CA - Parents Of Toddler Declared Brain-Dead Convinced He’s Still Alive

[Doghairrules]

New documents from the hospital. They did not know Israel had previously been declared brain dead when they accepted him. He was at CHLA since July 22nd and the hospital had notified the family a week in advance that they planned to disconnect support on 18 August. So it was not, as the family claimed, them rushing to disconnect him after the TRO was dissolved. The "independent" review the family wanted was Dr. Shewmon, who doesn't believe in brain death. The hospital also offered to cooperate with moving Israel to another facility that would accept him.
http://www.thaddeuspope.com/images/Childrens_Hosp_App_to_Dissolve_TRO_08-25-16.pdf

Very interesting. Wonder why Dr. Shewman still has privileges at UCLA?


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[Doghairrules]

I guess sometimes it pays to pay attention to the news. This case was on the news. I am surprised that they didn't know Israel was determined to be brain dead.

Me too. Makes me wonder if they didn't have an actual name. Google should be their friend...


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[i.b.nora]

Dr Alan Shewmon is also available for piano recitals.

An Afternoon with Frederic Chopin" - Piano Recital with Alan Shewmon, MD, AB '70
Please Join us for 'An Afternoon with Frederic Chopin' this year’s recital by Dr. Alan Shewmon. Works will include Preludes, Nocturnes, Mazurkas, Waltzes, and the ever popular Andante Spianato and Grand Polonaise Brillante!
Sunday, September 23rd @ 2:00pm
Location: Steinway Piano Gallery, 314 N. Robertson Blvd. West Hollywood, CA​

http://hcsc.clubs.harvard.edu/article.html?aid=373

 

[Tssiemer]

At what point is this child abuse?


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[K_Z]

Very interesting. Wonder why Dr. Shewman still has privileges at UCLA?


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Technically, this doesn't confirm that Shewmon has admitting privileges, just that he was the mother's choice for yet *another* opinion.

I'm reluctant to believe Shewmon was the admitting doc. The ICU intensivists at CHLA surely know "who" Dr. Shewmon is, and what his opinions are about brain death critieria. And a direct admit from Guatemala should have raised a lot of interest and questions.

I think it's "possible" that some of the arrangements for the admission to CHLA were misinterpreted, or that "someone" working with the transfer on the CHLA end initially may have thought (or been persuaded to think,or not correctedif they assumed) the patient was a Guatemalan citizen (since the admission was being arranged while the family was still in Guatemala). It's possible that they concealed the identity of Israel until he was back on U.S. soil, and physically inside CHLA.

Another scenario is that the hospital knew they were an American family, and assumed Israel became ill while on a trip in Guatemala, and were trying to find a way to return to the U.S.

The hospital can't start any *actual records* (medical or administrative) for the patient until they are physically in this country, and in the facility, despite phone conversations that occur during the transfer process. It may have been something as simple as the medical records rep who met the family (to do admission paperwork) and discovered who they actually were, and by then they were inside the facility.

I can imagine that lawyers who are particularly savvy *might* make suggestions to families to plausibly avoid giving needed information (for example, not return calls, not be available), or deflect questions (claim not to know, can't remember, or don't understand), or take advantage of international bureaucracy in other ways, as a mechanism intended to conceal the identity as long as possible until the patient was physically in the facility.

 

[K_Z]

Ah-- Dr. Shewmon is not on staff at CHLA, and does not have admitting privileges. Page 7-8 of the pdf. I'm still working my way thru the 218 pages, lol!

http://www.thaddeuspope.com/images/Childrens_Hosp_App_to_Dissolve_TRO_08-25-16.pdf

"Dr. Shewmon is not on the physician staff of Children's Hospital Los Angeles. CHLA is not required to grant him any staff privileges. CHLA is not required to accept a determination by Dr. Shewmon on the issue of whether CHLA should provide medical services."

"Children's Hospital Los Angeles cannot be forced to grant staff privileges to Dr. Shewmon for the purpose of allowing him to assert a determination inconsistent with accepted medical standards."

