I'd say let her go because I don't think she's ever going to wake up and keeping her on life support is just going to prolong the agony

I do agree with you that facility is in it for the money. They're preying on the hopes of the family.

The whole thing is a terrible tragedy but it happens.

It also increases the damage award for the family.

If it costs $4 million a year to treat her and she has a life expectancy of 10 years, the medical specials will be $40 million plus pain and suffering. If the girl dies, the most a jury would award is about $1-$2 million.

Surely by now, after all the expert testimony, the family understands that the girl is not coming back.

Because the longer she continues on the ventilator, the more any evidence of malpractice disappears.

Hemorrhaging is a very rare complication of tonsillectomy, but it does happen and contrary to what the msm would have you believe, this was not just a simple tonsillectomy.

Just the fact that she is reduced to be on a ventilator is good enough to sue. Plus there is far more jury sympathy for a little girl on a ventilator costing $4 million a year.

and did nothing that constitutes malpractice. I think the point that was being made is that an autopsy could show what caused the problem - and THAT might be the basis of arguing the doctors made a mistake.

a cardiac arrest due to acute hypoxia -- not uncommon in someone with excessive lymphoid tissue in the oro and nasopharynx.

These are extremely difficult cases to anesthetize and obesity compounds the problem because there is excess demand for keeping BP up in order to perfuse the entire body. The airway has to be maintained all during surgery and the anesthetic is given through the same airway. The duration of surgery makes it impossible to use IV anesthetics like propofol.

If this was due to a cardiac arrest during surgery, there would be a record of the cardiac monitor. However, from what I understand, she was doing well and already in recovery when this happened -- which suggests a postop edema of the lining of the nose and throat which caused the airway obstruction.

I don't know what the standard of care is for ENT surgery but if I were the surgeon, I wouldn't try to operate on both the throat and nose in one sitting. Separating the two surgeries by a few weeks would avoid the possibility of both airways getting blocked by edema at the same time.

She was fine and then suddenly she was bleeding out her mouth and nose, and brain dead a short time later. The hypoxia wasn't due to lack of oxygen, but lack of oxygenated RBCs..

It wasn't airway obstruction due to edema. It was hemorrhage, which from what I have read is a risk in the initial 24 hours after a tonsillectomy, and again 7-10 days later when the scab comes off. It's rare, but it does happen and people do die from it.

The bottom line is whether there had been edema or a nicked artery, the longer she remains on the ventilator, the less likely they are to be able to determine just what happened.

would be based on her life expectancy / earning capacity before her tragically-botched surgery, not on how long some facility can keep her on life support.

if she is deemed to have an earning capacity of $100K a year for 55 years, it is still far less that $4 million x 10 or 15 years.

life expectancy at $4 million per year cost and once they get a judgment reflecting that they will pull the plug? 'Cause if the judgment covers the costs and she has those costs, then what's the point? That's ugly.

Several years ago my husband was on a jury in a similar case. A 4 year old had had a tonsillectomy, and came out of the surgery ok, but afterwards somehow became oxygen deprived and was severely brain damaged. (Not brain dead). At the time of the trial, the boy was around 12 yrs old. The hospital (Children's Hosp in Los Angeles), surgeon, nurses and anesthesiologist were being sued.

The family was asking for full 24 hr care, a new home for him/them to live in, a new van to transport him, expenses to have him educated through college--even though he was too brain damaged to have the capacity to understand anything going on around him--and what his lifetime earnings might have been. It was estimated at that time, that he had about a 3 yr life expectancy. At the time of his death, everything from the settlement would go to his mother. So these are the kinds of damages that can be sued for. I don't know if it would make a difference since this girl is actually brain dead, as to how far they can go with what they want.

The mother's attorney was trying to say that someone was negligent, but after all of the evidence was shown, expert testimony given etc, it could not be proved that anyone did anything wrong. My husband said that the jury was very sympathetic, and really wanted to give the mother something to help, but they could not find for her. (He said that there had been some kind of care offered to the boy before the trial, but the mother had refused the offer. I don't recall if the offer was from the hospital, or doctors or ?.) The anesthesiologist was going to have to go through another trial because it was felt he could not be completely exonerated, and might possibly have done something wrong. Not proved that he was negligent but he was still on the hook so to speak.

It's such a sad situation, I hope this family is not being taken advantage of by vultures looking to make some money off of their tragedy.

Do you honestly think that a family, believing their child is really dead would keep her on life support -- for money - that goes to maintain her in the facility. Painful as accepting the death of a beloved child would be years of limbo where the child is not alive and doing all they could have wanted for her - nor dead. This means no closure for them.

I guess your sympathy is only for Indian diplomats.

Really sad story..

