Family wants to keep life support for girl brain dead after tonsil surgery #7

[joypath]

Thanks Donjeta. That's very interesting!! It contradicts completely the Families claim the hospital said the surgery was routine then. I wonder if Jahi had sickle cell. Extra precautions are always taken for those patients to prevent complications.

IF she had SS disease, it would have been noted on her chart (history) AND observed on her admission C.B.C. & differential as a hemoglobinopathy/cell variant. The cells under Wright stain have a definite "s" shape curve & they can "jump out" to the technologist. IF she had a sub-set of the HgbS disease, AGAIN it would have been noted on her chart (intake & history). She was NOT an "emergency admission" and from family public statements had been seen by other HCPs, thus NOT a neophyte to medical evaluation.

Back to the SS disease and some of its variants, that condition makes the erythrocytes (red blood cells) "stickier" & "cumbersome to flow", both conditions which assist in the blood clotting cascade/mechanism.


http://www.nhlbi.nih.gov/health/health-topics/topics/sca/

 

[Soliloquy]

I believe the autopsy has to be done by the corner that issued the death certificate, if that is the case they definitely would NOT embalm her for the flight back.

They would probably pack her in ice or some such thing and make the flight quick.

MOO - I think it's more likely that the Coroner's office will make arrangements for one of their MEs to perform an autopsy in whatever location the body is in when the family decides to their satisfaction that Jahi is "dead".

 

[kaRN]

Not trying to be argumentative, but I am eondering who "they" are when referring to who gave NW the suction device. They could be anyone, including her family members.

It's at the bedside in case of emergency. Nobody had to give it them.

 

[CHERIE.T]

http://thaddeuspope.com/images/Hosp_Opp_Motion_Compel_tube_01-03-14.pdf

I had not seen this document before.
Contains e.g. information about reflexes and automatic movements that may be present in brain dead individuals.

Thank you Donjeta, that is an excellent find.
If the familie's lawyer read these papers and explained their content to the family......how can Kahi's mom not understand what is and is not happening to Kahi's brain and body?

These documents CLEARLY state that Kahi is brain dead.
:twocents:

 

[CHERIE.T]

Grandma is an LVN and works at Kaiser. Someone posted her LVN license info way, way back. She's licensed in Alameda County, I believe? I agree with you and everyone else who believes that nobody in this family should have been suctioning Jahi, but in their own interviews, they admitted to doing it, and even claimed that Jahi was suctioning herself.

b b m
A huge thank you Leilei.
bumping this up.

 

[CHERIE.T]

I'm not sure I completely understand the timeline either but Jahi post-op, would have gone first to recovery which is referred to as the PACU (post anesthesia care unit). Her problems started there and she was moved to the PICU (pediatric intensive care unit). I think there's confusion in the reporting.

For reasons of infection control and patient and staff safety, food brought in for visitors to eat would not be allowed in either unit. Hospitals have cafeterias and even entire food courts for families to dine at. Probably not a McDonalds though :blushing: For good reason as this case illustrates.

My local hospital has a Starbucks (offering both coffee and baked goods) and a Subway....on the first floor >>>> in front of the elevators.

 

[joypath]

MOO - I think it's more likely that the Coroner's office will make arrangements for one of their MEs to perform an autopsy in whatever location the body is in when the family decides to their satisfaction that Jahi is "dead".

OR if the body IS outside the jurisdiction of the signing coroner, THEN the local standards of practice would "kick-in"! (yep, this has raised discussion within the ME community!). Most PROBABLY the autopsy would be conducted at the local of the body with the courtesy of a ME (forensic pathologist) from Ca. attending/witnessing. Remember that one must have a license to practice in the jurisdiction of the pathological evaluation IF one is performing the primary post. (yes, "rush & temp." conditional licenses can be obtained in some jurisdictions!). Point of fact, CD has the right to request an observer be present but CAN NOT demand that any "family chosen" forensic pathologist either perform nor observe the procedure. After the legal autopsy to complete the death certificate, the family can arrange for as many self-paid autopsies as they may choose.

MOST if not ALL jurisdictions have specific statutes that spell out OCME cases and IIRC, ALL death are reportable (how else would we generate our penchant for statistics!)

