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Life support extended for girl declared brain dead

By Lisa Leff & Terry Collins

Associated Press

LAST UPDATED: 06:57 p.m. HST, Dec 30, 2013

OAKLAND, Calif. >> The family of a girl who was declared brain dead after tonsil surgery received another reprieve Monday from a judge who ordered the 13-year-old to be kept on life support for another week.

Doctors at Children's Hospital Oakland say Jahi McMath will never recover, so they want to take her off the machines that are keeping her body functioning. Her family wants to continue life support, saying they have hope she will still pull through.

Shortly before a previous ruling would have allowed doctors to end life support at 5 p.m. Monday, Alameda County Superior Court Judge Evelio Grillo ordered the hospital to keep Jahi on a ventilator until Jan. 7 to give the family time to file a petition in state appellate court.

It's the latest twist in a harrowing legal and medical fight that has reignited a heated debate about when life support should end for a severely brain-damaged person.

On Monday, the family's lawyer filed suit in federal court, requesting that the hospital be compelled to perform a tracheotomy for breathing and to insert a feeding tube -- procedures that would allow Jahi to be transferred to a facility willing to care for her. The hospital has said it's unethical to perform surgery on a person who is legally dead.

With television cameras clustered outside the hospital, the family maintained a vigil as the deadline approached.

When Jahi's mother, Nailah Winkfield, heard of the delay, she wept and hugged relatives outside the hospital. She said it was an answer to her prayers and a sign that she was right to keep fighting.

"Who wants to know the date and the time their child would die?" Winkfield said. "I don't care what anyone has to say about what I'm doing. ... I have to do what is right for me and for Jahi."

She said she does not believe her daughter is dead because her heart is still beating.

Sam Singer, a hospital spokesman, said it would comply with the judge's new order but would oppose any efforts by Jahi's family to convince a court that she is still alive and entitled to the same rights as a living person.

"We are hopeful we will be successful so this tragedy can end," Singer said.

He also dismissed claims by Jahi's relatives that she has shown signs of life, saying any muscle activity was an involuntary muscle reflex.

The family's lawyer, Christopher Dolan, said when he called Jahi's mother at the hospital about the extension of the deadline, she said hospital staff had cleared family members out of a waiting room as doctors prepared to remove Jahi from the ventilator.

"He's giving us a meaningful opportunity to seek relief and what I consider a stay of execution," Dolan said of the judge's ruling. "I feel like I'm a death row lawyer, and it does not feel good."

The attorney said he knows he has been widely criticized by some for giving the girl's family a false sense of hope. But he said, "I am fighting for the right of parents to direct the health care of their child and for them to make the choice."

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

She underwent a tonsillectomy at the hospital Dec. 9 to treat sleep apnea and other issues. After she awoke from the operation, her family said, she started bleeding heavily and went into cardiac arrest. Then she was declared brain dead three days later.

In a declaration filed with the federal action by Jahi's family, Dr. Paul Byrne, a pediatrician who has questioned the definition of brain death, said he visited Jahi's bedside and observed her responding to her grandmother's voice and touch with a squirming movement.

"In my professional opinion, she is not a cadaver," Byrne said. "Her heart beats thousands of times a day."

The family's court filings said the New Beginnings Community Center in Medford, N.Y., is willing to take Jahi and provide 24-hour medical care. The facility's management could not be reached for comment Monday night.

Arrangements also have been made, according to the documents, with an air ambulance company for a doctor to accompany Jahi on a private jet from Oakland to Long Island for $27,950.

By Monday night, the family's fundraising website had raised more than $27,000 for a possible transfer.

Dolan said in a phone interview that he has also been in talks with a facility in Arizona because the family would like to keep Jahi as close as possible.

Earlier, Singer, the hospital spokesman, reiterated the position of its doctors.

"This is one of the most tragic situations imaginable," Singer said. "A family has lost their young daughter. But unfortunately, Jahi is deceased. No amount of hope, prayer or medical procedures will bring her back."

Hospital spokeswoman Cynthia Chiarappa has said officials would have to understand the capabilities of the New York facility before allowing a transfer. The hospital also said it would need to confirm there is lawful transportation included in any transfer plan and there is written permission from the coroner.

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HonoluluHawaii wrote:
This is the kind of thing that rips your heart out and also is costing the country millions of dollars. Now I suppose it would be wrong to limit the charges on the family for the care, however if a family wants care, most would give it to their loved ones. I was charged with the durable power of attorney with health care instructions for my grandmother who was declared in a coma and would not be able to be revived, after she had fallen and hit her head on the ground at age 93. Her doctor gave me the options and I decided to "pull the plug" on my grandmother and she passed away in two weeks time in 1996. These decisions have to be made, or the costs will escalate beyond belief. At the same time, the medical profession needs to have compassion and not let the bill go to the moon.
on December 30,2013 | 09:09PM
Tahitigirl55 wrote:
This is so sad but sometimes we have to come to peace with ourselves. As parents we love our children so much and would do anything to help them. I hope and pray that the family finds peace and will do the right thing. The cost is sometimes the worst thing and I wish them will as they continue to pray for her . Letting go is the hardest thing to do but sometimes we must. God bless your ohana .
on December 31,2013 | 04:41AM
HonoluluHawaii wrote:
Being in touch with Science helps, as I had a fairly great education at UHM and that helped me to understand as my grandmother went into a permanent coma in 1996. She could have been kept alive kind of a long time, however what are we going to do? As the default patriarch of our family, being the first born son and also first born, I was given the duty of trustee of my grandmother's trust as well as her attorney in fact, as noted in her Durable Power of Attorney with Health Care Instrutions, in my comment above. Still, life decisions can and must be made, either by consensus or by a person. The tragedy that the child in the above story is repeated many times throughout our country. Technology exists to maintain life beyond that was possible even fifty years ago. Cancer is another whole topic though. My first sister had taken care of our mom for the last six years of her life. My mom needed cancer surgery to survive and we decided to do it in August. Two months later, my mom developed pneumonia and went just like that in a week's time. My sister discussed options with me about our mom's final days. It was a more heart wrenching decision than with what happened with my grandmother. However our mom had been back and forth between home and emergency and hospitalization for the past six years and it seemed inevitable that the end would soon arrive. Seniors especially would have a very difficult time recovering from pneumonia and it was terrifying watching our mom take her last precious breaths on this Earth. At 83, she performed so well in raising the four of us. Now I being the oldest at age 56 is sort of "the boss", however I always was looked upon as "the boss" since my Dad passed away in 1991 and is interred at The National Memorial Cemetery of The Pacific. My mom joined him two months ago.
on December 31,2013 | 05:21AM
jess wrote:
The hospital is crying ethics now but wasn't it unethical to fail to check in enough on a patient who just underwent a very dangerous surgery? I feel horrible for the family and hope they get some closure. I'm not sure how I feel about keeping this girl on life support but my feelings have nothing to do with it as I am not her family. The hospital should be held accountable, I'm sure they will eventually but I'm sure civil proceedings will be costly both financially and emotionally for the family. Wishing them love and happiness in the new year!
on December 31,2013 | 06:53AM
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