Trials & Tribulations: Jahi McMath: Merely Dead, or Really Most Sincerely Dead?

Monday, January 6, 2014

Jahi McMath: Merely Dead, or Really Most Sincerely Dead?

GUEST ENTRY BY KZ!

This is a GUEST ENTRY by KZ. KZ is a CRNA (Certified Registered Nurse Anesthetist), who wrote the excellent series Dr. Murray's Death Drip Explained. KZ weighs in on Jahi McMath's current condition.

WARNING: Not for the faint of heart. Sprocket.

Prior & New Stories:
01/01/14 Jahi's Legacy - by CaliGirl9

01/03/14 The Long, Sad Death of Jahi McMath - by CaliGirl9
01/10/14 Jahi McMath: A Body in Limbo - by Sprocket
01/13/14 Legal History of the Jahi McMath Case - by VenomousFeminist

UPDATE 1/9/14: Sprocket here. For answers to medical questions about Jahi's diagnosis and condition, I highly recommend the blog Stories from the trauma bay, written by a physician who blogs under the moniker Doc Bastard. Doc Bastard has written several posts on the Jahi McMath case. (You can also find a link to his blog in T&T's blog list, on the right.)

Later today, I will working on a T&T "Quick Links" page for this case. Quick Links pages will gather in one place, links to all the stories written on T&T, the court documents, relevant news stories and links to twitter and Instagram pages. If you have a link to a story from an accredited news source, you can email it to me, or leave it in a comment.

Also, if you have found T&T helpful in understanding what has truly happened in this case, please consider recommending T&T or a specific post on Google. Thank you!

UPDATE 1/7/14: NCBI- Organ Preservation in a brain dead patient: information support for a neurocritical care protocol development

UPDATE 1/6/14 5:40 PM Children's Hospital Oakland, Supplemental Declaration of Dr. Heidi Flori

Jahi McMath

Source: Keep Jahi McMath on life support, Facebook page

Jahi McMath: Merely Dead, or Really Most Sincerely Dead?
By KZ
Last evening, January 5, 2014, the body of Jahi McMath was released by Children’s Hospital Oakland, to the Alameda County Coroner’s office. A Death Certificate has been initiated by the Alameda County Coroner, pending final completion upon the autopsy of Jahi Mc Math at a later time. The Coroner has released Jahi McMath’s body to the custody of her mother, Latasha Nailah Winkfield, for …..

Ongoing care and admission to another health care facility?

Or

Family religious and cultural rituals, including transportation of the body of their loved one, pending final disposition?

Your individual point of view on this tremendously tragic case will determine which of the above phrases you prefer to use to complete the first paragraph.

The family spokesperson, Jahi’s maternal uncle, the family attorney, and the cosmetologist spokesperson for the nonprofit, non-healthcare facility community center in New York (a building which rents space to therapists, not a licensed or regulated health care facility) offering to (care for vs temporarily store) Jahi’s body, continue to advance their agenda that Jahi is merely “brain damaged”, and as such, is entitled to state and federal protections. There is speculation by a number of web commentators and bloggers that this insistence on “brain damaged and disabled” versus brain dead, and “really most sincerely dead” is simply an attempt to preserve Jahi’s “aliveness” in preparation for a flurry of court actions designed at recovering monetary damages in excess of California’s pain and suffering caps. The uncle, in a recorded press conference referred to the number of $250,000 as “chump change”, and suggested that the more appropriate number is $30,000,000. Thirty million versus $250,000. Maybe it’s just me, but it is pretty unseemly to be tossing around these kind of numbers while Jahi is still alive. Or wait—is Jahi alive? Is Jahi dead?

The family took custody of Jahi’s body from the Coroner, and completed whatever process was requested to officially receive HER REMAINS. I can’t apologize for my use of caps there, because I thoroughly believe that the young teen with the bright smile died nearly 4 weeks ago. The last 3 ½ weeks has only been a painful and grotesque battle over who gets her body, and when. A contentious stalemate between a world class health care facility, and a family in the throes of anger, denial, and grief.

For the last 3 weeks, we have all read and heard about what brain death is, and what this family believes it isn’t. We have seen grainy examples of diagnostic tests, and discussions of “electrical silence” from EEG’s, and failed apnea tests. We have marveled and recoiled at discussions of spinal reflexes, and forced ourselves to watch videos of unfortunate souls with brain death who demonstrate Lazarus sign.

But for just a few paragraphs, I’d like to talk about another difficult set of facts that apparently none of the mainstream news reporters are willing to research and discuss. Possibly out of respect and deference to a grieving family, or for some other unknown motivation, I don’t know. Let’s talk about an anatomical certainty for a just a minute.

I am convinced most who read here are well informed about the process for determining brain death, the bedside tests and assessments, as well as the electroencephalograms and SPECT radionuclide perfusion tests demonstrating complete lack of blood flow in brain death.

Approximately 3-5 days after a determination of brain death, a process called “autolysis” begins in the brain dead individual’s brain. To put this in very blunt terms, the non-perfused brain begins to soften and liquefy, coagulating into a congealed mass of dead tissue, enzymes, and other products of cell death.

That is a miserable, grievous paragraph to write when you are discussing what has happened inside the skull of a much loved, shy 13 year old young girl with a beautiful smile, but this is what happens in EVERY case of brain death that is prolonged by mechanical ventilation. EVERY case. And I meant to use caps there for emphasis. The absence of blood flow cannot be reversed. Ever. By any means. There is no “waiting for the swelling to go down.” Most of the studies cited below are for populations of patients brain dead an average of less than 99 hours (4 days). Jahi Mc Math has been brain dead for at least 24 days, as of January 6, 2014.

From: The Paradox of Brain Death, by Pauline W. Chen

While normal brain tissue is firm, a brain that has been dead shows progressive autolysis, a form of biological self-destruction. “It will almost be like soup,” Dr. Harry Vinters, chief of neuropathology at UCLA, recently explained to me. He is the co-author of a major textbook on the pathology of the brain and has performed almost a hundred autopsies on the brain-dead. “It really depends on how long they have been on the ventilator. If they have been on the ventilator for two days, then the brain is grey and softened. But if, for example, a family has had difficulty deciding what they want to do and the patient has been kept on the ventilator for two to three weeks, then there’s tremendous autolysis. The brain gets very swollen, soft, and mushy.” The nerve tissue can become so friable that fragments of brain from the head will break off and float down the spinal column. “Sometimes I’ll be looking at a slide of the spinal cord,” says Vinters, “and I’ll see fragments of cerebellum floating around in the specimen.”

There is no rehabilitation for a liquefied and congealed brain. There is no hope for this individual to ever have any improvement whatsoever. Time and “nutrition” will not heal her brain, because in effect, she has no brain. The organ that was her brain is gone, completely and utterly gone. It is as if she has been “functionally decapitated”. This is what happens in brain death. This is the hard, sad, miserable, awful, grotesque TRUTH about what brain death is. This is why brain death IS death, and is recognized as death, as certain as cardiac death. No amount of wishing, magical thinking, hope or prayers will bring back Jahi McMath. Jahi does not need our prayers—but her family does.

References:

Wikipedia: Single-photon emission computed tomography

Nuc Med Resource: Brain Death Scan

NCBI: Stability and Autolysis of Cortical Neurons in Post-Mortem Adult Rat Brains

NCBI: On the Autolysis of Brain Tissue

SPRINGER: Autolysis of the granular layer of the cerebellar cortex in brain death

RESEARCH GATE: A clinico-neuropathological study on brain death

VQR: The Paradox of Brain Death

305 comments:

«Oldest ‹Older 1 – 200 of 305 Newer› Newest»

Unknown said...: Very interesting and informative. Apparently the family want to insert a feeding tube into the child's body. I wonder what sort of consequences that would have.; January 6, 2014 at 11:05 AM
Anonymous said...: I'm worried they are somewhere trying to feed her. Pouring Carnation instant breakfast or something down her throat. This is very believable at this point because nothing they have said or done up until now makes any sense.

I wish the mother had a few people around her to gently take her aside and help her let go. Instead they all appear to be losing grip on reality. Hope this isn't headed for a huge lawsuit. I fear it already its.; January 6, 2014 at 11:23 AM
Anonymous said...: Very, very good article and thanks! I had been trying to find something that explained, in clinical terms, what was happening to the brain during these past 3-4 weeks.; January 6, 2014 at 11:24 AM
Anonymous said...: Hopefully the space and (one would hope!) quiet away from the hospital will help this poor woman come to terms with her beautiful daughter's death. So much has gone wrong here but at the core a mother has lost her child, of course she is irrational, but hopefully not for much longer. Thank you for the explanations and updates.; January 6, 2014 at 11:38 AM
Sara Tonen said...: The diagnosis of brain death was created for the sole purpose of being able to legally & ethically harvest organs from bodies with beating hearts. One day we cared for the 'brain dead' and the next day we decided this mindset was antiquated and we could save countless lives by taking the organs from people with a pulse. Prior to 1968 the only accepted true-death was cardiac death. Jahi McMath's days of a beating heart are numbered. It doesn't matter what sort of treatment she receives, her heart will cease to function sooner rather than later. People dxd with TBD do not, nor have the ever, languished around for years on artificial ventilation. Regardless, to perpetuate the notion she will recover is to pander to the masses who love a human interest story. But the fact remains until her heart stops beating she is not a corpse and she isn't biologically dead. Brain death is accepted in all 50 states but do not think that all healthcare professionals are on board with it. I suggest reading the book Finis Vitae, if nothing else than to familiarize yourself with the other side of the debate.; January 6, 2014 at 11:48 AM
Sprocket said...: Sara Tonen,

It would be helpful if you referenced a reputable source for this statement:

"The diagnosis of brain death was created for the sole purpose of being able to legally & ethically harvest organs from bodies with beating hearts."

It's my opinion your statement doesn't accurately represent how and why the courts in all 50 states recognize brain death as "Really Most Sincerely Dead."; January 6, 2014 at 11:54 AM
Anonymous said...: I read several articles about tonsil hemorrhage and all of them seem to be similar to Jahi's story, except that most serious hemorrhages are treated with emergency surgery to recauterize. I wonder why that was not done, if it happened too quickly? I hope that the truth comes out about whether the hospital had any responsibility for her death. I hope not. I hope this was just one of the 40,000 cases where hemorrhage happens. At the same time, I feel for this family and for all those who are grieving for a loved one. I wish this turned out differently. At the very, very least, her mother can know that millions of people felt the loss of her child. Thank you for this site- this was the first place I turned to after hearing the news.- DH; January 6, 2014 at 11:57 AM
Anonymous said...: KZ - thanks for the informative post from a medical perspective. Beyond the clinical aspects of the information, It’s actually a very important philosophical point that informs the greater issue of what is life and death, which in turn informs policy. It's macabre, but necessary to play out scenarios like the below:

Would you mind commenting a bit further, from a medical perspective on how Jahi’s body would decompose (or not decompose) if theoretically kept in homeostasis for years or decades? Removing human error, ie a magical box that keeps Jahi’s body in perfect homeostasis, would Jahi mature into a woman? Would her nails and hair grow? Would she get acne like so many teenagers? Would she grow taller? Her brain will never re-generate, correct? But will body would continue to act as bodies do over time, even though her body is not informed by her brain in any way?

Brain dead pregnant women seem to be the most studied cases, and though it’s often reported the babies are healthy after delivery, the reports never note the condition of the mother’s body—simple things like did the medical staff have to clip the mother’s finger nails or does the mother have 2 inch long fingernails after 3 months?; January 6, 2014 at 11:58 AM
CaliGirl9 said...: KZ, you rock!

Hi Hekate Hades I can’t find a great deal of information regarding what happens while keeping a brain-dead person above ground. However, there are studies about gastrointestinal functioning in traumatic brain-injured (TBI) patients. So, I'm guessing the "feeding tube scenario" will go like this:

The gastrointestinal system, like the heart, has its own electric system, so it does not need the brain in order to function. However, it is not functioning perfectly due to hormonal and electrolyte imbalances. In TBI patients (which is the closest thing we’ve got in this area of study), the gut is not functioning well enough to keep its balance of good bacteria versus bad bacteria in check. Microscopically, the cells in the gut are more permeable, so fluids, including toxins, water, etc. are more freely able to pass in and out of the cell. This is not a good thing. When certain types of bacteria get into places of the body that they aren’t supposed to be, sepsis occurs. Think of people with E. coli sepsis. E. coli is normally found in our large intestines, but certain strains have caused major gastrointestinal illness and death from sepsis and multi-organ failure. (Note to medical types: I am greatly oversimplifying, I know. I don’t want to get into cytokines, and fibrinolysis…)

In short, the intestines of a brain-dead person are able to absorb nutrients, but in the case of an intestinal system that has not been fed in 3 weeks, autolysis is already taking place. I’m guessing there is the possibility of fistulas, both internal and external, working their way through the intestinal wall. There will be stool produced, and in all likelihood it will either leak (liquid) or need to be manually removed (impaction).; January 6, 2014 at 12:12 PM
CaliGirl9 said...: Hi Anon @ 11:58

Regarding your questions about puberty, menstruation, etc. Those will not happen because the pituitary, specifically the anterior pituitary, is needed for feedback for the ovaries to know what to do. Additionally, the anterior pituitary secretes growth hormone, so that’s not happening. The posterior pituitary is responsible for cueing the adrenal glands, sitting atop the kidney, to concentrate urine. Failure to do this is diabetes insipidus, and we already know Jahi has this from her uncle’s comments.

However, there ARE hormone replacements. I sincerely pray there is no Dr. Frankenstein out there willing to give that poor deceased child hormones so she menstruates or grows. My opinion is that she will not be above ground long enough to get those systems up and running.

Her muscles have no doubt atrophied (shrunk) over time. Because there is no brain, there are no voluntary muscle movements. Spinal arc reflexes are not enough to keep muscle tone.

In one of the previous threads, we were visited by an RN and a physician who were involved in caring for a brain-dead pregnant woman. Hopefully they will stop by and answer your question. Where I worked, we simply did not hold onto ventilator-dependent patients, let along possibly brain-dead patients, for more than a handful of hours.; January 6, 2014 at 12:26 PM
Anonymous said...: Sara- there are several cases of brain dead children kept alive on ventilators for 10+ years. Look into the work by Dr Shewmon- specific to patient "T.K"- this patient spent years brain dead on a ventilator, albeit with feeding tubes. He sites several other examples under the "truth will set you freer" blog which can be found if you google Dr Shewmon TK. Its interesting reading, although morbid- but remember, there is a legitamate religious case to keep the body alive until the heart stops. Whether that is a rational arguement when ventilation is needed I cannot say.; January 6, 2014 at 12:37 PM
Anonymous said...: - In one of Shewmons studies the patient went through puberty while brain dead and all grew at a normal rate, one from the age of 4 into adulthood; January 6, 2014 at 12:39 PM
Craftylikeafoxx said...: I've been really curious as to what happens to the brain... After all, Terri Schaivo's was said to mostly liquid at autopsy. So the details you gave were exactly what I was curious about. Brain fragments breaking off.... That surprised me!

I had sympathy for the family in the beginning, and although it may sound harsh, I have none whatsoever at this point. I've followed this circus from the beginning very close, and as more and more info comes out it's apparent money is the goal. The "official" Jahi website givejahiachance.com is just a cover page to get you to the link of the go fund me page. I expected to see lots of pictures and stories about her life, nope! Just 3 pictures of Jahi, then of course pictures of her crying mother that seems to never have tears, just a scrunch face. Oh, and a poor me letter by mom. At this point, I totally think Munchausen By Proxy along with greed is fueling her.