ETA:

Lots more on the transfer story. Begin reading the above pdf on page 14 of 218, the declaration of Dr. Markowitz (PICU Chief).

They knew who his real name-- just not that he had been declared dead and had a death certificate from April. They thought they were evaluating him for transfer to home care. They received the Kaiser records Aug 12.

 

[K_Z]

Some highlights from the appeal filed by CHLA.

Declaration of Dr. Markowitz, CHLA PICU Chief, states he contacted the medical ethics committee for consultation, who concurred with the determination of brain death and futility of further medical support of the body.

Dr. Markowitz contacted EIGHT other PICUs—all of whom declined to accept Israel in transfer.

Jonee wrote a letter to docs/ staff while at CHLA forbidding CHLA to do any brain death testing.

Aug 13 family was notified that on Aug 18 support would be withdrawn. (Aug 18 is the day Jonee filed the emergency restraining order.)

Declaration of Dr. Lew, CHLA Bioethics Committee Chair, says she knew Israel had been declared dead by neuro criteria by 2 northern CA hospitals BEFORE he arrived in transfer. Interestingly, she states she believes CHLA had an ethical and moral obligation to accept Israel in order to afford respect to the child who had died, and cease providing the inappropriate and futile medical intervention.

“…the primary moral obligation remains towards providing appropriate respect to the child who has died. This most important obligation means that the healthcare team ought to remove and discontinue the un-natural medical interventions currently in place which are no benefit to a dead child, and serve only as unnecessary intrusions on his corpse.” (page 23 of 218)

Dr. Lew advocated for a TIME LIMITED opportunity to obtain an alternative venue of care. CHLA did this, and notified the family of the plan, and the deadline.

“Once the time frame for seeking alternatives for care elsewhere has elapsed, it is morally permissible, and even obligatory for the healthcare team to discontinue all mechanical and organ supportive treatments, and free this child’s body from inappropriate manipulation.” (page 24 of 218)

http://www.thaddeuspope.com/images/Childrens_Hosp_App_to_Dissolve_TRO_08-25-16.pdf

 

[i.b.nora]

This really is kind of fascinating from a “who done what and when” point of view.

I have only gotten to about page 11 of the newest document before I just had to start reviewing some history. I noted that it wasn't until after Jonee filed her "you can't pull the plug" document that CHLA, in response and as part of the notification of their action, that CHLA had no known attorney for Jonee and only a phone number for her in Vacaville.

I looked back in our thread here and noted a June 7th post by K_Z which prompted me to look through Jonee's entries at her GoFund site.

I am increasingly of the opinion that from the very moment Alexandra Snyder and her legal foundation cohorts got their claws into the Stinson family, they orchestrated and planned ahead every single action from that time on.

I believe that the plan was formulated by the attorneys and was first conceived in its entirety prior to Israel's move from Kaiser to some secret location out of the U.S.

You can almost see the plan in action by following Jonee's updates at site. Unfortunately, there are no posting dates on the updates. All they say are things like 9 days ago, or 2 months ago so it is impossible to know exactly when the posts were made.

But, here is an attempt to follow their plan as it unfolds:

Looking back we know from a May 23rd Fox40 article posted here that Israel was moved out of the U.S.

Jonee Update #3 - 3 months ago (approximately June 4th) we learned that Israel had been declared "not brain dead" by doctor/s in the unnamed foreign country.

Jonee Update #4 - 3 months ago (also approximately June 4th) we learned again that Israel had been declared not brain dead and that they need money for a special medical flight back to the U.S.

Jonee Update #5 - 2 months ago (approximately July 4th) we learned that because he was declared not brain dead they will be returning to the U.S. with a new hospital willing to accept him. And, they need money to do that.

Jonee Update #6 - 2 months ago (also approximately July 4th). Reports that they got an EEG test and a pediatric nuerologist said Israel is not brain dead. And, seeking funds to bring him back.

Jonee Update #7 - 1 month ago (approximately August 4th) Jonee informs her readers that for the last eight weeks they have been in Central America, that they originally transferred him out of the U.S. on May 21st. And she says that now they have to get him back to the US for further treatment (and they need money).

