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California Family Struggles to Get Surgeries for Teen

APTOPIX Tonsillectomy-Brain-Dead-Girl

OAKLAND, Calif. (AP) -- The family of a 13-year-old California girl declared brain dead after tonsil surgery is encountering difficulty in obtaining two surgeries that she needs to undergo before she can be safely transferred to a long-term care facility.

A lawyer for Children's Hospital Oakland said Tuesday that it is unwilling to allow an outside doctor to fit Jahi McMath with the breathing and feeding tubes that the family has requested.

The hospital will not permit the procedures to be performed on its premises because Jahi is legally dead in the view of doctors who have examined her, lawyer Douglas Straus wrote in a letter to the girl's family.

"Performing medical procedures on the body of a deceased human being is simply not something Children's Hospital can do or ask its staff to assist in doing," he said.

The refusal appeared to reverse the position articulated Monday by a hospital spokesman. He said the hospital would allow a doctor retained by the family to insert a feeding tube and to replace the oral ventilator keeping Jahi's heart beating with a tracheal tube - surgical procedures that would stabilize Jahi if she is moved to a facility willing to keep caring for her.

Christopher Dolan, the lawyer for Jahi's mother, Nailah Winkfield, said he received the news as he tried to confirm the conditions under which the hospital would have allowed a visiting doctor and nail down the long-term care facility that might accept the girl as a patient. Dolan said he has been talking with the New Beginnings Community Center in Medford, N.Y., an outpatient client for people with traumatic brain injuries, and with an unnamed facility in Arizona.

The New York facility didn't immediately return calls seeking comment.

"They're speaking out of both sides of their mouths. They say one thing and we go down that road, and then they say something else," Dolan said of hospital officials. "The hospital said, `Bring us a doctor' and we said, `Tell us the conditions' and now, they've wasted a half a day of our time. We don't have much time."

Hospital spokesman Sam Singer said later: "This is academic. They have not produced a single physician."

Meanwhile, a state appeals court on Tuesday refused to order the hospital to insert the tubes, saying the issue has to go first to the lower court judge who has ordered the hospital to keep the girl on a ventilator until Jan. 7 pending the family's appeal. The 1st District Court of Appeal said it would consider the issue at a later date, if necessary.

Straus, the hospital's lawyer, reiterated in his letter that the hospital would release the girl's body as soon as her family provided a detailed plan outlining how the move would be accomplished and written permission from the coroner. But he said neither has been submitted.

"No facility has stated, unconditionally or otherwise, that it is prepared to immediately accept Jahi's body," he wrote.

Jahi underwent a tonsillectomy and related procedures at Children's Hospital on Dec. 9 to treat sleep apnea. Her family said she went into cardiac arrest after she started coughing up blood in the recovery room. She was declared brain dead three days later. The hospital then moved to take her off the machines that are keeping her heart and lungs going a few days before Christmas.

Doctors at Children's Hospital and an independent pediatric neurologist from Stanford University have concluded Jahi is brain dead.

Her family, citing religious beliefs and the hope that she will pull through, wants to continue life support. Alameda County Superior Court Judge Evelio Grillo initially ruled that doctors could remove her from the ventilator at 5 p.m. Monday, but two hours before the deadline gave the family another week to find a place to move her.

Straus filed papers Monday in both the state appeals court and in a federal court where Jahi's mother also has sued. He is opposing the family's request for an emergency order to keep Jahi on a ventilator indefinitely.

"The Superior Court correctly concluded, after three days of hearings and based on uncontroverted evidence, that Ms. McMath is, sadly, deceased," the papers state. "Turning off a ventilator that assists in delivery of oxygen of a dead person causes no irreparable harm - regardless of the parental or religious beliefs of the decedent's family."

The federal court has said it does not plan to act on the request until the case has worked its way through the state courts.

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francescop January 02 2014 at 6:50 PM

I live near Oakland and have followed this story daily in the San Francisco Chronicle. My understanding is that three doctors from Children's and two from Stanford have declared her brain dead. This situation is very similar to the case of Terri Schiavo, the brain-damaged Florida woman who died in 2005 after almost 15 years in a vegetative state. Her parents appealed every negative court ruling for that period. After the feeding tubes were finally removed, an autopsy showed that her brain had shrunk to half its normal size. I remember her mother stating that she could feel her daughter respond to her care despite the condition of her brain that the autopsy showed. My understanding of medical science is that brain dead is dead. This is a good time for everyone, who wants to relieve their loved ones from having to make these kinds of decisions, to execute a Living Will that will instruct your family about what to do in this kind of event. My father had one and it was a giant relief to be able to follow his instructions at the end of his fight with cancer. And he was able to die at home with his family nearby and not in a hospital. A pro forma Living Will can be found online and easily adapted to your specific needs. The hard part is facing, not your own death which is inevitable, but merely the prospect of our inevitable fate. Do it now!