Seeing this article this morning:

http://www.latimes.com/local/lanow/la-me-ln-jahi-mcmath-safety-concerns-20140106,0,2800807.story#axzz2pTdVysJs

It makes me wonder what's next for this circus... I can speculate where this statement will go... Because of the hospital fighting and all the publicity no Dr. or facility will take her because they wouldn't be safe? I'm sure there's something up their sleeve.; January 6, 2014 at 12:52 PM
Anonymous said...: Thank you so much for your accurate reporting on this sad case. This is turning into a Trayvon Martin circus, with the printed T-shirts, posturing by the family, and the one-sided manipulation of of the "optics" for public empathy. They are now thinking dollar signs. I hope the hospital has an air-tight case, and I hope this family doesn't get a dime. They are playing the system, seeing a lotto win, and re-animating their dead daughter in a most horrible way to further their selfish cause.; January 6, 2014 at 1:00 PM
Anonymous said...: I would first like to thank everyone who contributed to this and the original thread. I've spent most of today reading up on this and doing a bit of researcy myself. I keep seeing references to the family feeding her a hamburber, popsicle and making her laugh and talk immediately following the surgery. Does anyone have any links about this? - Dee; January 6, 2014 at 1:26 PM
Sprocket said...: Anon @ 1:26 PM

If you read CaliGirl9's first post again, you will see that references to eating a hamburger and talking were from comments she read on mainstream media stories.

I'm not sure of the "popsicle" comment. I believe I've read statements my other medical professionals that they are sometimes given by staff at other hospitals.

There has been quite a bit of misinformation in the mainstream press and the family's statements can not be considered an unbiased source of information either, as to what Jahi was doing, and when.

Sorry I can't be more helpful.; January 6, 2014 at 1:32 PM
Anonymous said...: Nope, you told me what I needed to know. I've only seen references to the hamburger in comments' sections too.
- Dee; January 6, 2014 at 1:35 PM
Anonymous said...: Meanwhile, on the same day as Jahi was pronouces brain dead, so was Sanaz Nezami. Her family showed dignity and grace, donating 7 organs to those in need, while suffering just as much as Jahi's famly.; January 6, 2014 at 1:37 PM
Sprocket said...: Great blog post by a trauma surgeon, who explains some of the misinformation in Jahi McMath's case.

Misinformation by "Doc Bastard at his blog Stories From The Trauma Bay; January 6, 2014 at 1:44 PM
4myfavoritethings said...: I've been following your post, most informative on so many levels.
I'm thankful that the CHO staff, patients, other parents & visitors no longer have to deal with this family.

While I'm interested in the physical things going on what about the legality of this situation ? What kind of precedent has this set with the release of the body from the coroner to the mother ? Can a family member take a 'body' home and care for it somehow ? I just can't believe that there is a place that would take this case ie body or any doctor that would insert a feeding tube .; January 6, 2014 at 1:47 PM
Anonymous said...: Internet is buzzing with reports that other patient families saw McMath family members suctioning Jahi in ICU, which may have caused her bleeding. This farce is being played out to cover what they did and to get $$$. Step-dad said in press conference last night (with Hell-bound lawyer) that the family was being discriminated against because they had to wear different kinds of badges from other patient families. (One set laminated, others not.) Boo Hoo! Other families were not allowed to have 8 members present. in ICU.; January 6, 2014 at 2:02 PM
Craftylikeafoxx said...: So she is touch and go due to lack of nutrients?

http://www.dailymail.co.uk/news/article-2534820/Jahi-McMath-13-not-make-day-released-mother-lawyer-says.html

I wonder... And it's my own curiosity.... Is the tissue in the throat damaged from decomposing?

Oh, and towards the bottom of this article.... The undisclosed location appears to be moms house
"Jahi left Oakland's Children’s Hospital & Research Center about 7.50pm in a critical care ambulance to the home of her mom, Latasha Winkfield."; January 6, 2014 at 2:04 PM
Craftylikeafoxx said...: Also, all of the "waste" products coming from a dead body, uhhh.... I would assume that its a biohazard. Can she really have all that going on at a home?; January 6, 2014 at 2:06 PM
Anonymous said...: Won't the Alameda county health department want to know where a decomposing body is being kept? I agree with Craftylikeafoxx....assume a biohazard situation is being created.; January 6, 2014 at 2:26 PM
Anonymous said...: I worked in neurosurgical trauma ICU at a Level 1 Trauma Center and teaching hospital in NY metro area. I have cared for approximately 30 brain dead individuals during my career. Some organ donors, some not. I took care of a 16/17 year old boy in a very similar circumstance - family not willing/able to let go. We kept him in ICU on a vent and basic support (did not feed) x 2 weeks. TMI warning. By the end, the whites if his eyes were liquidating, and his skin was sloughing off his backside in sheets. We were still performing basic care like bathing, turning, skin care out of respect and utter empathy for his poor single mother with no social support. There was no doubt to me that he was dead, as he was essentially decomposing. The smell was not of a corpse, but incredibly foul and we spent many hours trying to control odor, for both mother and other patients/visitors in ICU. I don't know if feeding would have made a difference; I cannot recall any brain dead patients ever defecating. This is such a sad sad story.; January 6, 2014 at 2:44 PM
Sprocket said...: Dear T&T readers:

If you've found CaliGirl9 & KZ's stories about Jahi McMath helpful and informative, please recommend the stories on Google®. Thank you!; January 6, 2014 at 2:54 PM
Craftylikeafoxx said...: @ anon 2:44pm:: I totally see why in the court hearing on Friday the lawyer for CHO said the staff felt demoralized having to take care of a corpse. Hopefully they can sue her for that!

I think they expected her to be in this state, Chris Dolan has something planned for them to be able to get more money.

Although it was very clear in the last court hearing that she is taking full responsibility for the body, I hope that works against her. I think they had no choice but to take that agreement. If all the sudden they said no, never mind... Then it would have been obvious that this is for money.; January 6, 2014 at 3:04 PM
Anonymous said...: I don't think that Jahi is at her Mom's home. There would be pictures from all the reporters buzzing around, right? I am actually curious about who is treating her, it's most likely Paul A. Byrne or similarly minded doctors.

The hang up is that doctors are usually licensed state-by-state, correct? There are compliance reasons that keep just any doctor from performing on just any patient? It would not surprise me if the reason the location is being kept a secret is related to the compliance of the doctors supposedly doing work on her since leaving CHO.

Also, given the national attention this case has garnered, it just dumbfounds me that the 'secret' location has not been revealed?

Something seems off...; January 6, 2014 at 3:27 PM
Craftylikeafoxx said...: Just doing a little researching... I found that when a family has control over the body rather then the hospital, they can refuse an autopsy. And although a cause of death is needed for a wrongful death suit, an autopsy isn't required. I have been reading a lot of statements made by Dolan about a rights violation. Maybe that's his sneaky angle to get more money.

A court hearing scheduled for Tuesday regarding whether feeding and breathing tubes can be inserted into Jahi may be canceled since she has already been transferred to another facility, Dolan said. The legal issue that remains outstanding is whether the family’s rights to make decisions about the girl's care were violated.

http://www.latimes.com/local/lanow/la-me-ln-jahi-mcmath-transfer-brain-dead-20140106,0,5200263.story#ixzz2pfEBu3Rn; January 6, 2014 at 3:29 PM
Anonymous said...: I hope that the hosptial took photos before she left. I wonder if the coroner was hoping that the heart would stop in the ambulance. I had noticed the comment about them taking her to her mother's home, and it makes me wonder just what kind of care she is getting.; January 6, 2014 at 3:39 PM
Anonymous said...: Yet another thought. How will the decomposition that is happening affect finding the reason for death? Will it play in favor of the family's lawsuit or the hospital?; January 6, 2014 at 3:56 PM
worm killa said...: "There is no rehabilitaion for a liquidied and congealed brain" Boom!; January 6, 2014 at 4:03 PM
Anonymous said...: Here is a sworn statement from Dr. at CHO
http://media.nbcbayarea.com/documents/HeidiFlori.pdf; January 6, 2014 at 4:06 PM
Anonymous said...: @:11:58 Homeostasis: "The ability or tendency of an organism or cell to maintain internal equilibrium by adjusting its physiological processes."
****
I have seen the word batted around on a couple of blogs now and not sure if people KNOW what it means....the body tends to try to self regulate normally.
However....Braindead the body is being artificially kept alive by Venting it and adjusting blood gases etc. I think the blog does a pretty good and gives a graphic example of this body is not in "Homeostasis". Far from it. It is in a advance stage of decomposition.
I'm mystified why someone would even ASK such a thing, like she is just sleeping and the fairy prince will kiss her and wake her up...magical thinking fairytale idiocy. You seem to have a morbid fascination with the death processes, perhaps you should go to embalming school...or not.
I'm seeing lots of weird questions such as this with a word thrown in "Homeostasis" in hopes it will make sense. It doesn't.
Go take a biology class.; January 6, 2014 at 4:15 PM
Sara Tonen said...: Sprocket, actually Harvard Ad Hoc gave TWO reasons for redefining death. The first was to address family distress and/or the (non) issue of 'potential' overpopulation of medical beds. Yeah sure, uh.. ok. The second reason was related to organ harvesting. The article is in pdf format

http://www.hods.org/english/h-issues/documents/ADefinitionofIrreversibleComa-JAMA1968.pdf

Prior to 1968 Harvard Ad Hoc , an individual in Jahi's condition was considered living - not dead, brain or otherwise.

Here is a very comprehensive article covering the history behind HAH, complete with references. It's a long read but very informative. It's just one of many. When researching how 'brain death' came to be, you can't get very far without running into organ transplantion. Without organ harvesting, there was really no need to define a person with a beating heart as being 'dead'.

http://www.im-glyfadas.gr/01/10/01100037.asp

As for how/why regarding all 50 states, I do not know the answer. A nation once thought it was ok to exterminate human beings based on their race/religion. The masses are often asses New Jersey is the only state that allows a religious exemption to brain-death criteria and NY requires "reasonable' accommodations be made in situations like Jahi's, although they don't define what those accommodations are. The 1968 Harvard ad Hoc is often revisited and further attempts are made to *expand* what defines death which is, at best, of grave concern.; January 6, 2014 at 4:18 PM
Anonymous said...: Excellent piece KZ, I hope that it will help anyone out there who still has any doubts or misunderstandings about brain death. Also, the comments by CaliGirl9 about GIT function and hormones is very accurate. I would also recommend DocBastard's articles on Jahi - he has written three excellent pieces about her including one that answers many layman's questions about brain death. I'm a big fan of his cynicism but for these write ups he has maintained a lot of sensitivity and compassion whilst still remaining brutally honest.
- Artefact; January 6, 2014 at 4:20 PM
Anonymous said...: thank you.; January 6, 2014 at 4:23 PM
Anonymous said...: Yeah, she's really dead and I doubt her body will last much longer. Here's a link to a declaration filed by one of the CHO physicians documenting the deterioration.

http://goo.gl/mqSQQI

RIP Jahi; January 6, 2014 at 4:34 PM
Anonymous said...: I've been following this blog for the legal aspects of this case, as well as a discussion of this case on All Nurses. Found this document that was presumably presented last Friday during one of the court hearings, from a CHO Pediatrician.

http://media.nbcbayarea.com/documents/HeidiFlori.pdf

Pretty much outlines the decline Jahi's body, as of last week. If indeed this was presented to a judge - how in the world could the judge still allow the transfer?

I despair for what is becoming of the legal system.; January 6, 2014 at 4:42 PM
Anonymous said...: Anon at 2:44,

It seems apparent that Latasha Winkfield is never going to accept her daughter's passing until she sees these gruesome changes with her own eyes. I find my thoughts travel to the psychological fitness of the mother. I realize that not all people grieve in the same ways but we do have psychiatric professionals capable of determining if grief has transmuted into something else, something mentally unhealthy. Is she capable of making rational decisions on behalf of Jahi's body? I am concerned that some of her statements indicate an amalgam of delusion and Kübler-Ross model bargaining. I note undercurrents of guilt and masochism, and narcissism. Latasha Winkfield is unable to face the reality of her daughter's death and what should be determined, by professionals, is whether or not she cannot or will not process; the distinction is important, especially with regards to the remaining minor in her household and what kind of exposure to this situation she [Jahi's sister] is facing.; January 6, 2014 at 4:44 PM
Anonymous said...: Court Document: Medical analysis of Jahi McMath's deteriorating condition.

http://www.mercurynews.com/bay-area-news/ci_24855412/document-medical-analysis-jahi-mcmath-deteriorating-condition?source=pkg; January 6, 2014 at 4:48 PM
Anonymous said...: i find this so very sad and frustrating. the attorney is saying that she's "in worse shape than we thought". what? she's dead. how much worse is there? he's despicable. of course he didn't think he could help redefine death. he must have just seen a potential money-making opportunity. he's a disgrace to his profession, imho.

this will negatively affect families and all healthcare professionals. "but is dad 'really' dead?". "are you sure?". i feel so sorry for those people who will have to face those looming questions. as if a doctor/nurse's role isn't hard enough. to then be doubted about the most basic facts...; January 6, 2014 at 5:19 PM
Anonymous said...: Her body is, according to the UK Daily Mail (big pinch of salt), already deteriorating and will not last the night. SO sad that this all could have been avoided.; January 6, 2014 at 5:46 PM
Anonymous said...: Sara Tonen, did you read and comprehend the articles you posted, because they don't say what you are purporting them to say.
-VenomousFeminist; January 6, 2014 at 5:55 PM
Sprocket said...: I see that readers are posting the document (Dr. Flori's declaration of Jahi's condition) that some are saying was presented in court on Friday.

I'm not sure this statement was presented in court on Friday for the following reasons.

The copy that is circulating in the media (I've put a link to it as an update at the top of the post), doesn't have a court filing stamp on it. It's also dated for TOMORROW, 1/7/14.

A good possibility is the document was given to the media by the public relations firm representing the hospital. I don't know. If someone has a media report that indicates how the document was found (Alemeda Superior Court web site or received from CHO public relations firm or CHO counsel) I would appreciate it.; January 6, 2014 at 5:57 PM
Sprocket said...: VenomousFeminist:

This was my exact problem with the initial statement I quoted. I don't believe Sara is making accurate statements as to why in all 50 states, brain death is a gold standard. The heart is just an organ, like many others, independent of the brain.

Conscious thought, and everything that makes us a living, thinking human being, resides in the brain, not the heart.; January 6, 2014 at 6:02 PM
Coconut said...: The poor hospital staff having had to deal what that...!

So, a coroner who is appointed by the state, can go against the state's H&S laws regarding the length of time one can keep a body, where, etc? If he signed and certified that she died on Dec 12, will this now mean everyone can keep a body for 3 weeks or more and have it "operated" on?
I wonder how they can justify this in view of Cali and/or USA legislation?; January 6, 2014 at 6:14 PM
Unknown said...: I just watched the uncle on Piers Morgan. He is now claiming that Jahi is moving her neck and head and that Attorney Dolan has also seen this.

The level of denial appears to be extremely high as they get further and further out on the limb.

Did anyone else watch this? Thoughts?; January 6, 2014 at 6:49 PM
Sprocket said...: T&T readers,

I've provided a direct link to Dr. Heidi Flori's court statement. It's at the top of the blog post for easy access.; January 6, 2014 at 7:08 PM
Craftylikeafoxx said...: @ sprocket.... I'm in a crazy lawyer family law battle. The date at the bottom is when he wrote it out. Which is a surprise because that was the 3rd. Anyways the date up top (7th) was for their court date tomorrow that was cancelled after this was filed. I was looking through my stuff and all of my responses were filed 24 hours prior. I am just speculating off my own court documents, but I would assume its similar. I am also in California.