Jonee Update #8 - 16 days ago (approximately August 19th) We learn that they are back in America after almost three months in Guatemala. She reports that Israel's condition has progressed and he has 2 EEG's that prove his brain is not "dead" and that there is still activity. And, they need money to buy a house to be close to 'the doctor'.

Jonee Update #9 - 5 days ago (approximately August 30th) "... we lost our battle on August 25th when the decision to continue my sons life was left up to a judge." And, oh, by the way, we need money for the funeral.

So, my feeling is that CHLA was a target all along, it was always a part of the plan. Jonee and Nate and more importantly the attorneys who advised them failed to mention to CHLA, the true story of Israel's short life, and it was the plan all along. I think the attorneys should be in jail. But, what do I know?

 

[SophieRose]

Here's some interesting information from the doctor in Guatemala treating Israel. Apparently a foundation was to pay for his hospital costs in Guatemala but never came through, and a donor was paying 70,000 Guatemalan Quetzals every 10 days, the equivalent of about $9,300. Because of lack of money he was being transferred to Roosevelt Hospital, a public hospital in Guatemala City. I don't know how a public hospital would be able to take him because I'm sure it would be overcrowded with patients.

Dated 6/28/16:

https://www.facebook.com/juanpablo.zaldana/posts/1101338969922904

 

[stormshine]

How much do you want to bet that "never came through" was "we didn't tell them the truth up front and they changed their minds when they found out."

Here's some interesting information from the doctor in Guatemala treating Israel. Apparently a foundation was to pay for his hospital costs in Guatemala but never came through, and a donor was paying 70,000 Guatemalan Quetzals every 10 days, the equivalent of about $9,300. Because of lack of money he was being transferred to Roosevelt Hospital, a public hospital in Guatemala City. I don't know how a public hospital would be able to take him because I'm sure it would be overcrowded with patients.

Dated 6/28/16:

https://www.facebook.com/juanpablo.zaldana/posts/1101338969922904

 

[i.b.nora]

That Guatemalan Doctor and Dan Woodard, the attorney who represented Jonee in court the day the judge made her final ruling, they both belong to organizations that are ideologically connected to one another. Woodard, apart from his regular practice over the years, has been with the Christian Legal Society for over 30 years. It is a nationwide network of Christian attorneys who are sort of 'on call' to represent or in Jonee's case (when the CHLA required her to have an attorney) make court appearances for.

Juan Pablo Zaldana, the Guatemalan Doctor, works for Asociacion de Medicos por los Derechos Humanos which is a Guatemalan "right to life" human rights group. (The kind that hates homosexuals). Their Facebook page is filled with Lifesite articles.

I feel there are deep pockets involved, but they are focused on making individual attorneys and doctors wealthier as opposed to passing it out to their clients. Especially since the appearance of the online 'funding' sites that suit their scams quite nicely, imo.

Anyhow, imo, they are all connected.

 

[Lippy]

How much do you want to bet that "never came through" was "we didn't tell them the truth up front and they changed their minds when they found out."

Scroll down in the comments, Zaldaña says that Israel was not transferred to Rosevelt after all. I corrected the translation, I am a Spanish Speaker and the auto translation was incorrect . Zaldaña makes another statement above that comment saying the same thing .

Juan Pablo Zaldaña
Juan Pablo Zaldaña Estimados amigos aparentemente alguién habló de los Estados Unidos y por el momento el niño no se trasladará al Roosevelt, les agradezco sus buenas intenciones y oraciones. Saludos
Dear friends apparently someone spoke to the United States and For the moment the child will not be moved to Roosevelt, I thank you for.....

 

[SophieRose]

Scroll down in the comments, Zaldaña says that Israel was not transferred to Rosevelt after all. I corrected the translation, I am a Spanish Speaker and the auto translation was incorrect . Zaldaña makes another statement above that comment saying the same thing .

Juan Pablo Zaldaña
Juan Pablo Zaldaña Estimados amigos aparentemente alguién habló de los Estados Unidos y por el momento el niño no se trasladará al Roosevelt, les agradezco sus buenas intenciones y oraciones. Saludos
Dear friends apparently someone spoke to the United States and For the moment the child will not be moved to Roosevelt, I thank you for.....