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Fran January 02 2014 at 1:11 PM

My son is healthy. I am not faced with this emotional turmoil. I won't have to live with the questions. She's still breathing and there is still a heartbeat. Living with having taken a child off life support must feel like it was your choice to end her their life ................ like with abortions. A doctor at that hospital killed her. You'd think they'd be ******* up to her something fierce! Sueing the hospital and doctor is going to happen. But it's not my place to tell them the decision to make. Emotions make some choices hard to understand. This is the hardest decision a parent would need to make. There is a lot more too it then we read about.

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Ivy January 02 2014 at 12:27 PM

The hospital administrators and the judges need to put themselves in this mom's place. How can she give up on the hope that her daughter may still recover. Her daughter went into the hospital for a routine procedure and now they say she is legally dead. Her mom cannot reconcile this in her head because it should not have happened. My mom was on a ventilator and they wanted to remove it and I refused. After 7 days she was taken off the ventilator and though she needed occasional oxygen, she lived 6 more years! Why are they in such a rush to let this child go. At the very least, assist this family with love and kindness and help them get their daughter to a facility so they feel they have done what they could for her. They should not have to fight to save their daughter. Isn't that what hospitals are for?

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Jackie January 02 2014 at 1:53 PM

Your mother was not diagnosed brain dead either...Big difference. This child has been declared legally and medically brain dead by multiple board certified physicians. There is absolutely no brain electrical activity, no blood flow to the brain, no movement of eyes and reflexes...all stating that the brain no longer functions. No facility is going to take a dead body...that is what is the hold up and problem with this case. No physician is going to risk his license to perform a trach on a dead body either. This case is about the death of a child and the family becoming delusional.

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msdebello January 02 2014 at 12:14 PM

So sad - how do you get to the place where you can give up on your child?

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Jackie January 02 2014 at 1:59 PM

Same way that families deal and accept the death of a child from an auto accident, bike accident, or any accident for that matter. Many families have had to deal with this same scenario every day in this country...with cancer, with complications from surgery, from murders, from auto accidents, drownings, etc This family isn't any different from other families that have had a tragedy happen...the only difference, the other families didn't play their grief out in front of cameras and with lawyers..

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Constance January 02 2014 at 10:50 AM

Way to late to donate her organs parents should have done that weeks ago,then they could see her life threw helping another live child..that would have been kind since so many need organs...i think they understand they just do not want to understand........

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mclkarim January 02 2014 at 10:46 AM

My cousin had Alzheimer's and was in a nursing home for 20 years. His mind had been gone for a very long time but he was so physically strong that his body lasted way longer than it should have. His son told me that he believes that the Lord took his father's soul way before his body gave out. I had never thought about such a thing before but it gave me great comfort.

In a way this situation is similar. This article does not disclose what happened to cause heart failure and coughing up blood, but in any event, the child is legally dead with no hope for recovery. Her soul is already with the Lord so what is the point of keeping her body alive? The parents need to let her go and have a thorough autopsy done to determine if there is any reason for malpractice.

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ihave1465fans January 02 2014 at 10:45 AM

Due to the high cost of medical malpractice insurance we no longer have any surgeons working here, however we have the best lawyers in the city ready to perform your surgury !

I believe the hospital will win this one once emotions settle back into reality !!

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ihave1465fans January 02 2014 at 10:13 AM

This is not a matter of pulling the plug and letting the girl die. The girl is already dead. The machinery is merely keeping organs functioning. Get mom a mental health counselor !

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Grasshopper January 02 2014 at 10:39 AM

You ARE NOT DEAD until you have no heart beat. She has one.

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ihave1465fans January 02 2014 at 10:47 AM

then turn off the machine and see if it stays beating, if not then its only beating by artificial means !

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Becky January 02 2014 at 11:33 AM

Her heart did stop beating, they hooked her up to a machine that started it beating and is keeping it beating by artificial means.

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Susan January 02 2014 at 10:07 AM

The hospital responsible for the botch surgery of this child is standing in the way of parents making their own decisions. No one else's opinion matters at this point. Let the family handle it in their own way. They have the right to make that choice.

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ihave1465fans January 02 2014 at 10:23 AM

What makes you think it was botched, The girl was obese, it was not a roiutine tonsillectomy, and the girl went into cardiac arrest, by the time they could revive the heart she was brain dead.

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ihave1465fans January 02 2014 at 10:04 AM

It's become clear that many people, Jahi's family included, don't understand or believe in the difference between brain death, in which all functions of the brain and brain stem have irreversibly stopped, and a coma or vegetative state, in which there is brain activity.

In doing so, we're exhibiting some of the same kind of denial that this family is caught up in. We're trying to rationalize death. We're operating under the assumption that there's an answer that can undo what has happened, or prevent it from ever happening again, if only we look hard enough. But if that were true it would be a miracle. And as Jahi's family will learn soon enough, you can't force those by artificial means.

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