Info also think that it's a stretch that she is at the mothers home, I would assume if it's a house, it was probably set up up just for this. Maybe renting. Even though that's a stretch. But I can't wrap my head around any facility taking her. Unless maybe a hospice? Maybe a nurse with hospice experience would know more?; January 6, 2014 at 7:12 PM
Sprocket said...: Thank you Craftylikeafoxx.

I don't know how they do things in Alameda County. I'm used to Los Angeles County, where, a document is not considered "filed" until it has that filing stamp on it. Down here, that's my "gold" standard.; January 6, 2014 at 7:24 PM
Sprocket said...: It's my opinion that Jahi is in a facility and not at her mother's home. But hey, I could be wrong about that, too. :D; January 6, 2014 at 7:24 PM
Anonymous said...: I wonder (or maybe I missed it) about her biological dad? Would he have any say in this matter? Deb; January 6, 2014 at 7:30 PM
Anonymous said...: Quote from the (delusional at best, intellectually dishonest at worst) attorney:

'Jahi is in very bad shape. Right now we don’t know if she is going to make it. The doctors are doing everything they can to help her make it through the day.'

What a definitive, albeit sad, win for science. Win in the sense that brain death (when correctly diagnosed) is final -- nothing brings brain dead people back.

To be clear -- if a family wants to privately fund the ventilation of a dead body, that’s fine with me. It’s never something I would support with my own loved ones, but to each their own.

I’m interested in the family and attorney’s reaction after heart failure?

Anyone think this is just going to go away?; January 6, 2014 at 7:33 PM
Anonymous said...: With e-filing, things are filed when they are e-filed and an electronic receipt is received. The clerk will stamp their hard copy, but it will reflect the date the document was e-filed.

- VenomousFeminist; January 6, 2014 at 7:36 PM
Anonymous said...: In the following article the lawyer says:
"Jahi is being stabilized so that she can be given a feeding tube, and that she was already receiving potassium intravenously."

What does that mean for her current detriorating body??
Jahi McMath receiving nutrients, family says - SFGate; January 6, 2014 at 7:39 PM
Coconut said...: It was said (uncle) that she was move to a Catholic facility...

Anyone see this interview with the NY facility...? She does not even know the difference between brain dead and coma and talks about speach training and the like... OMG

http://video.foxnews.com/v/3017790803001/could-jahi-mcmath-make-a-miracle-recovery/; January 6, 2014 at 7:43 PM
Anonymous said...: I seriously doubt she is at her mother's home. For one thing, Mom lives in the middle of a busy populated part of Oakland. I think that some of less reputable media outlets interpreted "released to the custody of her mother'" as meaning she was going home.; January 6, 2014 at 7:45 PM
Anonymous said...: I'm worried for the mother when the autopsy confirms the worst: her daughter's brain has turned to mush over weeks of whole brain death and that the other organs have, after all this time, failed. They can roughly date the deterioration, correct? Can anyone confirm this? It will only validate what the hospital asserted and prove that she kept Jahi's body in this terrible stasis for absolutely no reason other than her inability to accept tragic reality.; January 6, 2014 at 7:47 PM
Sprocket said...: VenomousFeminist:

So Alameda County has e-filing, correct?

Los Angeles County Superior Court... does not. It's all manual filing.; January 6, 2014 at 7:48 PM
Sprocket said...: Anon @ 7:47 PM
It's my understanding that Dr. Heidi Flori's statement has already documented the decay that was observed in Jahi while she was still at Children's Hospital.; January 6, 2014 at 7:50 PM
Anonymous said...: Sprocket,

Is this something they're going to allege is due to the hospital's refusal to "feed" Jahi? Does it appear to you that this is what they're gearing up to do?; January 6, 2014 at 7:57 PM
Sprocket said...: Anon @ 7:57 PM

To be honest, I am sleep deprived for the past two days.

(I've worked to get the three stories formated and publishe by KZ and CaliGirl9 and I'm working on several sewing projects late into the night.)

I have not fully read, just skimmed some of the legal documents. I believe this is not about love or life or grief or an inability to let go.

I believe it is about revenge, power, hate, exploitation....

I believe the family will eventually file a lawsuit against the hospital, if it hasn't done so already. The family representative as much said so, with his comments about $250,000 being "chump change."

Whatever move the attorney makes, understand that something that is said or implied in a court filing doesn't make it so. In a court document you need facts (and prior appellate court decisions as the basis of your arguments to prove something to be true.

We will have to wait and see what the family's claims are, in their court filings. How they go about "proving" their claims will be another issue entirely.; January 6, 2014 at 8:07 PM
Anonymous said...: Seems it would be difficult to seek compensation for pain and suffering alleged after the date on a death certificate? How much pain and suffering can a dead person go through?

Further, I don't think anyone is liable for pain and suffering caused by pathological refusal by family members to accept the death of a loved one?

If what Sprocket writes is accurate, that all this has been some sick money grab on part of the attorney and family, then I hope they lose in public disgrace along with civil and criminal repercussions as ruthless as using a little dead girl for financial gain.; January 6, 2014 at 8:25 PM
Craftylikeafoxx said...: I agree sprocket... Nothing good or godly is behind this. At this point, their 50k they've gotten from donations is enough, I hope they get nothing else.

It does surprise me that with all of the resources to educate ourselves on things.... these people are donating and praying for a miracle. Especially these $500 and $1000 anonymous donations... Blows my mind.

Maybe this secret facility is actually the morgue; January 6, 2014 at 8:56 PM
Anonymous said...: For the last couple of weeks, the family has publicly claimed that she has been improving, looking good, responding to her mother's voice, starting to move, etc. and that was proof that she was still alive. Now today the attorney said that she has been deteriorating over the last few weeks because they haven't fed her. I think if the family and attorney are going to lie, they should at least be consistent!; January 6, 2014 at 8:57 PM
Anonymous said...: Terrific job, all bloggers!
As a neurologist, I truly appreciate your efforts to present the facts in this sad tale.
Get some rest!; January 6, 2014 at 8:59 PM
Sprocket said...: Thank you Anon @ 8:59 PM & the rest of T&T readers:

All credit goes to CaliGirl9 & KZ who put in the hard time researching then writing their articles.

All I did was ensure they were formatted correctly for the blog, and all the links work.

The court document of Dr. Heidi Flori's statement of observations is already linked at the top of this entry.

Thank you again everyone for reading T&T!; January 6, 2014 at 9:05 PM
An_altered_View said...: What difference does it make? The girl did not die under normal circumstances. She will not be allowed to complete the process or rather the turning off of the machines will not be allowed and so if the process is for her to die, they are only prolonging it for her. Unless, divine intervention occurs. But in the end, with the girl unable to speak for herself, the parents who have turned to God for an answer will get one in his time. If they can continue to finance the support and keep their daughter around, then why should anyone object? Leave the statistics and politics out of it and comply with the wishes of her parents. No one should have a single thing to argue about unless they can stand in their shoes.; January 6, 2014 at 10:06 PM
Anonymous said...: The Daily Mail is a British tabloid in the worst Fleet St. tradition. They are still erroneously reporting things like routine tonsillectomy despite numerous comments correcting them. Don't take their word for anything. They live to stir the pot, and manipulate public opinion.

All this well researched well written material isn't going to make a bit of difference to that family, their supporters, or their shyster lawyer who said in a press conference last night that Jahi would one day walk into CHO and hand them her death certificate. (Maybe he meant when the zombie apocalypse comes.) I could barely stand to listen to that miserable excuse for a human being. The family believes or PRETENDS to believe that God will wave a magic wand and Jahi's rotting corpse and melting brain will be restored. That's why no science, logic, or reason will get through to them. That and the fact that if witness reports are true, family members (one a nurse) performed suctioning on Jahi, and allowed her to eat and talk against doctor's orders. There are suggestions that THEY started the bleeding, panicked, and immediately started spinning stories to blame CHO for what THEY did. They resisted removal of the ventilator until they could get their stories worked out, and they needed time to get a lawyer - and what a lawyer they found! A guy with a rep as the biggest shakedown artist in California. With all the press attention and people tweeting that Jahi was being removed from the hospital exactly when she was, you'd think someone would have followed them. Word is she's at a Catholic hospice. She sure hasn't been flown anywhere when all flights to the East Coast have been canceled.

The judge in this case bears a large portion of the blame for entertaining this insanity. Do you elect judges in CA? If so, make sure you vote this one out!

This whole thing is an abomination. It's something out of Psycho. They aren't the McMath family, they are the Norman Bates family.; January 6, 2014 at 10:21 PM
Anonymous said...: What happened to tough guy Piers Morgan? He thinks the family is right and the hospital wrong. Well, he was a former Brit tabloid editor who lost his job over a phone hacking scandal. I might just jump on the NRA bandwagon to get him deported. Here's a clip:

http://piersmorgan.blogs.cnn.com/2014/01/06/jahi-mcmaths-uncle-im-just-still-praying-that-one-day-ill-be-able-to-see-her-smile-again/?hpt=pm_mid; January 6, 2014 at 10:30 PM
Coconut said...: This from some forum:

"I posted a little bit ago that there was a rumor floating around that they took her to Cardinal Glennon in Missouri. Just found out that "Dr Byrne" has connections there as
well and may also even be licensed to practice there."; January 6, 2014 at 10:49 PM
smalls777 said...: This article is nice because it extends our solidarity to our fellow MDs and RNs at cho. I'm sure they all need to know, we all support them.

http://www.insidebayarea.com/opinion/ci_24835895/spectacle-childhood-death; January 6, 2014 at 11:10 PM
smalls777 said...: Also, Dolan states in news conf, that a "Catholic" facility has taken her. I have a feeling she is still in CA; January 6, 2014 at 11:11 PM
Anonymous said...: @ An_altered_View JANUARY 6, 2014 AT 10:06 PM

Welcome a counter response to my reply below. To be clear, I have no problem with a family's right to privately fund the ventilation of a dead body. However, your post seemed to go well beyond supporting a family’s rights.

An important preface to my reply below is that I use the term legally dead because as of Dec 12th, Jahi was legally dead. Let me type that again: Jahi was dead by law, as of Dec 12th. Half a dozen doctors, a judge and a coroner all came to the same conclusion--I hope you are not disputing that legal fact? Enact sacred religious ceremonies, believe the almighty hand in all this, etc. -- there is no law against that -- but there is also a legal system that affects all of us, and laws must be followed. Even if the hospital wanted to release a legally dead body to someone, even a parent, you cannot just release dead bodies under any circumstances!

What difference does it make? Besides that rule of law and legal definitions of death cannot be flagrantly cast aside, one difference is that much of the cost incurred by Jahi is not privately funded. Another difference is that other kids were not availed Jahi’s ICU bed, because her legally dead body occupied it for much longer than the industry standard of 3 days after death.

I hope you don’t see the above reply as quoting statistics and politics. In short, the difference is based on scarcity. Scarcity of resources that Jahi’s family used (money and hospital resources) at the expense of others, and that's wrong. The hospital, though often vilified, seemed to play things by the book, and I challenge you to find objectively verifiable instances of where the hospital went awry of the law.

If you are advocating for revisions in the law, that is a different line of reasoning. However, your post indicates your line of reasoning to be, quite literally, “what difference does it make?” It’s my sincere wish that you see in my reply the difference that it makes.

As a final note, lots of people that do not support Jahi's family have accepted the legal definition of death and moved on, or as you put it, have stood in the family’s shoes. So Jahi's family is at odds with lots of other people who have lost loved ones as well, and are well informed of the grief of losing a loved one.; January 6, 2014 at 11:53 PM
Anonymous said...: So... it may well be their right to decide the outcome of their daughter's decomposing remains. I wished to transport my mother from the mortuary to graveside in a decorated homemade wood coffin & car caravan… but the coroner would not, without a lengthy & expensive process, issue us a permit & the body for the 3 mile drive. We had to pay a huge fee for a hearse.

If they can raise funds privately, perhaps we all should simply wait for the inevitable. I don't personally care if there is a seance... if they surround the patient with prayer circles, or place a pyramid. They can bring in ghost busters, voodoo docs, perform an exorcism. Bleed the deceased, place leaches… burn incense & sprinkle holy water. Anyone can agree to speak spells & incantations, call for UFO's, cover the walls with pics of crucified bleeding bodies. Her handlers can chant & dance, self flagellate, slice open their palms… as long as they pass the plate & pay all expenses.

What they cannot do (along with sacrificing animals & virgins)… They cannot… CAN NOT DO… is ask me & other tax payers to pay for their religious beliefs about the soul & when it leaves the body (that's what this is about, you know, according to that douche Paul Byrne) They cannot ask the public to pay for their religious beliefs nor endorse them. That is forbidden by the Constitution. It keeps us from being a Taliban theocracy. If they can raise the funds, & there is no hope of recovery… let the family do its rituals, no matter how primitive or unscientific. Perhaps they will stop inflicting their beliefs upon us.

I blame the lawyer & their preacher for inflaming emotion & igniting greed. The child was loved… she was obviously encouraged to find satisfaction & pleasure thru food… she was rewarded with candy trips & they all suffered from seeing this sign of joy removed. It may not be our way of encouraging happiness, but who will cast the first stone? I simply refuse to be forced to pay for others' stigmata…; January 6, 2014 at 11:57 PM
Craftylikeafoxx said...: Omg thank you anon 11:57pm!!!!

I'm gonna start with... I really have no clue why I have become so frustrated with this situation. I will say I've printed a living will so me an my husband can make it clear we don't want to be vegetables, and we definitely don't want to be decomposing corpses in the spotlight. And our 3 kids, oh no! never in a million years. As a mother, as a human being, I want to say... I would never be happy in this state and I would never force my child to be in that state, even if it met millions. Now with Terri Schiavo, I feel the husband was being the bigger person. I felt he was right, especially because he tried for years. She was so beautiful, but many people have no clue because anytime you google her all you see is a vegetable with her front teeth hanging out. I told my husband, let me die a little bit cute... Please... at least let the last year of pictures that everyone sees, let them be ME. Me when I was myself. So I'm pretty confident he's gonna pull the plug, and that is love.

Now, that being said... @at an altered state/

I agree that the family should make the decision, and it needs to be an informed one. Obviously this has turned into anything but that. When all they speak of is money a lawsuits, it's obvious Jahi is not their concern. Can you say that you would want to watch your child rot from the inside out? I understand it really doesn't matter to them because it's a corpse the family has been parading around for money, and thank god she feels nothing. But really??? There is a huge difference in allowing a family to choose treatment and letting a family be fueled by greed in keeping a corpse alive (kinda). They are not funding this, the mother works at Home Depot and has no benefits through them, Jahi is on SSI for all the issues she's has, the stepfather is unemployed, there are 3 other children in the home as well, and she works part time to receive supplemental welfare and Medical. So obviously they are not paying for all this. I somewhat support receiving assistance, really I support it if you are trying.... Really trying. It's disheartening to see the brother who's twitter quote is "Not trying to get those followers up, tryin to get them dolla's up" (Classy) and he tells media 250k is chump change. Wow, left me a little speechless.

I think we all saw this story and felt hurt, I know I did.... But, now... I could have squeezed more tears than the mother has. But this, well it's a circus. I can understand wanting 2nd opinions, I've had to do those things myself. But at the end of the day, you have to sit down and face reality. Although I have to admit a lot of this is for arguments sake. I believe, and it's my own opinion, that they knew from the beginning she was dead, the Schiavo foundation along with lawyers jumped in and gave them hope. NOT hope that Jahi would live but that she was worth more brain damaged than dead. It's unfortunate. There have been other cases where families kept their brain dead children on life support due to religion. Mordechai Brody was one..... money wasn't their motivation, they were Hasidic Jews.

