession of pediatrics, presented testimony before legislatures since 1967--sounds like he's pretty respected in his field. What, exactly, makes you think he's a quack? He sure doesn't look like a quack to me.

He may be great at neonatology, but he should leave neurology to the neurologists. Overstepping one's own level of expertise is the first level of quackery for a physician. Doing so intentionally in a public forum is the second. Diagnosing a patient without having personally examined them is the third.

Whatever he once was, he is now a quack.

He's no quack. And I doubt that the legislature would have had him testify if he were. But, of course, here on DU, we reserve the right to call anyone who disagrees with us a quack, right?

They serve as the link between medicine and the law. There needs to be some legal directive for when to call them.

If there is no legal definition of "death" and it's all up to the physicians, then as an MD myself, I could pronounce you dead right now. What state are you in? I can start filling out the paperwork.

Thinking, feeling people with brains that work.

That's not quackery, that's pure fucking evil.

I don't think that Byrne is necessarily against organ donation. He's against the idea of "brain death" as it's currently used, to harvest organs. And I think he's right.

Wonder what happened in this lawsuit: http://www.dailymail.co.uk/news/article-2208896/Patrick-McMahon-lawsuit-Donor-network-pressured-medics-declare-patients-dead-organs-harvested.html?ito=feeds-newsxml

Only morons get science news from the Daily Heil.

edit: Here, just to make it easy for you: http://www.truthaboutorgandonation.com/informeddecision.html

But I would assume that, since he is against it for himself, he is against it for others. That's his morality. I don't think that he is necessarily against donation for brain dead people because of his religion. I think that he thinks that many of these people are actually still alive.

I think that there is too much money involved in organ donation. It lends itself to corruption. And "brain death"? Not a settled issue, and I don't think that we have the technology to settle it right now.

Look around the site a little more, look at the other organizations they link to. They're 100% opposed to organ donation.

But so what? I take information from all sides; so should you.

edit: And a dangerous crank at that.

and is willing to let people who have a shot at a long healthy life die without a transplant.

That's stupid and evil.

It amazes me, the people who are called "cranks" and "quacks" simply because they disagree.

The science of "brain death" is not settled science. There are many scientists who disagree with this notion; Byrne is not alone. I don't doubt that his religion plays some part in his views, but so does others'. The fact is that we don't really know, because we don't have the technology, when the human brain is truly dead; we cannot test beyond the first couple of layers. In addition, we know that the brain has holistic, and even holographic properties, so until we can test the entire brain, we really are just guessing, and I don't think we have the right to do that, whatever our religion.

There's a reason that neurologists aren't making his claims, and it's because they're not supported by people who understand the brain.

Here's a hint: a legitimate doctor with such an important discovery would publish in a respected journal, not in web pages and pamphlets put out by anti-woman crank organizations.

And he's done extensive research on this topic. That makes him a non-crank. And, I think, one of his early patients, a baby, was found to be brain dead. The baby is now an honor roll student.

You wouldn't trust a neurologist to diagnose and treat a problem in your pancreas. Likewise, you wouldn't trust a endocrinologist to diagnose and treat a problem in your brain.

You wouldn't trust a neurologist to monitor and treat any problems arising from a pregnancy. Likewise, you wouldn't trust an obstetrician to diagnose and treat a problem in your brain.

And so on.

Specialization means you don't know much beyond the general public outside your specialty. Your opinions outside your specialty should be treated with the same level of trust as the opinions of the general public, even though you have "Dr" in front of your name.

I don't know about you, or others on here, but I don't have the time to keep track of every single publication that is accepted here as credible, or not credible. Who does? I do my best, as I'm sure everyone else does, to quote credible sources. This article was written up in more than the Daily Mail. Another personal attack and you'll join my Ignore list.

I don't think they care.

This persistent mis-information campaign you are on is evil. Please stop. Please.

Dr. Paul A. Byrne, a Neonatologist, is Director of Neonatology and Director of Pediatrics at St. Charles Mercy Hospital in Oregon, Ohio, is Clinical Professor of Pediatrics University of Toledo College of Medicine, Board Certified in Pediatrics and Neonatal-Perinatal Medicine, Member of Fellowship of Catholic Scholars. Dr. Byrne is past-President of the Catholic Medical Association (USA), formerly Clinical Professor of Pediatrics at Creighton University School of Medicine in Omaha, NE, and at St. Louis University School of Medicine in St. Louis, MO. He is author and producer of the film "Continuum of Life" and author of the books "Life, Life Support and Death," "Beyond Brain Death," and "Brain Death Is Not Death." Dr. Byrne has presented testimony on "life issues" to eight state legislatures beginning in 1967. He opposed Dr. Kevorkian on the television program "Cross-Fire." He has been interviewed on Good Morning America, public television in Japan and participated in the British Broadcasting Corporation Documentary "Are the Donors Really Dead?" Dr. Byrne has authored articles against euthanasia, abortion, and "brain death" in medical journals, law literature and lay press. Paul was married to Shirley for forty-eight years until she entered her eternal reward on Christmas 2005. They are the proud parents of twelve children and grandparents of twenty-six grandchildren.

When my sister was dying and Methodist Hospital in Houston was trying to pull the plug on her--she was conscious, aware, and absolutely terrified--the right wing blogs interviewed our family, and posted all kinds of stuff in support of our fight. We're all still liberals.

You speak to those who will listen; that's the way it is.

She's brain dead. Let her rest in peace.

It's sick.

With a coma, the lights are still on inside. They are just not in a conscious state. People can still wake up from a coma. But when someone is brain dead, the TV is unplugged. She's gone.

enter the family clergyman who says the girl should be kept on life support while they pray for the miracle that will make her well. He says, after all, that miracles are real because they are documented in the bible.

This family is being manipulated and abused by clergy, quack doctors and lawyers while they are most vulnerable. Those that would do this to a family during such a time of crisis are the scum of the earth.

just another RW hypocrite.

some "saint in surgical garb"? Never forget that half of all doctors graduated in the bottom half of their class, and that 'D' stands for diploma.

I had to read the headline about 4 times before figuring out that it's not about "Doctor Who"

Without blood flood to the brain irreparable brain damage occurs in a matter of minutes, she hasn't had blood flow to her brain in weeks.

She is dead.

It is a horrible situations, but the only thing the parents are doing is keeping all the other organs alive. The part that really makes her her (her brain) is long gone and there is no way to bring it back.

Even if one were to define death in purely theological religious terms that "death occurs when the spirit of the person permanently departs the body" there would be far less of a case that death occurs when cardiac activity stops - given that it has long been possible to maintain circulation artificially as is done all the time for numerous cardio-thoracic procedures - but it is not even remotely possible to maintain electrical activity if the brain were to be similarly disconnected from the rest of the Central Nervous System

for the family, this could have been avoided.

Shout at me if you wish, but I get the feeling this family was probably dealt with in a detached manner, leading to a misunderstanding, leading them to believe the original physicians just didn't care, resulting in this.


Very, very sad. Doctors, nurses, and humanity need to remember to live and work with just a teensy bit of compassion for the betterment of us all.