Sample: http://www.nyc.gov/html/ocme/html/services/investigation.shtml

http://www.ct.gov/ocme/cwp/view.asp?a=2166&q=295106

http://www.westchestergov.com/labsresearch/medexaminer/med.pdf

https://malegislature.gov/Laws/GeneralLaws/PartI/TitleVI/Chapter38/Section4

PS: I've provided links of agencies of familiarity :blushing:

MY very humble opinions, of course

 

[CHERIE.T]

If - big IF - they took Jahi out of state, would California's laws still be enforceable at that point? If her heart stops beating in some other state, does the California coroner's office have any authority over what happens next regarding returning the body for autopsy?

Good question... I'd like to know if the mom being Kahi's GAL has weight in all 50 states?

 

[Herat]

It's at the bedside in case of emergency. Nobody had to give it them.

But you have to turn a switch or a knob to actually get suction working.

It isn't "on" just sitting on the wall. Someone has to turn it on, much like you have to turn on a faucet to get water out of it.

 

[Quester]

Re: CHO nurse/s on duty during crisis, TIA …

1. Did anyone in JM’s family personally know the nurse/s who was/were on duty during the crisis?

2. Race of nurse/s who was/were on duty during the crisis? [Somehow, I think it makes a difference to this family.]

3. How many CHO nurses typically would have been right there/nearby in the PICU? [If PICU had 1:1 ratio and JM was in room 10, can we assume there were at least 10 nurses in the immediate area? 20 nurses if rooms were double occupancy?]

4. If nurse/s was/were on a shift change, as stated by the JM family, at the time of the crisis wouldn’t that mean there would have been two nurses right there or nearby as one would have been updating the other about the status of the patient in that 1 nurse to 1 patient ratio area?

 

[CHERIE.T]

Soooo... things are getting discussed that have nothing to do with the official court documents, including comments at the end of media reports, comments which are not official nor have they been vetted for accuracy and could be rumor. Got it.

Yep, just like those same exact things are discussed here on 99% of our threads.

 

[Morag]

I guess I define fault differently than others. If I'm being disruptive in a hospital, it's my fault regardless of who fails to contain me. jmo

What I meant was- if there are a bunch of people being disruptive in the ER or wherever-of course they are the ones making the trouble. But if the hospital, with all its resources allows it to continue- and it continues to disturb others- then the others have every right to believe that the hospital is at fault for allowing it to continue.

In the post which I responded to ( back several pages), someone described a huge gathering of LE personnel who were there to support and hold vigil for one of their own. The hospital failed to stop the disturbance, and at that point the hospital was at fault for allowing their other patients to be annoyed and disturbed. No one should act like that in the hospital setting, and no hospital should allow it to continue.

When I was recovering from a C-section, I kept smelling cigarette smoke- people were smoking in the stairwell adjacent to my room. The nurse said, oh, they're allowed to smoke there, and did nothing. When my husband arrived later, he went to the head of ob/gyn and made a complaint. After that there was no smoking, because the hospital, who was responsible for the well-being of its patients, did their duty.

Now I think I'll go out for a quick cig! :blushing:

 

[ItsJustaName]

I agree with you and don't blame her either. She believes she can come back to life, she isn't pulling life support until its clear she isn't. And i wouldn't be trusting doctors after my little girl died. Certainly not doctors from cho. I would never trust a doctor who didn't use her name and just called her the corpse. There are many religious beliefs that says the soul stays around til a body is put to rest, that is why we use the phrase so not bashing her for it either. At any route, she is Jahi not the corpse to her family and that should have been respected by all. You can say Jahi is dead, Jahi is a corpse, Jahi etc. but to dehumanize her is sickening. I wouldn't take a child to cho just for that attitude itself. We read cases where a family member calls the child a body or we want the body and immediately get suspicious bc it isn't normal to dehumanize or give up on your baby.

I think the insinuations that the family caused her death are just mean spirited. I want to know why the nurse wasn't there within seconds and doing the work, not handing buckets to the family.

JMO

I would say there is no longer a "she". There no Jahi left only Jahi's body.

 

[mck16]

What I meant was- if there are a bunch of people being disruptive in the ER or wherever-of course they are the ones making the trouble. But if the hospital, with all its resources allows it to continue- and it continues to disturb others- then the others have every right to believe that the hospital is at fault for allowing it to continue.