It's all very disappointing. Ok Ok I'm done ranting, lol.; January 7, 2014 at 1:02 AM
Anonymous said...: @ Assertive Woman, I am sure most of you making your comments about exactly what happened while this child has been in ICU before and after she suffered major complications from this so called routine tonsillectomy, which I am sure was explained to the family as the procedure that was taking place, is coming from the many so called medical professionals at CHO, who should be following all ethical guidelines and adhering to HIPPA, instead of trying to cover their asses and releasing this child medical history to the public which is a clear violation on all levels, ethically and morally.; January 7, 2014 at 1:14 AM
Craftylikeafoxx said...: This comment has been removed by the author.; January 7, 2014 at 1:14 AM
Anonymous said...: I sincerely hope that Christopher Dolan is disbarred for the terrible role he has played in this dreadful situation. While I no longer have sympathy for the family and believe that they are looking for a payday rather than any possible "cure" for their dead daughter, as their representative he has made statements to the press that are at best delusional and at worst deliberately deceptive and so inflammatory that I can't believe he is considered "fit" to practice law. His latest statement about this dead child being in "bad shape" because her corpse hadn't been fed in the last 26 days and she was a "sick girl" to begin with beggars belief. I'm sure he is aware that a hospital cannot provide life extending measures to a corpse. Providing false hope to a delusional family and repeatedly making erroneous statements to a general public that to a large extent doesn't understand the vast difference between brain damage and brain death must cross some ethical line for a medical practice attorney. If not, I'd certainly like to know why not and get the law changed so that the public is never fed this kind of garbage again and I hope the hospital sues him to kingdom come. I've no doubt that other children's lives' have probably been jeopardized due to lack of an ICU bed while he and Jahi's family have been perpetuating this charade to keep her dead body on a ventilator. I have experienced the sudden loss of a loved one in ICU and understand the shock and pain but they have had nearly a month to come to terms with this, most families have hours, and their actions have become selfish beyond belief.; January 7, 2014 at 3:28 AM
Tamara C. Northern California said...: Honestly, this is the best site for information and links to further stories and intelligent commentary by commenters. Thank you.

Here is my not so intelligent commentary for this morning (super tired, sorry). I believe they moved Jahi to New York. Omari and Dolan did their interview with Piers Morgan in the CNN Studio, which is in New York City. Why would they fly there for an interview and not do it by satellite instead if she were still here in California? Also, at one point in that interview Omari stated that Jahi WAS everyone's favorite and then corrected himself to say IS. Very curious. What a sad case. I feel for CHO and hope to make a donation by the end of the year. They do amazing things for Children and are a non-profit organization. And folks, PLEASE fill out an advance directive so you never have to linger like this poor child. And if it is your choice, please donate your organs. My 26 year old niece is on dialysis and will need a kidney transplant. Her twin sister had 2 kidney transplants - one from her dad (my brother) and one from her older sister. But as there are no family members left that are a match, my other niece will need a donated kidney from a generous soul after death.; January 7, 2014 at 3:53 AM
Anonymous said...: Coconut, there is no way she's at Cardinal Glennon. I have heard but one helicopter in the area since the storm on Sunday, and it would not have fit the time frame of this transport. (I live right up the street on Grand, and it's been quiet as a church mouse out, so I'd know.) And due to the snow, drifting snow, ice, and subzero temps, I can't see any transport company willing to move a body. Only the living would receive such courtesies right now.

No. There's no way Jahi is in Missouri.; January 7, 2014 at 4:09 AM
Anonymous said...: @Sprocket - It's been years since I practiced in CA courts, but a quick check of the website indicates that they have fax filing (which I remember from ages ago) and limited e-filing. Most courts are moving to e-filing where I currently live/work, and federal courts moved in that direction quite some time ago.

- VenomousFeminist; January 7, 2014 at 5:24 AM
Anonymous said...: Here is my own personal "brain pain" for the day ... now that Jahi is in a "safe place" - who is regulating / overseeing this? There just has to be a record of where they took her, and who is "treating" her, right? The public doesn't NEED to know this now, but there must be some details eventually. After all, there still needs to be an autopsy, one would think there would be a chain of possession (not sure what the legal term is) of the BODY? Did the judge just say "Here's the body, she's yours, Mom, you are responsible from now on" - and that's it?? This bothers me so much. Please tell me I'm wrong!; January 7, 2014 at 6:50 AM
Anonymous said...: How did it come to this?
The public morphed from sympathetic to puzzled to disgusted to furious.
As for the family, either they are angling for a big payoff or they are too dim-witted to grasp the concept of brain death. Either way they shouldn’t be making any decisions in this case. Both the child and society need to be protected from them.
As for their lawyer’s comportment in this entire case: beneath contempt. He singlehandedly has validated every sleazy-lawyer stereotype. The family meanwhile is playing into their own negative stereotypes. Did you see them on Nancy Grace last night? Talk about true colors.
We deserve to know where she has been taken and what ‘treatment; they are exposing her to. I don’t know who’s doing this, or why. They need to be exposed for what they are. If they are a charitable organization, their contributors deserve to know what their contributions are being squandered upon. The healthcare ‘professionals’ who are aiding and abetting this farce need to be exposed as well. Do not know if they can be legally punished for this travesty but they certainly can be ostracized.
Vitriol, arrogance, stereotype. Jahi was an innocent little girl. She didn’t deserve this bitter legacy; January 7, 2014 at 7:46 AM
Jill said...: Sadly, I ceased feeling sorry for the child and family after about week #2 of this debacle. That was reinforced when the uncle referred to the 250K settlement cap as "chump change" more than once. Here are my questions, though:
1. When the heart does stop beating (I give it a week) because she is legally dead, the family is not required to have an autopsy performed, they just call the funeral home for arrangements. Is this correct:
2. Since the mother assumed liability for the child, took her out of the hospital, when it is finally over, even if they did an autopsy, there would be no way after all this time that exactly who did what could be verified. CHO cannot be held liable for malpractice, and the family cannot be held liable for interfering with postop instructions. One balances out the other, no lawsuit, 250K for nuisance value and it's over. Is this something that makes sense?
Personally, I would like to file a suit against the attorney/uncle (pimps in my view) for giving everyone PTSD, having this whole sad situation played out in the media. Their 15 minutes should have ended on 12/14.; January 7, 2014 at 8:06 AM
Anonymous said...: Agree with everything Jill wrote-and am more convinced than ever that money is the end game for these people. I really wish that a viable autopsy could have been performed; if, as some have reported that there was interference by family in post-op - then someone in that family should be held accountable.

At this stage...even the $250k "nuisance" payment would be too much, IMHO. I think many of us who follow this blog and others (and yes, are playing arm-chair medical professionals/lawyers) would love to see and undoubtedly feel assured right now that CHO was blameless.; January 7, 2014 at 8:35 AM
Anonymous said...: Lets say that Jahi's body were being housed in the family home, even for a short interim between facilities. This brings about serious concern for any other minor children in the home, I believe 3 siblings. I have no doubt there has been some psychological damage to these children.
But pretending not, there certainly will be mental ramifications if they are exposed & forced to witness their sister's lifeless corpse, rapidly deteriorate before their eyes. Nightmares are the minimum!
So I ask, where is Social Services on this unprecedented, & potentially harmful situation?
Additionally noting the uncle & attorney have undoubtedly contributed to the mother's delusional state. But should this woman not undergo some level of psychological evaluation, for her well being, & more mportantly the benefit of these other 3 minor children?? I have no doubt the impending reality effects she is already facing (we hope), will only spiral downward.
As to claims her condition greatly worsened less than 24 hours after removal- certainly seems to speak volumes to the superior care the hospital WAS administering to maintain the body. However I realize time is a natural contributor too, having now surpassed the 3 week timeframe. I think was documented in one other case.
The uncle stated the attorney was unknown prior, contacted by mobile phone in the middle of the night by him. That attorney is unethical & should be disbarred. Watch how quick "doting" & co-conspirator uncle, turns on him when things fail to follow their intended agenda. Family will precede it, or follow *suit… & then file "one" against.
Anon/CT; January 7, 2014 at 8:54 AM
Sprocket said...: Good morning T&T readers!

I will try to answer some questions/comments. Understand, I don't have the knowledge of KZ or CaliGirl9, and I have not seen the footage of any of the "talking head" shows.

Here are links to transcripts from a few shows:

1/6/14 Jane Velez-Mitchell

1/6/14 Nancy Grace

1/6/14 Anderson Cooper

Dr. Drew and Piers Morgan are not available yet.

Attorney's often say, whatever they need to say to the press, to keep their client happy. Just think of all the criminal defense attorney's who have insisted to the media their clients are innocent of first degree murder charges. What an attorney says to the press, is not really relevant in a court of law.

What a plaintiff says to the press, is not really that relevant in a court of law, unless of course, there are corroborating statements from eye witnesses, or medical records that validate that statement.

Talk is cheap, but motion papers filed in court, (making the same claims to the press), must have irrefutable, independent validation backing up those claims to convince a judge they are true. Like CaliGirl9 has said several times, student nurses, learn from this tragedy and document everything, no matter how insignificant it seems!

The lower court judge's ruling in this case was sad, but it is not significant, does not impact at all, in regards to to future cases of brain death. That doesn't happen until an appellate court reviews a case and confirms or reverses a lower court's ruling.

(Legal eagles, please chime in with your particular area of knowledge/law.)

As far as to where Jahi is, my gut tells me she didn't travel very far. I don't believe she got on a plane or a train or a greyhound bus because half the country is experiencing unheard of freezing temperatures, and thousands of flights have been cancelled. IF, IF, IF Jahi's travel was 12 hours (like I've heard some reports say, and I don't believe ANYTHING out of the mouth of the family or the attorney) it's someplace unaffected by the weather.

I doubt that this case will initiate, any revision within the law, regarding what IS or ISN'T "brain death." JMHO.

The bottom line is, until the medical records are released, as to what happened minute by minute with Jahi's CARE at Children's Hospital Oakland, everything is speculation. Everything. As far as I know, that information, as to what happened during surgery, in post-op recovery and in the pediatric ICU, has not been released. The only way that can come out, is through subpoena via a court case.

Regarding Jahi's uncle doing an interview in New York, I believe his twitter and/or instagram posts indicate he was at the CNN studios in Los Angeles. The show can be filmed from locations other than New York.

Until the dogged investigative reporters dig up which facility Jahi is at (and have proof, such as photos of the family entering said facility, etc.,) we don't know where she is. It's unlikely we will find out what type of care she truly is receiving until if/when a lawsuit is filed.

A reader asked: "How did it come to this? The public morphed from sympathetic to puzzled to disgusted to furious."

The general public is furious because they see what the family refuses to see. That this is not about their love for a child, but about revenge, hatred and greed. JMHO

Thank you again, everyone, for your comments and being respectful to each other. If you are making a statement about what someone supposedly has said, please try to provide a link to the source, but not the entire article in a comment.; January 7, 2014 at 8:56 AM
Sprocket said...: 1/6/14 Piers Morgan transcripts; January 7, 2014 at 9:10 AM
Em said...: I have not slept a full night since the body was moved. Call me hysterical, but I too have visions of the family trying to make her eat or drink this is now a matter for science fiction. In the previous links or articles that I have sent I have not been able to add my own words because at this point I am horrified and terrified. I am 45 years old and have always been a spooky person at things that go bump in the night. And things have been bumping, relentlessly. This is a horror show, a farce only second to that of the Tawana Brawley case. I am sure that comment will cause an uproar, however I was thinking and trying to figure out just where I had seen expressions like this families before? And it was back than when a family who was suffering, with what they thought was the truth, and only when they realized they had gone too far, the greedy attention seeking lawyers and "spokesman" wouldnt allow them too recant or stop the train wreck that was barreling forward.; January 7, 2014 at 9:13 AM
Em said...: I also just found this one and perhaps will never eat again either http://www.gopusa.com/news/2014/01/07/jahi-mcmath-receiving-nutrients-family-says/; January 7, 2014 at 9:20 AM
Sprocket said...: At this link, supposedly the family spokesperson, the uncle, said Jahi traveled by ground and there were no complications in her transfer.

IF TRUE, this tells me she is not that far from the family, such as, back east or in the midwest.; January 7, 2014 at 9:44 AM
Sprocket said...: This comment has been removed by the author.; January 7, 2014 at 9:45 AM
Sprocket said...: Jahi McMath arrives at long term care facility. CBS News; January 7, 2014 at 9:46 AM
Anonymous said...: Is anyone else skeptical of the family/attorney's claims of "death threats"? Reading some of the dialogue in the posted clips that they are spouting to the various media sources (Anderson, Jayne, etc) -whereby the girl is responding to mom's voice, touch and actually grabbing her just makes me think that they are going beyond the pale for this kind of attention - including saying that they've received death threats. If such stories are true...and Uncle is such a news camera junkie - where are the video clips from his I-phone backing up the girls return from the dead? I don't believe anything about that family and the attorney any longer - except that they are all looney tunes.; January 7, 2014 at 9:48 AM
Anonymous said...: I admit it. At first, I too hoped there would be some sort miracle. It was Christmas, I was uneducated about brain death and hoped like hell some magic would happen. But now I know that the only miracle possible was for the people that wouldve been saved by Jahis organs. I feel (felt) for this family and have cried for all the commenters who share similar stories of grief and loss. I do not understand how Jahis monther can look at Jahi's body and not know she is gone? Cant they see it in her eyes, which surely are not bright and smiliing anymore. At what point is it desecration of a body? When her skin sloughs off and they still pump her with fluids? If someone dropped dead, and another person jumped on to provide CPR, and refused to get off for weeks, as the body decomposed, they would be considered crazy. If someone's dog died, and they did the same thing that this family is doing, the entire world would be hysterical and PETA wouldve gotten involved. I agree it is their daughter, but what if they involve a taxidermist and put her in the corner - is that ok? Is social services making sure her other children are not being traumatized by this, or neglected? I cannot take this crap. I stay up too late and read too much about body decomposition and am pissed that this has gone too far (yes, I know its my fault for caring). The comments made by the family and lawyer make me phsyically sick and I grieve for the families who face this in the future and will think this is a valid option. - DH; January 7, 2014 at 9:51 AM
Anonymous said...: According to the Denver Post -

"Dolan said Monday that Jahi is now receiving potassium, minerals and hormones through an IV, in addition to antibiotics."

Someone mentioned the horror of causing this girl to grow and menstruate. If she is in fact receiving hormones, this horror may actually become fact.

-Cherlyn; January 7, 2014 at 10:08 AM
Sprocket said...: ContraCosta Times

From the article:
"Alameda County Sheriff's spokesman Sgt. J.D. Nelson said that while he does not know where Jahi was relocated, it was his understanding that she was taken out of the state. He said that as part of the standing court order and an agreement with the Coroner's Office, Jahi's body would have to be returned to the Alameda County coroner's office in the event her heart stops beating."; January 7, 2014 at 10:20 AM
Anonymous said...: @Anonymous "Is anyone else skeptical of the family/attorney's claims of "death threats"?"

No I'm not skeptical. People get death threats over far more trivial things than this situation. Too many in the public are commenting on who is paying for this. If someone is truly concerned about their tax dollars being paid out for this travesty, and they are not stable, then yes I can envision a death threat or many coming from this. There could be many other reasons for a death threat in this situation as well.

There is a lot of anger and frustration over this issue - don't be skeptical.