Cosmicone's post - I'm wondering if they're just doing what the lawyers "advise"....

The family should give the gift of life for the holidays and ease their suffering.

Ask Terri Schiavos husband what a multi-year vigil is like.

Where is Sarah Palin and her talk of death panels? Show her the bill and let her and the TP weigh in.

Perhaps they would be able to see their daughter in the form of the lives she would save -- surely the organ recipients would love to maintain some relationship with them.

That seems...ill-advised for a 13-year-old.

Hope this doesn't turn into another circus like that was.

and now there is a lot of evidence from a variety of experts that she is not going to recover.

I can understand parents clinging to the hope the first couple of weeks and getting more opinions -- I would probably do the same if it were my child. However, at some point, acceptance sets in and most mature people prefer to deal with the loss and have a proper grieving rather than a far more painful process of clinging to the hope. Clinging to the hope means each passing day when the daughter doesn't wake up, you relive the loss all over and wait for another day.

This is an extremely tragic story and I hope some inhumane attorney is not behind this to get 33% of a bigger pot.

It is a cruel situation for them. They likely are second guessing every decision they made - even though they likely were simply following the advise of the doctors. Their actions seem more emotional than rational, but they just - unexpectedly - lost their child.

I hope some real friends of theirs convince them not to proceed down this path. However, the decision is not as simple as you suggest and the family may well be in denial and still hoping for ANY life for their child.

This is tragic and I feel nothing but sympathy for the parents.

A machine is sending air in and out of her lungs, which is keeping her blood circulating and her heart pumping. But she's dead.

but seriously... I used to be a "frequent flier" in the ER at Children's.

It's frustrating to me that this family is taking resources for their dead kid that could be used to treat other critically ill children.

If it's about resources they should be eager to unload her. Instead they're insisting that they can't do surgery on a dead patient.

At some point perhaps the whole story will come out but right now it surely looks like the hospital staff and doctors share the blame for this horrid, fucked up situation.

They're happy to have her body removed. They are unwilling to do surgery on her corpse. The nursing home that was going to take her backed out when they found out the real situation; that they would be essentially maintaining a corpse. 6 different doctors -- 3 of them independent specialists hired by the parents and a 4th hired by the court -- have found her irreversibly brain dead.

Last edited Sat Dec 28, 2013, 02:09 PM - Edit history (1)

which was the above poster's comment. BTW, a second nursing home facility tentatively agreed to take her but would need Children's cooperation.

In terms of practices, it's a shame that Children's has insufficient safeguards to prevent this tragedy even after it paid out millions to the family of the child who was severely brain damaged as a result of complications from a combined tonsilectomy/adenoidectomy surgery two years ago. That surgery was also done to address sleep apnea.
http://www.contracostatimes.com/news/ci_24799118/jahi-mcmath-2-years-ago-girl-wound-up?source=pkg

There is no way that Children's will come out of this without suffering damage to its reputation.

and when the autopsy finally is done, it will be harder to determine what went wrong due to the changes that will have occurred over the past 2 weeks, and that continue to occur.

There were significant differences between the case 2 years ago and this case. However, one thing stands out as similar...inadequate aftercare.

In this case, the mother states that nurses left it up to her to control Jahai's bleeding.

In the prior case, the daughter was discharged despite not appearing or behaving as normal.

Sure, it means they will be in a weaker position to win a malpractice award but money won't buy them a new child.

The earlier case was just settled in November, a few weeks before the McMath surgery. One wonders what if any changes in procedures were instituted at Children's as a result of the earlier lawsuit.

Her mother has stated that she believes that God may "spark her brain to wake up."

6 doctors have examined her and declared her irreversibly brain dead, with no cerebral or brain stem activity for weeks now.

3 of them were neurologists hired by the parents, and they still refuse to recognise or accept that she has died.

What these parents need more than anything else is either good, solid counseling to help them accept that she is gone. Barring that, they need less media attention and some more time to come to that conclusion on their own.

As I wrote before, we don't know what transpired before they went to the media. We don't know what if any supportive counseling was offered to them. We don't know if the hospital circled the wagons and hoped that McMath's family would just move along on their own. We don't know if the family's spiritual advisers have tried to help them work through the shock and grief or whether they're emphasizing miracles. We don't know if there are members of their own family who are trying to help them let go either for that matter.

The whole thing is a mess.

When the parents requested that they be able to bring their own doctors in to examine her, the hospital cooperated.

The hospital didn't bring in the media, and its hands are tied in terms of publically defending themselves due to HIPAA laws.

I think the lawyer is the real problem here, feeding false hopes and milking their grief for all its worth. That and whoever their religious counselor is.

As for the intentions of the facilities or parents I don't know. I feel so bad for her family.