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To: MD Expat in PA
Again, you don't know that, you selectively repeat things that support the hospital and ignore anything else?

Let's be honest here, would you ever, under any circumstance, say something which criticized a hospital?

23 posted on 01/02/2014 6:22:59 PM PST by nickcarraway
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To: nickcarraway
Again, you don't know that, you selectively repeat things that support the hospital and ignore anything else? Let's be honest here, would you ever, under any circumstance, say something which criticized a hospital?

What am I ignoring and what makes you think I would never under any circumstance, say something which criticized a hospital? If you are assuming that I am a doctor because of my screen name and therefore am sticking up for my “kind”, you are wrong. The MD is “Maryland” not “Medical Doctor” if that is what you were thinking.

However, I don’t and neither do you know if the doctors and or the hospital staff are at fault for the girl’s death. According to what the family and their attorney says; when Jahi started bleeding heavily, they were told the bleeding was “normal” and the nurses didn’t do anything at first or until it was too late it is alleged. If that is true, then the hospital should be sued and her family compensated for a wrongful death and I contrary to what you seem to assume, would support that outcome.

According to this, it sounds to me as though in the ICU, her severe bleeding was not promptly addressed:

http://www.contracostatimes.com/news/ci_24819771/document-appeal-describes-jahi-mcmaths-post-surgical-bleeding

However also understand that just because someone dies after surgery, that doesn’t necessarily mean the doctors and the hospital screwed up. And again, this was not just a routine tonsillectomy. She also had her adenoids removed; her uvula reduced and had nasal surgery for a deviated septum, all in an effort to alleviate her severe sleep apnea. I’m sorry you think those facts are “selective” or only in support of the hospital. But those are the facts.

Any one of those surgeries has risks of complications, namely profuse bleeding (look it up for yourself if you don’t believe me). And sometimes patients have unexpected complications; some patients don’t react well to anesthesia, their blood doesn’t clot normally, a blood clot breaks loose and a hemorrhage occurs, or the stress of surgery causes a heart attack; consider that even though she was young, Jahi was morbidly obese and we don’t know anything about her medical history or any underlying conditions she might have had. She didn’t die directly from blood loss BTW – she died from a massive heart attack. However, hypovolemic shock, i.e. severe blood loss can cause a heart attack and very well might have in this case, however we don’t know if by the time Jahi was given blood, if it wasn’t already too late to save her or if the heart attack was the result of blood loss, how much blood loss there really was or if the heart attack was coincidental to the bleeding. FWIW I had a tonsillectomy when I was 18 and yes, there was a lot of post-op blood which lasted for days. It was nasty and disturbing but it was “normal”. And bleeding from the nose and mouth after also having a uvula reduced and nasal surgery would not be uncommon or abnormal. Of course copious amounts of blood, i.e. hemorrhaging, gushing blood would not be normal and if that was ignored and not responded to as a medical emergency, then yes, the hospital would IMO be a fault.

But sometimes, in rare cases the doctors and nurses do everything right by the book and the patient still dies. That is why, when you or I consent to having surgery, even “minor” outpatient surgery or even a tooth extraction, we sign a release form, one that lists all the possible risks and complications, including the risk of death.

Then this is this from a court document:

In the document, the family's attorney, Christopher Dolan, says "originally the surgery was uneventful and (Jahi) awoke from sedation in the recovery room speaking with her mother ... (and) asking for a popsicle."

The girl was brought to the intensive care unit, where her mother was told that caregivers would fix her IV, the document states. After 25-45 minutes, her mother found her sitting up in bed and bleeding from the mouth.

Another request for help from Jahi's family brought a larger container to collect blood, and, later, a suction device. Jahi's grandmother, herself a nurse, "made multiple requests, and then a loud demand, for a doctor."

Consider this “inconvenient” tidbit. Why was Jahi “speaking” to her mother and asking for a popsicle in the recovery room right after she came to? I would think that considering the surgery she just had, that she and her mother would have been given instructions, just as I was just for a tonsillectomy, not to attempt to speak and not to eat or drink anything for the first 12-24-hours. Did her mother give her a popsicle? Did she or the grandmother encourage her to speak? Did they overreact and get Jahi overly excited and afraid when they saw her bleeding? Was the initial amount of bleeding normal, but exasperated by perhaps the mother or grandmother who is a nurse but what kind of nurse; an RN, LPN or a nurses aid, got carried away with the suctioning and dislodged a blood clot and made matters worse?

Of course this is conjecture without all the facts in evidence, but if we are going to conjecture and jump to the conclusion that the hospital killed the poor girl, then it is also fair to conjecture and at least ask questions about the family’s actions. No?

But no matter what happened and why and how, Jahi is very sadly dead. She isn’t in a coma or in a PVS, her brain ceases to function on any level, there are no signs of any electrical activity in any part of her brain, even the brain stem, and there is no blood flow, her pupils are fixed and dilated, she does not breath on her own without the artificial respirator and all this has been confirmed by multiple tests performed by at least 3 neurologists over the course of several weeks. Her heart continues to beat, her body still feels warm to the touch, her muscles sometimes jerk and spasm but that does not mean she is alive.

Q: Is there any scientific basis for the family's belief that the girl is responding to the family, is aware of her surroundings, or could recover?

A: No, according to Nancy Berlinger, a bioethicist with The Hastings Center, a nonpartisan research institute devoted to health and medical issues.

"One of the things very confusing about cases like this is that the patient looks alive, the heart is beating, the body has a normal color ... the body feels warm," Berlinger said. "What is going on now is the maintenance of function by mechanical means."

Children's Hospital spokesman Sam Singer said Jahi's family also could be mistaking the movements they say she has made to an involuntary muscle reflex sometimes seen in brain-dead patients that doctors call the "Lazarus effect."

Q: How long can a person who is brain dead survive?

A: It's hard to know because in most cases families agree to suspend mechanical means of support, but it's safe to assume that a ventilator will not keep a patient's heart beating indefinitely, according to J. Randall Curtis, a professor of medicine and an intensive-care unit doctor at the University of Washington. The brain stem, the part that controls breathing, is no longer functioning in a brain-dead person. Although a ventilator can keep the heart and lungs working for a while, the organs will eventually shut down without input from the brain, Curtis said. Ventilated patients also are at risk of infection, he said.

"People's hearts have continued beating for a month sometimes, with the ventilator, but no one has ever been documented to be brain dead and come back from it," Curtis said.

http://www.npr.org/templates/story/story.php?storyId=258709291

24 posted on 01/03/2014 5:24:26 AM PST by MD Expat in PA
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