Just my 2 cents - Cherlyn; January 7, 2014 at 10:29 AM
Misty said...: I saw a tweet last night on the Mercury news, that also said that the sheriff said that the body was taken out of state. I wouldn't think that someplace in Nevada would be too far- and I've seen hired ambulances driving to Reno before. However, it could also just be the family trying to hide whatever they are doing.; January 7, 2014 at 10:33 AM
Sprocket said...: It's still speculation at this point, even by the Alameda County Sheriff's spokesman.; January 7, 2014 at 10:34 AM
Misty said...: And I wonder if the "death threats" are just people who are saying that she's dead and it's time to pull the plug. They have already shown that they are either not mentally stable and will take things way out of context, or that they are out for attention and will exaggerate.; January 7, 2014 at 10:36 AM
Misty said...: Okay, last thought for now. I'm guessing at the hosptial she would have been recieving TPN or something similar to it. It can keep people who have normal brain function alive when something goes wrong with their digestive tract. (two friends of mine have been kept alive for months on it when they were recovering from two other issues) If this is the case, the family has no idea that "nutrition" isn't always through the mouth. Some articles have said that she was receiving carbohydrates through IV, so I'm assuming it was some sort of nutrition.; January 7, 2014 at 10:41 AM
Misty said...: @Sprocket- it's scary that there is a body out there, but the legal powers don't even know where it is.; January 7, 2014 at 10:44 AM
Sprocket said...: I don't see it as "scary" that government officials don't know where Jahi is.

The mother took possession. That was all approved by the coroner. Statements made in the media state she is in a facility.

When Jahi's heart stops and cannot be revived, I seriously doubt that there is a funeral home ANYWHERE, that will receive this body without notifying the local coroner. JMHO, but that's what I believe.; January 7, 2014 at 10:50 AM
Misty said...: I think my bigger worry is if they are not as crazy as they seem and they're doing it for the money, and they hide the dead body for a while after the heart stops, in order to get more "donations."; January 7, 2014 at 10:57 AM
Em said...: I see it as ghoulish, just beyond scary! Who else but a Dr. Frankensteinish entity would give a cadaver vitamin and mineral supplements? Supplements to what???? When will this be considered desacation of a corpse?; January 7, 2014 at 10:57 AM
Anonymous said...: I'm the skeptic who doubted the "death threats'. Ok..I get it - there are more nuts out there than countable. Right now...I'm skeptical about this so-called "facility" where by the body is given vitamins and nutrients, like Em says above. Like Misty - I'm wondering if they are just hiding the body.

Where were these "miracle-working" doctors and nurses that the nutty attorney speaks of, for the past two weeks?

Without a body to autopsy - then it's their words to the press. The hospital records may prove that all surgery and follow-up was routine - but does anyone think that in those records could be damning evidence of post-op interference that the family wants to not come to light?; January 7, 2014 at 11:21 AM
Anonymous said...: First of all, I appreciate this blog and the information that is shared here. I found the medical posts about brain death to be educational and helpful to understanding this situation.

What I would most like to read next is about denial, psychological denial, and from a medical or psychological perspective. Let's assume that denial is the case here. How does denial work in the face of mounting evidence that proves a state, in this case, the permanent state of death. How does a person maintain their denial? How much psychological energy is used in order to keep believing something that is not true? If energy is poured into maintaining the denial, what is the cost to the organism, what else suffers? Are there clues, like agitation or confusion or impaired sleep....?; January 7, 2014 at 11:47 AM
Anonymous said...: @Anonymous -

The attorney for the family has stated he has no plans to pursue a malpractice suit against the hospital. He reiterated that today. In a malpractice suit, the family's interference would come to light.

I believe the lawyer is looking at suing over the behavior after death. The family is complaining that the hospital was racist because not all visiting family members were given a "laminated name card". This is the angle I think they are looking at instead of airing all their dirty laundry in a malpractice suit. Every dirty detail would come out - they don't want that.

- Cherlyn; January 7, 2014 at 11:50 AM
Anonymous said...: Just a few thoughts here...
First, I don't think the family is able to release the whereabouts of the body. Whatever facility is providing her "care" probably made the family sign multi-million dollar confidentiality agreements to avoid any publicity, government inquiry into ethics and licensing, etc. Or it could be a "we'll take her in, we won't charge you a dime, but in exchange you are under contract not to reveal who we are" kinda thing.

Second, I once got to observe a veterinary pyometra surgery. (for those that don't know, its a uterine infection seen in cats/dogs who have not been spayed and it is deadly if not caught in time) and the smell of the removed organ permeated the entire treatment area. Two staff members had to leave. If this is similar to the decomposition of the body, wouldn't that be reason enough not to attempt to surgically insert the trach and the feeding tube? I would think the "pop like a balloon" analogy due to all the gases being generated from decay wouldn't be too far off the mark? If they DID feed her McDonalds, beef can take like a week to fully digest, not to mention its fast food so all the preservatives in it. That and the family's suctioning error, yeah I wouldn't want an autopsy done either!

Thirdly I have to agree with other posters who said if she's responsive, SHOWING that would be in the family's best interest wouldn't it? Prove that CHO and the other doctors were wrong so Dolan could go after the hospital for attempted murder? (He'd never get a conviction but I think he's crazy/stupid enough to try!)

Lastly, I was reading the transcripts from the "talking head" shows. One thing stands out....the family gets to say what they want, but by law the hospital cannot send their own representative to defend themselves. They make it out like CHO has something to hide when in all reality CHO has been begging to talk. Its the family who are abusing the law to keep CHO from doing so.

I think, and I sincerely hope I'm right here..that there isn't going to any chance in hell they'll get more then the 250K maximum. First you have to find a court and a jury who haven't heard and already formed opinions on this case. Then of course the hospital will be able to present their side. I just don't see it happening, but then again they convinced a judge to extend the TRO. And what a screwed up judicial system CA has, no offense to anyone who lives there. But if I did I sure as heck would be writing to the bar association about Dolan and whatever official department who overseas the judge as well.

I felt for the family at first, I have a 13 year old daughter. But now I am just completely disgusted by the whole thing.; January 7, 2014 at 11:51 AM
soccergeezer said...: To me, this entire situation is a cautionary tale for why the cap on pain and suffering (which has not been changed, even for indexing since its passage in 1975 or 76) needs to be re-examined. While it can be argued that having no limits leads to insanely inflated awards, the converse is also true: the cap is grossly insufficient when it comes to covering the potential costs of care and when it comes to damages as punishment for negligence.; January 7, 2014 at 11:53 AM
Sprocket said...: Clinical denial.

I'm no expert on this, but from what little I know, it is similar to when people forget things to protect themselves, because the memory/knowledge is so painful, they are unable to bear it.

The only thing that comes to mind from what I've read, is the credibility and deception expert Eyes For Lies

During the Casey Anthony murder trial, her mother Cindy, was a complete contradiction.

Eyes For Lies explained that the many hoops her twisting logic jumped through were a classic example of clinical denial.

In this post from Sept. 2011 Eyes For Lies explains that Cindy Anthony was in clinical denial.

I quote from Eyes For Lies' post:

"There is no doubt about that. Cindy Anthony clearly has denial problems and was an enabler, but it could be her mechanism of survival. Denial is not always a conscience decision, or willful deception. I wish people could understand this. Is Cindy trying to minimize Casey's behaviors? Absolutely. Is she unable to accept the truth? Absolutely. Is what she says about Casey ridiculous? Absolutely, but does it mean she is purposefully trying to deceive people? No. Cindy is in true clinical denial.

Most people, Cindy included, wouldn't cope knowing they produced a psychopath."
End Quote

Now, is Jahi's mother in clinical denial? I personally don't think so. Like I said, IMHO, this is about revenge, hatred and greed.; January 7, 2014 at 12:05 PM
Misty said...: @soccergeezer- I could be wrong, but I have read somewhere that the pain and suffering is separate from what you can win in damages for future care.; January 7, 2014 at 12:14 PM
Anonymous said...: Thank you for your posts and comments. I have no medical training whatsoever so please take these questions not as a challenge to anything stated, but as sincere questions I have concerning these cases.

1. Some of the comments have suggested that the entire process of keeping a brain dead person on a ventilator produces some creepy, gross results--melting brains, rotting organs, etc. How then, is the state of Texas forcing a corpse to be kept on a ventilator in the case of the pregnant woman? Or is she really not brain dead?
2. Why is the term brain dead used in the first place? If you are going to modify the word "dead" with the word "brain" in my mind you are saying there is a difference between dead and brain dead. If I am going to "pull the plug" on a loved one, I want to know beyond a shadow of a doubt that I am not killing them.; January 7, 2014 at 12:37 PM
Anonymous said...: wouldnt they have to proove negligence, then pain and suffering/damages? There must be a way around the 250k cap since the hospital just paid 4.4 million to the family of the other little girl who died after tonsilectomy. If they cant proove negligence then the case is over. I could be wrong.; January 7, 2014 at 12:46 PM
CaliGirl9 said...: Just stopping by to say "thank you" to all of the intelligent and thought-provoking commentary that our stories have generated. KZ and I (especially KZ, as she is still in active advance nursing practice) both believe that as individuals who have received nursing education, part of our duties are to disseminate accurate information and to teach as best we can.

Yard work beckons, but I will try to stop by later to clarify/answer questions. But I will part with this delicious thought: Will Jahi's family finally "get it" as skin sloughs off, as she leaks fluid from whatever orifices, and decay is apparent to even a blind man? I don't EVEN want to think of the bacterial goo and what's in it because the body is getting antibiotics. At this point, wherever she is, the ghouls caring for her are choosing to do so, and that means there's more sick, delusional people out there than we thought.; January 7, 2014 at 1:13 PM
Craftylikeafoxx said...: I hope they get it, I have a feeling they will blame decomposition on CHO.

I'm not a Nancy Grace fan, but I do like when she challenges things. I really feel she did no research, nor did any of her guests she brought to speak on the issue. I was hoping she would challenge them more. Not in a rude way, but she just backed them and their nonsense.

@sprocket.... I agree with you on the clinical denial... That was a good reference. If I really felt Jahi's mother couldn't accept all this then I would understand and maybe have some sympathy. But she, and all her family understands the situation.... I think they've been very educated on how to get the most $ out of it. Regardless if they watch her skin start sloughing off.... So gross. SMH; January 7, 2014 at 1:32 PM
Misty4Me said...: Piers Morgan tweeted it's 68 degrees where he is, so he's definitely not in NY. Don't think he's spending a moment worrying about Jahi after his performance last night; he's been tweeting about cricket all day. (I just might have to un-follow him.)

@ EM Re: Twana Brawley. I remember that case well. Since Uncle (aka Norman Bates) brought up the 'D' word - discrimination - first, I feel justified in vising it. Who's missing from this tableau? Where are Jesse Jackson, the Rev. Al, and Sarah 'Death Squads' Palin? You'd think this case would be right up the alley of all three, but not a public peep from any of them - that I'm aware of. Maybe because all three, even that fruit bat Sarah, know that dead is dead.; January 7, 2014 at 2:27 PM
Anonymous said...: $240,000 IS "chump change" for what sounds like a series of errors on the part of Children's. There should not be such a low cap on medical error resulting in death or disability.; January 7, 2014 at 2:50 PM
Anonymous said...: "1. Some of the comments have suggested that the entire process of keeping a brain dead person on a ventilator produces some creepy, gross results--melting brains, rotting organs, etc. How then, is the state of Texas forcing a corpse to be kept on a ventilator in the case of the pregnant woman? Or is she really not brain dead?"

This is what is really confusing. There are all these medical professionals running around on comment boards/forums claiming what happens after brain death, things that directly contradict each other and I have seen it here too. The declaration released seemed to verify many of the things some medical professionals had been referring to and was almost reassuring because finally you could know who to believe about what was going on.

And it is an excellent question, even going way out on a limb and assuming this fetus is not also severely brain damaged or even brain dead, how can the mother's body possibly sustain it for so long with such terrible blood pressure and organ failure? What are the outcomes for feti general under these conditions? Some actual medical journal articles, not random people with stories from the internet.; January 7, 2014 at 2:51 PM
Anonymous said...: @Anonymous at 12:37. I am in Texas. They are keeping pregnant mom not only on a vent but everything else necessary to sustain her body until the fetus is determined to be viable due to laws protecting the right of the fetus. It's sad in the event that it is totally against what this mother wanted in the event this happened and there is no way to say this baby is going to viable or healthy when born. Jahi was declared brain dead, and none of those additional measures were taken which was in compliance with the court order.

I too would like to say thank you to all of the comments and posters of these blogs. I caught on to this horrific story after seeing a news story about the pregnant mom here in Texas and I've been keeping up here and there. Terrified by all of the misinformation and I've prayed for Jahi's sake that her heart has enough and stops. Quickly.; January 7, 2014 at 2:54 PM
Anonymous said...: Am I the only one that wonders how the lawyer and Uncle are getting anything done/taking care of Jahi, when every 5 minutes, they are running to the press? It's disgusting.; January 7, 2014 at 2:56 PM
Coconut said...: I think those who suggested that the body may still be in CA, maybe you are right... Dolan spoke of having the body "settled" after appr. 12 hrs and they confirmed only road transport was used. Checking Med Way's flight logs, none of them included a trip out of Ca... lol

This is a tweet from the uncle:
::I NEED A PEDIATRICIAN IN THE LOS ANGELES AREA THAT WILL BE WILLING TREAT MY NIECE JAHI MCMATH:::PLEASE CONTACT ME ASAP
-----

Does anyone know why or on which basis judge Grillo extended the temporary injunction until Jan 7th since they appointed Dr. Fisher who, after examining Jahi, confirmed and concluded that she was/is brain dead, fact also confirmed by the coroner certifying she died on Dec. 12...!?

Does this not mean the the judge actually acknowledged that she was not dead (yet), because the family was/had already been extremely accommodated in the grievance and acceptance process by the hospital, I mean 3 weeks to understand someone died is a long time.

Does this also not mean that the judge did not take into account or recognised the coroner's date of death being the 12th of dec.?

Is this not creating prejudice now for other people wanting to extend ventilator support on dead ones and then take the body on a drive around to get it "fixed"?

Thank you CaliGirl9, KZ and Sprocket for this very interesting and educating blog and all your efforts!; January 7, 2014 at 3:22 PM
Craftylikeafoxx said...: @ misty4me.... Good call on the rev. Al sharpton and all the other annoying protesters. I really do think this is getting so much media attention due to the family and their quest for money. It outrages people. I am surprised more people haven't stepped in, but common sense must exist in most people after they educate themselves on the situation.

Not sure if anyone is familiar with this case, Jesse Koochin, who's parents also fought and were granted the ability to take him home after being declared brain dead. He was fighting a cancerous brain tumor and was in a coma.... A feeding tube was already in place. He lived 2 months at home. In the link below it shows a picture of him wrapped in blanket, I assume his body can't control temp. And below that an eerie photo where he already looks dead.

http://www.ksl.com/?nid=148&sid=82028

I found this small post the mom had done on a website for jesse which is no longer active. I find her to be delusional about him getting better after being brain dead. It's also crazy that she was administering vitamins to him on her own in the hospital. She's sounds off her rocker. Maybe more in denial than anything, but after we have been educated about the decomposition of a brain dead person.... Jahi's mother and Jesse's mom sound a little off to watch this happen.

http://curezone.org/forums/fm.asp?i=334108; January 7, 2014 at 3:48 PM
Anonymous said...: Anonymous wrote: "$240,000 IS "chump change" for what sounds like a series of errors on the part of Children's"

Uh - to Anonymous...a series of errors? Where are you getting this information? CHO, to my knowledge, hasn't released any official information due to the HIPPA laws. What constitutes this "series"? I'm really curious to know.