Thanks.

Can you translate the payment part? I don't think I got the 70,000q every 10 days right. Seems too high, although initially it would include the two surgeries and all the testing. I guess it could be high because he's in a hospital,, not a convalescent home.

 

[Lippy]

Thanks.

Can you translate the payment part? I don't think I got the 70,000q every 10 days right. Seems too high, although initially it would include the two surgeries and all the testing. I guess it could be high because he's in a hospital,, not a convalescent home.

Currency conversion comes to $9268.00 usd (every 10 days). Sounds reasonable to me, although I have no idea of medical costs in Guatemala. He was on a ventilator and required a lot of care so it doesn't sound outrageous.

 

[Donjeta]

They knew who his real name-- just not that he had been declared dead and had a death certificate from April. They thought they were evaluating him for transfer to home care. They received the Kaiser records Aug 12.

So did the family deceive the hospital about the availability of insurance...? Is there any insurance company that will pay for the continued care for a deceased person for this long?

 

[K_Z]

That Guatemalan Doctor and Dan Woodard, the attorney who represented Jonee in court the day the judge made her final ruling, they both belong to organizations that are ideologically connected to one another. Woodard, apart from his regular practice over the years, has been with the Christian Legal Society for over 30 years. It is a nationwide network of Christian attorneys who are sort of 'on call' to represent or in Jonee's case (when the CHLA required her to have an attorney) make court appearances for.

Juan Pablo Zaldana, the Guatemalan Doctor, works for Asociacion de Medicos por los Derechos Humanos which is a Guatemalan "right to life" human rights group. (The kind that hates homosexuals). Their Facebook page is filled with Lifesite articles.

I feel there are deep pockets involved, but they are focused on making individual attorneys and doctors wealthier as opposed to passing it out to their clients. Especially since the appearance of the online 'funding' sites that suit their scams quite nicely, imo.

Anyhow, imo, they are all connected.

There is an opinion piece on the "lifesitenews" website that does not have an author, but purports to be written by an attorney involved with the Israel Stinson case. The link in that article is to the life legal defense fund, which does not have the article up. Anyway, to summarize (since we can do that here), there were 2 things that stood out to me.

First, the attorney/ author says that the doctors in Guatemala "agreed" to treat Israel without cost during the last few weeks at the Guatemalan hospital. It is very wide open what "agreed" means, why only the last few weeks, and whether that means they enthusiastically "agreed", or "agreed" not to transfer Israel (for non-payment?) while they looked for another facility.

The second thing that stood out to me is that apparently the Life Legal Defense attorney was not close by, or even involved on a daily basis communicating with Jonee from the time they arrived in Los Angeles. The attorney/ author says Jonee called her "10 days ago" and said that CHLA was going to remove Israel's ventilator "the next day". The attorney says he or she flew to Los Angeles and "assisted" Jonee in filing the emergency injunction request (Aug 18). That was the TRO in place till Sept 9, and subsequently dissolved. The attorney also says that at the time he or she flew to LA, they assisted Jonee finding a "local attorney" to "work with Jonee going forward." That says they either weren't much involved, or not able to be involved going forward (or both).

It seems Life Legal Defense doesn't really accept a case from beginning to end as the primary attorneys, IMO, from these kind of comments. They pop in and out as needed for crises and emergency filings (they are donating their time), and try to find local attorneys who are like minded to take on the day to day stuff.

IMO, that is unethical. If they take on representation of a vulnerable family/ client, in the midst of a medical crisis, they should be there and available for ANYthing that comes up. And, of course, licensed in the state the patient is in. I realize that this level of practice and handing off the client, popping in and out, may not meet the state bar requirements for breach of ethics in the attorney/ client relationship, but as a general statement, this kind of attorney practice is why some see them as opportunistic and predatory.