In the post which I responded to ( back several pages), someone described a huge gathering of LE personnel who were there to support and hold vigil for one of their own. The hospital failed to stop the disturbance, and at that point the hospital was at fault for allowing their other patients to be annoyed and disturbed. No one should act like that in the hospital setting, and no hospital should allow it to continue.

When I was recovering from a C-section, I kept smelling cigarette smoke- people were smoking in the stairwell adjacent to my room. The nurse said, oh, they're allowed to smoke there, and did nothing. When my husband arrived later, he went to the head of ob/gyn and made a complaint. After that there was no smoking, because the hospital, who was responsible for the well-being of its patients, did their duty.

Now I think I'll go out for a quick cig! :blushing:

When my son was in ICU and in very critical condition I of course went to his room every chance I could respecting the visiting hours. I was there one night and had been there for over the time and it was late. I asked the nurse if I had to leave and he told me he would never ask a mother to leave her son in the condition he was in. Maybe the staff was trying to show Jahi's family a little extra bending of the rules because of her condition. jmo

 

[Isabelle]

Thanks Nore! :seeya: She's an LVN which is Cali's version of an NA or LPN. She's not qualified to suction but would have been trained to understand the rationale as to why she wasn't qualified.
How is your son now? Praying he's well!!! This thread is moving so fast it's hard to keep up. You're totally right though about the clots, even sutures or a graft if one was used. Great to see you Nore! happy New Year friend!

Must be a state thing. Louisiana allows LVN/LPN's to suction for any and all needs. In our state a NA is a nursing assistant aka nurse's aide and not licensed.

 

[ItsJustaName]

I've lost track of who speculated it was unlikely for a McDonalds to be in the hospital - there was one at Childrens Memorial Hospital in Chicago at few years ago.

"McDonald’s says it has restaurants in 27 U.S. hospitals. Children's Hospital Los Angeles and Riley Hospital for Children, both on our list, host McDonald’s. Other children's hospitals with McDonald’s include Children's Minneapolis, Kosair Children's Hospital in Louisville, Ky., Joe DiMaggio Children’s Hospital in Hollywood, Fla., and Rady's Children's Hospital San Diego."

 

[Isabelle]

But you have to turn a switch or a knob to actually get suction working.

It isn't "on" just sitting on the wall. Someone has to turn it on, much like you have to turn on a faucet to get water out of it.

In recovery the suction is left on and is turned on as soon as patient enters the room. At least where I worked it was.

 

[CHERIE.T]

http://news.kron4.com/news/jahi-mcmath-doctor-releases-statement-following-meeting-with-family/

snipped

We want the public to know that the family has not permitted us to discuss the medical situation. We are unable–without the family’s permission–to talk about the medical procedure, background or any of the details that are a part of this tragedy. Details that would provide transparency, openness and provide answers to the public about this situation.

bam! >>> That's one bold statement.

 

[Karmady]

I've lost track of how speculated it was unlikely for a McDonalds to be in the hospital - there was one at Childrens Memorial Hospital in Chicago at few years ago.

"McDonald’s says it has restaurants in 27 U.S. hospitals. Children's Hospital Los Angeles and Riley Hospital for Children, both on our list, host McDonald’s. Other children's hospitals with McDonald’s include Children's Minneapolis, Kosair Children's Hospital in Louisville, Ky., Joe DiMaggio Children’s Hospital in Hollywood, Fla., and Rady's Children's Hospital San Diego."

Just a guess, but I suppose hospitals with ronald mcdonald houses/rooms probably couldn't/wouldn't object to having a restaurant on the premises.

 

[Sonya610]

When I was recovering from a C-section, I kept smelling cigarette smoke- people were smoking in the stairwell adjacent to my room. The nurse said, oh, they're allowed to smoke there, and did nothing. When my husband arrived later, he went to the head of ob/gyn and made a complaint. After that there was no smoking, because the hospital, who was responsible for the well-being of its patients, did their duty.

Now I think I'll go out for a quick cig! :blushing:

Sheeshers you should have kept quiet! That way when you were able to walk YOU could have gone into the stairwell to have a cigarette too! Course maybe because of the baby thing you weren't smoking but still, why ruin what little is left for others.

These days you have to leave the "property" to have a cigarette and that means it is impossible for patients (course these days we also have e-cigs, the hospitals will no doubt eventually try to ban those too but until they start strip searching patients they won't be able too).