And, skeptic that I am...IF CHO or someone connected with the hospital DID make a legitimate error on the procedures followed - then, yes I'd agree that the $250k would never replace a loving child. What I see going on (and admittedly it is only from the Uncle/Attorney) are some pretty heavy delusional antics and, as some pointed out - keeping people busy running to the media. None of the family has said much about what happened to cause the death...just how miracles occur and how they are raising $$.

But...- if you know the "series of errors" committed by CHO...maybe you could enlighten us?

Skeptic; January 7, 2014 at 3:52 PM
Craftylikeafoxx said...: With Marilee Munoz, the Texas pregnant woman. She was 14 weeks when she was found brain dead, will she make it to a safe point in the pregnancy to deliver, or will her organs start sloughing off as well? I would assume she will be in the same state as Jahi's body?; January 7, 2014 at 3:54 PM
Anonymous said...: @Coconut - Anonymous in Texas here again! It's my understanding Judge Grillo extended the TRO to 01/07 because the attorney for the family filed in the appellate court that day as well. Judge Grillo had to defer his ruling to give them time to review the case.; January 7, 2014 at 4:03 PM
Coconut said...: BTW another interesting thought... The coroner issued a death certificate but "officials haven't given an official cause of death..."

Is brain dead not an official cause of death in the state of California? The ICD-10 (International Classification of Diseases used to code death certificates) has a specific code, G93.82, to do so. Would an autopsy not be increasingly difficult and probably only carried out to (try) determine what caused the initial bleeding?; January 7, 2014 at 4:31 PM
Craftylikeafoxx said...: @coconut... Brain death is considered death in California.

I feel at this point if an autopsy is done, it won't reveal anything. With her slowly decomposing it seems impossible. The coroner said early on he will have a hard time finding a cause of death.; January 7, 2014 at 4:53 PM
Anonymous said...: I am the NY nurse who commented above re: being in similar situation and the decomposition. Re: pregnant woman, when you are trying to keep organs in brain dead person viable, there are drugs given via IV that raise your blood pressure by clamping down circulation to the extremities. These even stop working after awhile I assume that is how they keep the placenta with enough flow for the baby. In my case with 2+ week boy, the medical team pulled vasopressin and all but Low volume IV support. But if you think you are donating the organs, it is an intricate waltz to keep enough perfusion pressure, particularly for the kidneys. Hope this helps. Here is a pretty good article. When you have a person who the team thinks is going to become brain dead, the cardiac support is initiated just in case the organs will be harvested. Once the brain hits the point ofno return, there is a very clear profile in vital signs. As the brain stem is dying/herniating, there is a last ditch effort to pump enough blood to the brain through the roadblock of massive swelling. The blood pressure will climb and climb, until it starts to crash. It crashes because the "computer" (brain) just shut off.; January 7, 2014 at 5:08 PM
Coconut said...: @Anon 4:03

Thank you, I found this document ... http://www.cci.drexel.edu/faculty/ssilverstein/1230rrr.pdf

and can now understand the time needed to review..

it also describes that Jahi did speak to her mother right after surgery and subsequent events according to Dolan...; January 7, 2014 at 5:31 PM
Misty4Me said...: @Coconut: Brain death is the result, not the cause. The coroner needs a reason 'why' brain death occurred. Given the chance, the coroner would have tried to determine the cause of the bleeding that set this tragedy in motion, and if any food (burger) was in the stomach, he would have found that. (Interesting that in a 2,000+ year old mummy, scientists were able to determine on autopsy that the deceased had eaten melon before they died.) I have grown increasingly skeptical of the family's motivation. It certainly isn't for Jahi anymore. Taking her body on tour is at the least a disgrace and at worst an abomination. Money may not be the #1 motivating factor either. If the family suctioned, and fed Jahi, they could well have killed her - which would be a reason to want to keep her alive. Here is a case of an Ohio man who beat and shook his baby daughter nearly to death, and then fought with the mother to keep the child on a ventilator so he wouldn't be charged with murder:

http://abcnews.go.com/Health/teen-parents-battle-life-support-baby/story?id=10373536

"Jada's mother, 18-year-old Deja Ruiz, wants her daughter removed from life support. But Jones, who was charged with assault and child endagerment in the case and who could face murder charges if Jada dies, quickly filed court papers to keep his daughter on life support.........."; January 7, 2014 at 5:39 PM
Anonymous said...: The New Beginnings website as an update on Jahi. The update wants people to believe that she is at their facility.; January 7, 2014 at 5:44 PM
Anonymous said...: I've followed each of the stories written here regarding this case and I want to say first, I applaud you. There is first-hand professional knowledge but everyone has really done their homework.

Which brings me to my questions, this evening. How can these journalists continue to refer to this as "routine surgery" on a "perfectly healthy child"? I'm not naive. I get that they're going to pick and choose points that serve their agenda. But at this point, with all of the sources out there to include the family's own statements, they have to know it was more than routine. And that this poor, precious child was most certainly not "perfectly healthy"! I find it had to believe there's nothing illegal about them knowingly and blatantly perpetuating lies and misinformation.

Or perhaps I truly am quite naive.

-Lil; January 7, 2014 at 5:54 PM
Anonymous said...: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924930/

This article explains what is usually in place as a person goes from severely brain damaged to brain dead. These support measures are usually left in place a short time even if family chooses not to donate, or if brain dead person's organs cannot be used/are not viable,; January 7, 2014 at 5:57 PM
g kuzma said...: I have wondered about what pulled me into this case. I don't usually get sucked into news stories like this - it's quite rare, actually. I see this case as a very sad and obvious demonstration of society's failures. This one case reveals failures in everything from our education system to our welfare system to our healthcare and legal systems. I see Jahi's family as a clear and present manifestation of how the education system in California - the Union's richest state, I believe - was completely inadequate. These people neither understand basic principles of health, nor the basic principles of parenting, nor basic science. Also, many people are upset by welfare's financing the mother's $100 nails and the excess amounts of food that got Jahi and her parents to be obese in the first place. I could go on - the health and legal problems set in relief here are manifest and don't need my description. On top of all that, the fact that the family and the lawyer are blatantly lying to the entire world (e.g. see Nancy Grace's interview with the mom & attorney) is downright infuriating to many people.
My point is that this one case really stuck all the problems in our collective face at the same time. I feel sad about the condition our society is in, and very sad that the human being known as Jahi McMath took the brunt of all these problems and was deprived of her future on this planet. That's what sucked me in to the story. Anyone else?; January 7, 2014 at 6:01 PM
Sprocket said...: Anon at 6:01 PM:

I've not heard that welfare financed the mother's nail appointments? Where did you read that? I was under the impression Jahi's mother worked for Home Depot.

What in the world makes you think California is the US's "richest state?" You can't be from California otherwise, you would know our state is desperately broke.; January 7, 2014 at 6:15 PM
Anonymous said...: Anon in Texas again. I went and read the statement on the NB webpage which led me to their FB page. They have a post from today that simply says "Save Jahi" with a photo, a link to a story that Jahi was starved for 3 weeks while fighting for her life, and a bible verse "Mt. 25:35 I was hungry, and you fed me thirsty, and you gave me drink..."

What I thought was better is the entire review section is people questioning their motives and their ability to accept and care for a body with no facility in place to do it. Again, this whole thing is so bizarre and I cannot look away.; January 7, 2014 at 6:17 PM
Misty4Me said...: The parents are using their Christian faith as the argument for machine supported maintenance of a corpse -- I'm not calling it what it ISN'T, "life support", and when you think how many Christians we have in this country...well....we had better sort this out, or it will become routine. An excellent point was made here earlier: The family's despicable lawyer is a personal injury attorney who relies on expert testimony from doctors to try his cases, and yet, in this instance, he rejects the expert opinion of SIX doctors and becomes his own expert. Think of all the money he can save on future cases when he doesn't need to hire expert doctors. He can give all the medical testimony himself!; January 7, 2014 at 6:19 PM
Anonymous said...: I think that Jahi's body could very well be at Cardinal Glennon. If you look at New Beginnings' website, it says they are waiting to hear from Angela Clemente & Associates. There is a pediatric group for Cardinal Glennon that is know as Angela Clemente Associates.; January 7, 2014 at 6:23 PM
Coconut said...: Thank you Misty4Me and what a horrible tragic story too!

@Anon 5:44 I doubt it, in this interview...

http://sanfrancisco.cbslocal.com/2014/01/07/jahi-familys-attorney-says-case-could-set-precedent-for-parents-rights/

it is stated that she is still being "stabilized" to get the feeding tube and she is still at a Catholic facility.

Has there been no comment from the NY state health department regarding the NB's facility, being an outpatient one and without a license to care 24/7 for a "body" hooked up to medical equipment? Surely they must be looking into that?

Dolan has now stated that he will not defend the family should they wish to file a suit against CHO...; January 7, 2014 at 6:24 PM
Anonymous said...: Does anyone know how long the bleeding continued and why a doctor did not come before the arrest? Moreover, I have read that emergency surgery to re-cauterize would be a typical response to heavy bleeding- anyone know if this would be the usual response? I assume no one knows what happened in Jahi's case, but what about other examples- such as Miley Cirus's brother, who Hemorrhages a couple days after tonsillectomy..; January 7, 2014 at 6:26 PM
Diana said...: I have a really bad feeling that poor Jahi is just at one of her family members houses, I very much doubt that any licensed medical facility would agree to take her in, or to perform any medical procedures on her. I do not believe that she is at the place in NY, considering we know that she was transported by ground, that she arrived at her destination within 12 hours, and that evidence from twitter shows that Jahi's family is still in the LA area.
The family has made it seem like she has already been hooked up to a feeding tube & tracheotomy tube. We know that Jahi's grandmother is a registered nurse, it is possible that she was the one who performed the procedure? Can any RN's on here confirm if RN's are trained on such procedures?
I very sincerely hope that her family is not just going to let her deteriorate at home while they collect more money.
I would also like to leave you with the profile quote from Jahi's uncle's twitter account, just to make it more clear what his motives really are in this

"Not interested in getting my followers up, just worried about getting them Dollars UP!"

Yup, I think that pretty much sums it up; January 7, 2014 at 7:05 PM
Sprocket said...: Anon @ 6:26 PM:
We do not have ANY information on Jahi's care. We do not know what happened, minute by minute.

All we have are allegations by the family and statements from their attorney. These are NOT unbiased sources for information about what happened during the surgery, during her time in recovery or during her time in pediatric ICU.

We just don't know.; January 7, 2014 at 7:05 PM
Sprocket said...: It's my understanding that Jahi's mother lives in an apartment building, not a house.

I'm asking people to please be respectful to each other. Calling someone "small minded" is not respectful.
Thank you.; January 7, 2014 at 7:07 PM
Anonymous said...: In reading the comments, I'm seeing a lot of discussion about the $250K cap, but not a a lot of real understanding what that means. Since I'm not a medical expert, I'll contribute a little legal expertise. Standard disclaimer - none of the information contained herein contains legal advice, nor is it meant to comment on the validity or invalidity of potential claims in this specific, or any other, case.

When calculating damages for a civil tort suit, we (lawyers) look at two categories of damages. There are pecuniary/specific damages - things like property damage, medical bills, lost wages - basically what the injured person is out of pocket as a result of the alleged negligence, and then there are general damages - damages for pain and suffering. There is no cap on the pecuniary damages. It's likely that the medical bills for Jahi are in the rage of $500K at this point, at least, and that doesn't take into account lost wages for the mother, the step-father, or any other out-of-pocket costs (parking, etc.). On top of that, the family can request general damages for their emotional distress in an amount not to exceed $250K. That cap, however, only applies to a finding of negligence on a medical malpractice cause of action.

There are also potential claims for wrongful death which also have their own damage calculations -- loss of consortium, anticipatory lost wages for the child's estate, and again those general damages, for which there is no cap in a wrongful death case.

Finally, there are punitive damages, and that's where we're looking at real money. In California, punitive damages can be assessed at up to triple any actual damages, and they apply to those causes of action which are set forth in the federal lawsuit - interference with freedom of religion, discrimination on the basis of disability, etc. They also cover the cost of attorneys' fees.

There's a lot going on here, and money is at the root of many of the actions. Jahi's mother is truly grieving, and is choosing to believe that she can will her child alive. I have a 13 year old daughter, and my heart hurts for anyone in the position of having to accept the loss of their child.

-VenomousFeminist; January 7, 2014 at 7:25 PM
Anonymous said...: Misty4Me, I am a Christian and if my family left me on a machine like Jahi's family has I would come back and haunt them...; January 7, 2014 at 7:29 PM
Misty4Me said...: Let's get with it people. The lunatics are running the asylum. A cursory look at various Facebook pages with anything to do with "Catholic" or "right to life" will show a whole lot of people with a whole lot of money spreading a whole lot of misinformation and outright fabrications. Here's and example from a FB posted link:

http://www.nationalrighttolifenews.org/news/2014/01/jahi-mcmath-flown-to-new-york-facility-feeding-and-breathing-tubes-to-be-inserted-today/#.UszDNvRDvg1

Then check out #JahiMcMath or #Jahi, and similar hashtags on Twitter.

We didn't think the family would get Jahi out of the hospital on machines, but they did. We thought the judge would put an end to the freak show, but he didn't. She could very well be in a facility. We have become a nation where "life" has taken on a whole new meaning. Life - whatever you define that as - at all costs. Even to the point of killing doctors and blowing up abortion clinics, or keeping dead people "alive" on machines. Science and medicine by all means - if it means dead-life or life-death, but hell no to science and medicine if it's abortion - even if the fetus puts the mother's life at risk, or if it can prove a person is DEAD. Strangers can become involved in what should be the most private of family decisions. How many times do we have to watch this stuff before it sinks in???

We have crossed through time and space and logic and science and reason...... and arrived in The Twilight Zone.; January 7, 2014 at 7:35 PM
Anonymous said...: I don't know if you saw this but here is an article that gives a description of the body on a ventilator my brain can digest. Although this site has been very informative.

http://www.mercurynews.com/science/ci_24857783/jahi-mcmath-brain-dead-teens-body-may-be; January 7, 2014 at 7:41 PM
Anonymous said...: In the court documents (http://www.cci.drexel.edu/faculty/ssilverstein/1230rrr.pdf) it mentions that while Jahi was bleeding profusely her mom left her with the step dad while she got the grandmother.. I thought that was weird because if it were me the step father would have been the one to tag in the grandmother while I stayed with my baby.; January 7, 2014 at 7:46 PM
Anonymous said...: I believe it is a house. her address is buried in the court papers. Realtor.com lists it as a single family dwelling.; January 7, 2014 at 7:55 PM
Anonymous said...: For Diana @ 6:26
Jahi's grandmother is an LPN/LVN, which is very different than an RN as far as scope of practice is concerned.
RN scope of practice differs by state. I am currently an advanced practice RN on the East Coast. The only sort of feeding tube that an RN may place in my state is an nasogastric or orogastric tube, neither of which are really designed for long term feedings. A Dobhoff (which is placed in the nose) is not typically in the scope of practice for RN's, as the placement is a bit trickier than an NGT. A feeding tube that protrudes directly from the stomach is a surgical procedure, which an RN is obviously not able to do.
The only sort of RN that could place an airway that is semi permanent to replace an oral endotracheal tube (a tracheostomy in someone's neck is a permanent airway) would likely be a CRNA, and even then a CRNA's surgical airway expertise is often not terribly extensive, and would likely be limited to emergency cricothyrotomies. The area where a tracheostomy is placed is very close to several major arteries, and therefore requires surgical expertise that an RN does not possess.; January 7, 2014 at 8:12 PM
g kuzma said...: @ sprocket

Eeks! I thought I removed the "richest state". Being from the midwest, I erroneously thought it was because of all the actors. So after writing that I looked it up and saw it was not true, then tried to edit my post before, well, posting, Guess I failed. Sorry - I was wrong.