They emphasize that they provide donated legal services while representing Life Legal Defense, and to their agenda-driven organization (Life Legal Defense). That's important, because it says that they do not see their first obligation as the vulnerable clients they sporadically represent thru LLD. It's a left-handed way of saying their paying customers (or their "regular job") comes first, then the agenda of their non-profit. That puts the vulnerable clients pretty far down the list of priorities, IMO. So that may explain why, IMO, Jonee's legal approach was so disjointed and disconnected, requiring lots of last minute "emergency" filings.

 

[K_Z]

So did the family deceive the hospital about the availability of insurance...? Is there any insurance company that will pay for the continued care for a deceased person for this long?

No, I don't think they deceived CHLA, if that is what you mean. That long pdf of the court findings, and especially the declarations by Drs. Lew and Markowitz, make it clear that CHLA knew what they were getting into with Israel's case.

Israel was a medicaid patient when he was alive, but medicaid would not pay for care once there is a death certificate. So CHLA knew there was no one to bill when they accepted Israel.

No private insurance will pay for ongoing care after a patient is deceased, either. The hospital "absorbs" that as charity care. ICU and surgical expenses for organ donors are reimbursed from the organ procurement non-profits. The family of the donor, nor their insurance, is never billed for any of that.

The pdf linked states that Israel was receiving MediCal (medicaid) during the original admission to the local hospital in Vacaville, and during the transfer hospitalization to UC Davis. Jonee used "insurance" as a rationale when she requested transfer to Kaiser-- that was in several articles. It's pretty clear, IMO, that she was avoiding the second brain death exam at UC Davis with the request to go to Kaiser, buying time. UCDavis certainly accepts and cares for medicaid patients, so Jonee's comments early on that she "thought" he had to go to Kaiser for insurance purposes is really ridiculous.

It's even MORE ridiculous when you factor in that she, via her attorneys, accused Kaiser of EMTALA violations when they accepted and cared for Israel! Holy cow, that is absurd in the extreme. EMTALA is "anti-dumping", not "anti-admission to the PICU". The whole purpose of EMTALA is to prevent "wallet biopsies", and diverting low income patients or the uninsured to hospitals further away. And yet, Jonee tried to convince the court that Kaiser refused to care for and "stabilize" Israel (who had been in a high level PICU at UC Davis for weeks at that point). She was trying to convince the court that Kaiser had no right to declare Israel dead, because of EMTALA. I remember months ago posting that this argument about EMTALA would NEVER make any headway in the courts. (And it didn't.) It was a silly argument on it's face, but probably the pro-life attorneys didn't have any "real" basis to file on (such as an error in diagnosis), so they pulled this out of a hat to see if it would work as a delay tactic. (They knew an EMTALA argument was a dead end, IMO.)

I think the costs for the time Israel was at CHLA will be absorbed into their charity care. I don't think they will bill Jonee, and they can't bill medicaid for a patient who has been legally deceased for 4 months.

 

[K_Z]

Currency conversion comes to $9268.00 usd (every 10 days). Sounds reasonable to me, although I have no idea of medical costs in Guatemala. He was on a ventilator and required a lot of care so it doesn't sound outrageous.

That's dirt cheap, compared to U.S. costs. PICU care (mechanical ventilation plus monitoring, meds, nurses, docs, labs, imaging, etc) in the U.S. "starts" at about $2000/ 24 hours. That figure is from about 6 years ago, so it may be more now. ECMO, for example, would be substantially more. Israel had ECMO for about a week at UC Davis.

Many developing nations charge far less than U.S. prices, which is partly why "cash" elective surgeries have become more popular through international medical tourism. This is essentially what Jonee chose-- international medical tourism, although for a different medical condition than something like elective cosmetic surgery, or dental implants.

http://www.medicaltourismguatemala.com/

 

[katydid23]

How much do you want to bet that "never came through" was "we didn't tell them the truth up front and they changed their minds when they found out."

You are probably right.

If I was rich, I would absolutely donate money to help a baby in a coma, who needed critical care to recover. But if I found out the baby was brain dead, I would use that money for other needy patients instead.

 

[Lilibet]

K_Z I just want to thank you for generously providing your expertise to this thread. I'm a regular reader, not poster, and your clear explanations are immensely helpful. It's too bad you're not a journalist too!