As to the nails, it is widely reported that the mother has California welfare insurance and the daughter is uninsured. No one anywhere I read has contested that the mother is on welfare - you are the first. So if you're right, then I retract the comment, but it is quite widely reported. I think they call it MedCal. And her nails, well, look at them. Anyway, in that part of my post I was stating that people are upset about it - and they are. If you read comments on the LA Times articles, Seattle PI articles, CNN articles - many people mention those fake nails as being evidence that the mom has poor judgment. Now if she's not on welfare, that would be moot, but - again - it's been reported elsewhere as fact, so I had believed it.

Incidentally, this "preview" feature on comments is a little odd! Maybe that's how I bungled it before. Not sure.; January 7, 2014 at 8:14 PM
Unknown said...: I have sources on FB. Jahi is not in NY. The last new beginnings heard about Jahi was a message from a lady in NY whi said the lasy she heard was Attorney Dolan said Jahi was "medically fragile" due to no TX or nutrition at CHO.
It was also mentioned by this person that Jahi is the hands of and world class professionals .. These people are hard core pro lifers ans they are connected to the Schrivos family.; January 7, 2014 at 8:15 PM
g kuzma said...: Incidentally, I was inquiring about why people have felt so sucked into this story, not about whether every detail being reports in the media is accurate.; January 7, 2014 at 8:17 PM
Anonymous said...: I think Jahi's grandmother is a LPN, not a registered nurse. I think the pieces point to her being at Cardinal Gannon as I stated above.; January 7, 2014 at 8:18 PM
Misty4Me said...: Sane Catholic opinion.:

Jahi McMath and Catholic Teaching on Determination of Death

http://www.ncbcenter.org/resources/jahi-mcmath-and-catholic-teaching-on-the-determination-of-death; January 7, 2014 at 8:33 PM
Anonymous said...: First off, thanks to everyone, site owner and commenters, who take the time and effort to shed light on this tragic story. It's the best place to go for information.

Further above, someone asked how far denial can go, and why the mother of Jahi McMath simply cannot accept her child is dead, in spite of it being so obvious. I have no experience in psychology or psychiatry or in any other medical field, but I reckon I know something about losing a loved one.

About two years ago, my husband died in a car accident. I couldn't believe it, and I couldn't accept it. I'm usually a very calm and shy person, and, if I may say so myself, not a particularly dumb one, either. But back then, I turned into a maniac. I went into total hysterics at the hospital, screaming, yelling, lashing out at everyone, even scratching a nurse's face that the poor woman had bloody welts all over it. What made it all worse, was some doctor (could have been a male nurse, I don't know) yelling at someone else how on earth I could have been allowed to see my husband without consulting him first. At that moment, I totally lost it. First I accused everyone of having killed my husband, then I suddenly was convinced he was still alive and they all lied to me, just to do something terrible to him later. Of course I was restrained and sedated and that was it for that day.

I believed for months my husband was still alive. It didn't help much that I was hospitalized and couldn't even go to his funeral, which still hurts today. Luckily for me, I had friends who had the patience of angels, understanding doctors and helpful nurses who finally, finally could make me understand. And still, even today some of the 'denial' is still left. I know he's dead, I have accepted the fact, got my life back together, go riding, care for the horses, I can even laugh and enjoy a nice day again without going 'If only...'. But I still have all his things, all his clothes, his stuff in the bathroom, everything. A part of me still pretends he's just out for a business trip or something. He had a favorite cheese he loved, and I always have that cheese in the fridge. Since I never liked that sort of cheese and don't eat it, it usually sits there until well after expiration date and then I throw it away and buy a new one. I know it's probably not the healthiest state of mind, but I reckon as long as I'm lucid enough to realize it's an idiotic thing to do, it's not quite as bad as it sounds. There could be worse neuroses. At least I didn't try to drag his dead body home.

But that's the point - I was lucky that there had been good people around me, that I got the help I needed. Had there been someone, just one, who had 'supported' me in my weird thoughts, I probably would have done, or at least tried, just that. I have seen his body and it was a real terrible accident, and still I was convinced he was alive. Had he looked 'whole', or, like Jahi's mother said of her daughter, 'warm and with a pulse and a beating heart', oh my god, I'd probably be in a straight jacket now.

I cannot blame Jahi's mother, no matter how absurd the whole travesty gets. I feel sorry for her. She has no friends to look after her and care for her, she's surrounded by a bunch of hyenas. And with all the voices around her talking about 'life support', citing the Zack-Dunlap-case, all the nutcases encouraging her to 'fight' for Jahi - how can she possibly believe her child is dead?

There but for the grace of God, go I...; January 7, 2014 at 8:33 PM
Anonymous said...: First of all, thank you for this blog, it has provided a wealth of information. As with many here, I have been in thrall with the story, even getting into a lengthy debate with someone on a political blog I visit occasionally. This person was of the "Jahi needs to be given a chance to live" persuasion. Last night I saw an interview with Terri Schiavo's brother on Hannity and wrote Hannity that it was an incredibly horrible interview - neither man seemed to know anything about the situation, but were making noises about the family making the decision, etc.

That said, my feeling is that Mom is using all of this as a distraction from the guilt she is feeling. My understanding was that the surgery option was chosen after receiving a second opinion. My guess is that Jahi's pediatrician told Mom that Jahi needed to go on a diet and lose 10-20 lbs. which would likely resolve, or at least mitigate, the sleep apnea issues. Here we see another example of poor parenting and general laziness - surgery was the easy option. This child was suffering, no doubt, from many near death experiences on a regular basis. She was also precognitive, knowing somehow that this would not end well for her.

If Mom and Grandmom performed all the acts that seem to have led to Jahi's death: food, talking, suctioning a blood clot - then keeping the child "alive" and making a big stink about it was the only route open to her.

And, so, she will watch her child rot before her eyes and blame that on someone other than herself.

When I used the term resurrection to the political poster and said that this was what the family seemed to be wanting, stating that the Bible only talks of two cases of people rising from the dead: Lazarus and Jesus and that Jahi was neither, the poster told me that my comment was disturbing. S/he told me to get a grasp of reality. This pretty much sums things up, doesn't it? What is real and what is fantasy.

I like to think that I'm the rational one, but so many people seem to be on Jahi's mother's team and that is truly scary.; January 7, 2014 at 8:35 PM
Anonymous said...: I'm so glad I came across this site. So informative. I have followed this story on Jahi and find it quite disturbing. I usually follow stories on brain injuries (though I know hers is brain death) because my youngest son who is now 22 years old, was seven years old and hit by a van while he crossed the street in front of his school. School had just let out for the day. The hospital called my work and said my son was in a accident and come directly to the ER. My boss drove me and I remember not knowing which son? It was heart wrenching. When we got there my husband was clutching a Nun's hands praying near a ambulance, he had rode in the Ambulance with my son. He told me my son's heart had stopped on the way, they had resuscitated him. My son was unrecognizable, his face swollen and black. They put him in a medically induced coma. He flew from there to Cottage Hospital where he stayed for a week and then transported to Loma Linda Hospital I rode in the ambulance with him to Loma Linda. They let me stay in his room for the whole eight weeks. My husband came on weekends. When he woke up he didn't know anyone but mommy. I still cry when I type that 15 years later. He was lucky he learned to walk and talk all over, lots of physical therapy. He is 6' 4" and strong as a horse. I read a lot in my 8 weeks with him in the hospital about brain injuries. The Hospital let me take Medical books from their library back to my room. So I do understand a lot about the brain and how it works. If my son had been in Jahi's condition, brain dead. I would have to say goodbye that would be no way to "live". My sons severe traumatic brain was a "shearing" type, his whole brain was moved in his head when he was hit. So every lobe was affected.
It hurts me to hear the family put down the nursing staff, I know from being in the children's hospital that the nurses are the most caring people alive.
Thanks to everyone for all the insight. Peace Out; January 7, 2014 at 8:56 PM
Sprocket said...: I'm sorry I've been absent and unable to answer all of your questions. I'm working on a sewing project that is due tomorrow. I'm also trying to get some new Kitty Mat Beds ready to post for sale on my sewing blog. Please forgive me.

Anon at 8:33 PM:
My heart goes out to you for your loss. At the same time, I sincerely thank you for willingness to share your painful experience with all of T&T's readers.

Regarding Jahi's mother's insurance /nails /home /employment, I've not read that she was in a house. I've read news reports that she lives in an apt. in a busy metropolitan area and works at Home Depot. I don't know if she's full time or part time at Home Depot. Her insurance may be as you describe because of the family income. I don't know much about the father at all.

Everyone, please try to just post a link to a source article support your comment, and not text from the article.

I'm going to change the posting box settings to open up in a pop-up window. This embedded posting box is difficult to navigate if you are trying to edit your comment before posting.

Thank you so much everyone, for reading and contributing to the conversation.; January 7, 2014 at 9:02 PM
CaliGirl9 said...: Hi Diana
Jahi's grandmother is a licensed vocational nurse, and as such, unless she's received special training, she cannot attach a bag of enteral feeding solution to a gastrostomy tube, nor can she suction through a trach tube—which are usual RN duties.

I believe an advance practice nurse, as is KZ, could change the trach tube if need be. A regular RN like I was cannot; I do not have the training. However Jahi's grandmother is apparently IV certified, though I've not seen the source of that claim.; January 7, 2014 at 9:03 PM
Anonymous said...: What would happen if the body suddenly disappeared or was destroyed? Say, the place she's being stored "accidently" burned. Or someone came in and "stole" her body - maybe even at gun point. Or...heaven forbid...it got up and walked out of the building. Would it be at all advantagous for the family to rid of the corpse so there could never be an autopsy? Could they claim she was alive up to the point of disapearance and still sue? Just thinking out of the box here.; January 7, 2014 at 9:11 PM
Sprocket said...: Anon at 8:56 PM:
I'm so sorry you had to go through that experience with your son. Still, I thank you for taking the time to share your experience of your son's accident and recovery.; January 7, 2014 at 9:11 PM
Sprocket said...: Anon @9:11 PM:
I certainly agree that is thinking outside the box. :D

I seriously doubt that will happen, but I've been surprised by this case before.; January 7, 2014 at 9:14 PM
Anonymous said...: Is there a California attorney who can help me understand why the mother was appointed Guardian ad Litem of a deceased child? The case is not available for viewing on Alameda County Domain Web right now, and I am wondering if the Petition for Appointment of Guardian ad Litem was filed before Jahi's death on December 12, or if the judge accepted a Petition for Appointment of Guardian ad Litem after Jahi's death. I haven't seen that process used for someone who was deceased.; January 7, 2014 at 9:20 PM
Anonymous said...: Found this blog by chance and think it's amazing -- I've enjoyed the education I've received by those on the medical end. I know it must take up a lot of time so I thank you for doing this.

Forgive me if this has been posted before but I have yet to read through every comment...

I work in the news media and am pretty familiar with Los Angeles. I can tell you that Piers Morgan does tape segments there from time to time. This has led me to believe -- and this is all speculation on my part -- that Jahi is somewhere in southern California. If she wasn't, both he and the slimy lawyer could easily have done a satellite interview with CNN at any of the network stations in the Bay Area.

Also, if you see a post that uncle made to his Instagram account yesterday, he posted a picture of 'Worlds Best Mom/Hollywood' souvenirs that he apparently got for the mom. These are the same items that crowd every shelf in the stores lining Hollywood Boulevard -- just one block from the CNN studios.

So it looks like uncle is helping to relieve some stress by getting in some sightseeing. Who knows, maybe he took in a show at the Pantages Theatre as well.

http://instagram.com/p/i20BqcIpgd/; January 7, 2014 at 9:29 PM
Craftylikeafoxx said...: As all this chaos goes on, it's hard not to hate Dolan.... This interview interests me because at no point does he state he believes she's alive, and even says he had to soul search when taking the case.

http://www.mercurynews.com/crime-courts/ci_24865029/jahi-mcmath-streetfighting-lawyer-takes-heat-death-threats

My husband reminded me with a quote we received from a lawyer... She didn't care who was right or wrong, she was just gonna make sure she won.; January 7, 2014 at 9:43 PM
Diana said...: Thanks anonymous and CaliGirl9 for clarifying the training for RN's, very informative; January 7, 2014 at 9:44 PM
Craftylikeafoxx said...: @ Tammy jones

Lol.... Your soooo right about the brother, it's like he's on tour for his new movie coming out.... Which I wouldn't be surprised if did like the Schaivo's and started books an movie deals right after she dies.; January 7, 2014 at 9:45 PM
KK, ICU RN said...: I suppose it varies by state. but LPN/LVN's CAN and DO attach "enteral feeding solution to a gastrostomy tube,she suction through a trach tube—." Patients who have trach tubes in long term care facilities have these duties performed by LPN's all the time. Most LPN/LVN's after a period of time are IV certified. In some states, they are even able to give medicine through an IV. In my state, PA, they are not.

I'm an RN with 17 plus years experience and am CCRN certified in adult critical care nursing with 12+ years experience in this arena.
I'd be able to replace a trach tube if it came out but couldn't place one at the bedside. Most critical care RN's can do this. Only Doctors with surgical training can place one at the bedside. I don't know of anyone who would put one in on a patient who'd been declared brain dead.; January 7, 2014 at 9:46 PM
Misty4Me said...: @ Jacquline W:
Why am I not surprised that sources say Jahi's body is in the hands of "hardcore pro-lifers". What did I tell you about crossing into the Twilight Zone? If people target abortion doctors, actually kill them, and blow up Planned Parenthood clinics, do you think they'd stop at 'taking care' of a dead body? They are probably surrounding her and praying over her even as we type. I can well imagine. I knew someone who's child 'drowned' and suffered traumatic brain injury. Without the parent's permission, the school principal and some members of his extreme church came to the hospital, and prayed over 7 yr old (we'll call him) Jimmy. Their prayers failed to bring Jimmy out of deep coma. One day the parents walked in on them having a prayer circle around their son's bed, and asked them to stop. Before the people left, they told the boy's parents that the reason Jimmy didn't rise up healed from a miracle was because of THEIR lack of belief. Can you imagine? Jimmy's mom said she wouldn't worship a god who punished an innocent child for something she did.; January 7, 2014 at 9:58 PM
smalls777 said...: The only confirmation I've seen of granny being lvn with iv cert is, on the ca lvn board lic verification. It's safe to assume, the above commentator mention lvn/lpn scope is different by state. I only know of lvn able to start ivs in ca via cert. Never heard of any cert for enteral feeds etc. I'm pretty certain they cannot suction or touch a trach. Suction, period. Even invasive stuff Rns perform, or even function independently without an rn license supervising. I know when we had lvns, that's how the functioned at our facilities. Also, ratio laws apply to rns even if they have lvns under them. So they should be 1:1 1:2 etc. Rn in the bay area btw; January 7, 2014 at 10:32 PM
Anonymous said...: If you go to Jahi's Uncle Omari's Instagram page at http://instagram.com/p/i20BqcIpgd/ and read the remarks from "marvsmisses", who is identified as Nailah Winkfield (Jahi's mother), it is interesting to see her response to him for the Best Mom Award he got her. I don't know how to post a link to her response so I will copy it and post it below.

marvsmisses
@iamomari um hm! Clears throat for acceptance speech....... Yes I personally would like to tell Children's Hospital and all the negative people in the world to kiss my entire ass!!! And thank you!

To me, it just seems like such an inappropriate and flippant post coming from Jahi's mother. My heart breaks for what this poor child has and continues to be put through.; January 8, 2014 at 12:02 AM
Anonymous said...: Hey Sprocket...I know you're not a lawyer, but do you think California will be revisiting sections of their Health and Safety Code when we're finished? I was reading the complaints Dolan filed, and he exploited the ambiguous definition of "independent confirmation" in CHSC 7181 to mean "someone not affiliated with the hospital". The court, understanding that other litigation was possible, bought into it. That's why we waited another 10 days for Dr Fisher's report.; January 8, 2014 at 12:48 AM
Unknown said...: @misty

Indeed, those people are nutters.. I know they have Jah because this new beginnings is in tight with the terry schiavo foundation.. I also found out that Jahi has a step mother that was in visting jahi with the family while she was at CHO....

The stepmom said things at CHO were bad between family & STAFF.Said the doctors seemed angry every morning to find Jahi still alive.(( her word's not mine) Anyway you can see how this sets up the opportunity for the pro life crowd to offer falsehoods...

Bad situation , I think Jahis mom is being used by of people with different agendas but I have very little doubt that her only worry is Jahi..... These pro life quacks are very good at producing a thousand stories of brain dead survival miracle tales and when your child is also.brain dead you will believe these people...

Those people are like vampires, always looking for fresh blood to drink... They have found Jahi...; January 8, 2014 at 12:48 AM
Anonymous said...: There's the case of a woman in Texas who collapsed (suspected embolism) in the middle of the night while getting up to care for her baby. She was 20 wks pregnant at the time. She and the baby were w/out oxygen for an hour before EMT's arrived. Husband wants her removed from life support but hospital is legally bound to keep her supported until theyve completed viability tests on the baby. I have to go w/the hospital on this one. Even though the baby was w/out oxygen for an hour (doesn't look good) Id still want to know 100% for certainty that the baby was deceased as well. As her husband, I couldnt live with any "what if's" As for Jahi? BEST article (above) Ive read. Coma is not the same as brain death. Since this has been talked to death already, all I'll say is I hope this new hospital and the family reach a mutual decision to let her go soon. The scientist in me wants to know if a new brain scan all this time later, could show Jahi's mother that her brain has and is turning to liquid. You cant deny THOSE kind of pictures and still think she'll heal and come out of this. I feel for her even though all this is making it worse when the end result is still the same.; January 8, 2014 at 1:02 AM
Anonymous said...: Awful...awful...awful. Did this person have birthday parties? Get married? Walk a dog? No. Science goes way too far.; January 8, 2014 at 1:04 AM
Anonymous said...: This is the first Ive heard of this but I do know she survived the initial surgery only to start bleeding in recovery. The food? How? You cannot eat a burger (swallow harsh red meat) after tonsil removal. No way.; January 8, 2014 at 1:07 AM
Anonymous said...: Wait....what happened to her being transferred to a NY facility?; January 8, 2014 at 1:09 AM
Unknown said...: This comment has been removed by the author.; January 8, 2014 at 1:09 AM
Anonymous said...: This must be happening to Jahi as well. Thanks for the real info on what truly happens.; January 8, 2014 at 1:11 AM
smalls777 said...: Sorry for the comment I previously posted being so, well, illiterate. Typing on a tablet or phone is, impossible, add to the equation my 3 year old = disaster. My point was, LVNs in CA, generally do not work independently, without a rn or md license. They cannot, although certified, even perform such duties as an IV. Also, even if as an RN, our scope of practice allows us to perform duties such as placing lines, fluids, bags to g tubes/pegs etc, we are not allowed to do that without MD orders and it isn't something we can do in the home. (Another CA RN, chime in if you know better). Our scope of practice can be found on the CA BRN.

I also want to add (and I'm sure it has been discussed) one cannot simply go into a new facility and start performing duties that we generally as an RN can do at our own employer. For instance, granny suction at cho when she is a kp lvn. The RN should and most likely stopped that as that is against the law.

As I lie her unable to sleep because I'm consumed by this, I wanted to bring up one more thought: while jahi has been at cho, the family repeatedly said she was moving, breathing, improving, etc. That they basically knew she would thrive once they got her out of the hands of cho. Yet the moment she left cho, Dolans first report stated she was fragile, not doing well, hoping for the best but it looked like the worse was coming. Here is where my brain starts to tick: is this a ploy to place blame on cho for not letting her reach her facility on time? How did she go from improving, to suddenly, as she is removed from cho, her condition has worsened. I do understand nothing is worse than death and therefore these allegations are null. I'm just wondering if the attorney chose this time, this move to break to the family that she won't make it so that they would let go?? Does that make sense?? He wanted to fight cho and make sure all blame is on them, knowing there was already an end.

To answer someone's question about why such a huge interest. I say it's the RN in me. I am always consumed by interest in medicine. Always. This started as soon as the family began to place blame on the rns. It always angers me when, what I personally feel are ignorant people, blame the very people who care for them. Time after time, as an rn I find myself dealing with families like jahi. Entitled families. "This is what you get paid to do!" I do not get paid to be harassed, treated like a maid, asked to bring meals, chairs stools, beds, blankets to entire families. I didn't go to school to be a housekeeper. I went to school to take care of your loved on. Don't block my way, don't interrupt my clinical work, and don't tell me how to do my job. I HAVE experienced poor, disrespectful behavior and then when things do not go there way, they want to cry wolf. So as having seen this first hand, I felt deeply sympathetic to the staff at cho. My other curiosity lies in death and the dying process. I just didn't understand how this mother could be so blind. And I cannot stop reading on what will happen. Plus I am cynical I suppose and love reading the silly arguments by the supporters. Sorry. This has become a long post. The end.; January 8, 2014 at 5:34 AM
g kuzma said...: @ Assertive Woman, Roar

You wrote: " It always angers me when, what I personally feel are ignorant people, blame the very people who care for them."

Yes, that makes a lot of sense. I had that feeling when I read the hospital's affidavit about all the accommodations they've made for this family, and yet they still have nothing nice to say about CHO. On Nancy Grace they claimed the hospital tried to deny their being with Jahi on Christmas. According to the hospital affidavit, they ended up letting a whole group vigil in there and a Christmas tree - for a deceased person! So perhaps the hospital tried to limit how many people and the family threw a huge fit, then distorted it into the Nancy Grace story. That's the kind of thing that is so utterly demanding and unappreciative that it's hard to be sympathetic to Jahi's family, at least the ones in the public eye.

Well, thank you for the work you do as a nurse. I've had 21 surgeries for Ehlers-Danlos Syndrome and I know the HUGE difference a competent and kind nurse can make. It sounds like you certainly are one. People like you are a true blessing to people like me.; January 8, 2014 at 7:59 AM
Annie said...: Hello, everyone. First off, I want to say that this is an exceptional blog. The depth and breadth of knowledge supplied here should be mandatory reading for anyone interested in the Jahi McMath case. I come from a family of nurses- though not one myself- and my hat is off to anyone who chooses this as a career. There may be a few bad nurses out there (as with any profession), but the majority go above and beyond when caring for other people’s loved ones. This is true of the staff at CHO, it seems.

Here is my question for the forum. Apologies if it has already been posted. Is there any chance the family slipped across the border into Mexico? It is well within the transport time of twelve hours. We know that some family members are in the L.A. area, and there are internet rumblings about a facility near San Diego taking her in. It isn’t all that difficult to find a weak spot on the border to slip through if they chose not to pass a checkpoint. Is it in the realm of possibility that she is no longer in the country? If so, can the family be forced to return her to the U.S.? Could the family bury her in Mexico and avoid an autopsy, or have an autopsy performed at the place of death? Sorry to be so long-winded.; January 8, 2014 at 8:17 AM
Misty4Me said...: This is a must see video posted on Twitter by @DocBastard. It shows a heart beating on a machine awaiting transplant....NOT attached to the donor.

***WARNING - Graphic Medical Content***

Beating Heart: Machine Pumps Blood Thru Donor's Heart

https://www.youtube.com/watch?v=5sy9F-ekPHc; January 8, 2014 at 8:52 AM
Anonymous said...: @g kuzma
Could you post a link to the affidavit you mentioned?; January 8, 2014 at 9:14 AM
g kuzma said...: Yes, it's not the Affidavit, it's an Opposition to Restraining Order. I had also read Dr. Heidi Flori's Affidavit and had them confused - sorry.

http://www.scribd.com/doc/195182229/Children-s-Hospital-Research-Dec-20-2013-Opposition-to-Temp-Restraining-Order; January 8, 2014 at 10:13 AM
g kuzma said...: Here's more about their Christmas party:

http://www.jetmag.com/news/family-spends-christmas-jahi-mcmath/; January 8, 2014 at 10:16 AM
Misty4Me said...: @Annie:

Firstly, never be sorry to ask a question!

As to where Jahi's body has been taken, there is tons of speculation, but little hard fact. A poster on here last night claimed to have inside info that she's in the care of Terry Schiavo related zealots, but no location given.

What I want to know is, where were the news media? You'd think some enterprising paparazzi would have been lying in wait, following to see where the body was taken. Interesting that either no one cared enough to hang around the hospital, or the family pulled a really sneaky stunt and somehow got the body out without anyone noticing.; January 8, 2014 at 10:29 AM
Fat Asian Baby said...: Thanks to Sprocket, Caligirl, KZ, and all the thoughtful commenters, especially Artefact, whose contributions have been invaluable. I've been following this coverage closely but have remained on the sidelines, since I didn't feel like I really had anything useful to contribute. I just wanted to pipe up at this point and mention that the New York Times ran a fairly substantial piece today about Marlise Munoz, the brain-dead pregnant woman in Texas, that readers may find interesting:

http://www.nytimes.com/2014/01/08/us/pregnant-and-forced-to-stay-on-life-support.html?hp; January 8, 2014 at 11:15 AM
Anonymous said...: Thank you so much for the very informative posts! I was trying to explain to my husband the difference btwn "brain dead", TBD, and coma. These posts most certainly helped me get through to him the major differences (he thought the hospital was not acting responsibly), and to help him see why TBD is non-reversible.

A few things from the posts I read --- re: Jahi's Mom having "welfare insurance". It's MediCal, and it's available to low-income people whose jobs do not provide it, not just the disabled/unemployed. If Mom was covered, it's likely Jahi was covered under a similar program for children. Or she could have been on bio-Dad's insurance. CA does a lot to get kids medical coverage. Hundred-dollar nails? Well, not that hard to get in CA (everything's more expensive here). It's likely the family also was on food stamps or relied on a food bank. Many of the foods available to food banks are calorie-dense, but nutrient-poor. In other words, to get what it needs, your body signals for you to eat more. The face of poverty in the US is not skin & bones. It's obesity. It takes $$ to eat & live healthfully, to be thin.

As for the comments re: "right to life" groups & "Catholic facilities" that may or may not have taken in the body... *sigh* The average right-to-lifer is not one of the people denying science & insisting that Jahi is alive as long as her heart beats (by artificial means or not). Most of us recognize that science is indeed the authority here and that the soul (for those of us who believe) is seated not in the heart but in the brain, the source of all that makes us who we are. Life is sacred. Once life leaves the body, it should be treated with reverence, for both the life it contained & the amazing creation that it is. I think most would go so far as to say that keeping this girl's body going & denying her a dignified & natural death is sacrilege. Wrong. An abomination. The Catholic Church has already recognized that its dogma is in line with science here - Jahi is dead even by any reasonable right-to-life standards.; January 8, 2014 at 11:42 AM
Anonymous said...: I think so many of us in the healthcare industry are drawn to this case because it's the making of our nightmares. IF the stories about the family feeding Jahi hamburger are true and if she was talking and laughing then they violated post op procedures. For anyone other than a staff nurse or MD to suction her creates a huge liability issue for her family. A family who refuses to follow medical advice and then starts bringing in lawyers and lawsuits and playing the blame game is a worse case scenario. This whole situation is a nightmare.

The judge added to the problem when he declared Jahi dead but allowed her to remain on machines. Once 5 or 6 doctors have stated she is brain dead the machines should have been shut down. The judge should have ordered the coroner and the medical examiner to the hospital to examine Jahi and reported back to him so he could make the final ruling to remove the machines.

According to California statues brain death is dead. For this farce to have continued this long is a disservice to the family and the state. How will the medical examiner ever determine the cause of death at this point? They have no doubt already begun the paper autopsy by examining all of the medical records but the physical autopsy will be inconclusive as the soft body tissues are no doubt too deteriorated to tell what happened.

I have empathy for the family as well as the staff of the hospital. The feeling that you've failed the family by not getting them to understand death has occurred is hard enough. But for them to blame staff for what appears to be their own part in it is harder yet. But I have no compassion for the attorney in this case. He is an enabler to encourage them to deny the death of this child. There have been some pretty accurate opinions stated on here about him.; January 8, 2014 at 11:51 AM
Em said...: Now the family wants privacy
http://www.cnn.com/2014/01/08/health/jahi-mcmath-update/; January 8, 2014 at 1:01 PM
Anonymous said...: Well, THIS was predictable: http://www.sfgate.com/bayarea/matier-ross/article/Jahi-McMath-case-used-as-Consumer-Watchdog-5123174.php; January 8, 2014 at 1:23 PM
Coconut said...: This says she got the tubes....OmG

https://mobile.twitter.com/iseeyou_nurse/status/421023695591972864/photo/1

and malpractice campaign has started...
http://sanfrancisco.cbslocal.com/2014/01/08/phil-matier-jahi-mcmath-case-now-at-center-of-malpractice-campaign/; January 8, 2014 at 1:43 PM
Anonymous said...: The trach and feeding tube seem to be in. Sister's instagram account:

http://instagram.com/p/i60m6vo0sN/#; January 8, 2014 at 2:02 PM
Anonymous said...: Thank you to all for this blog (esp. creators and professional contributors.) I used to think people were almost psychopathically callous in denying sympathy to Jahi's family and ascribing motivations to them. I have now completely changed my mind after reading everything I could find about his story including this blog and its links (including official court proceedings and news from the family, etc.). It appears Dolan is making his case of negligence and is doing it through the family's religious beliefs in order to buy him more time because his case hinges in the very short window of time between Dr. Shanahan's diagnosis of brain death. He needs to cast doubt that her exam was wrong so he can prove negligence AND it seems like (although I could be reading the court document incorrectly) that CHO didn't comply fully with providing all Jahi's medical records (sounds bogus though) and did not provide an independent MD to confirm diagnosis because the MD's they used were still in 'relationship' with CHO.
It makes sense to pander to the families sense of 'religious denial/beliefs' to widen his window of doubt.

All very complex in terms of some legal terms, rules but I can somewhat see his game plan-but it's still foggy because it's logically complex & I'm not familiar with legal rules/regulations. I wish a lawyer would break this down more so I can clear up my foggy picture. I do however have a crystal clear understanding of the medical science involved...that part is easy for me.

I hope this case (if it keeps going) does not give special rights to religious fanatics to argue or change the true definition of death. I hope it also does not force treatment on brain dead patients (as a result of change in definition of brain death).; January 8, 2014 at 2:45 PM

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Monday, January 6, 2014

Jahi McMath: Merely Dead, or Really Most Sincerely Dead?

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Trials & Tribulations

Monday, January 6, 2014

Jahi McMath: Merely Dead, or Really Most Sincerely Dead?

305 comments:

Betsy A. Ross

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