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Jahi McMath Brain Death: Was It Hospital Malpractice?

hospital malpracticeJahi McMath’s story is heartbreaking – and utterly perplexing. The 13-year-old went in for a common tonsil and adenoid removal surgery and came out brain dead. Neuroscientists say that there is no doubt about it: the girl is clinically dead, despite the fact that machines have kept her heart beating and lungs inflating for nearly a month.

The family says surgical errors have led them to believe they have a hospital malpractice case and that the hospital hopes the girl would die to avoid the expensive litigation to follow, should she survive and require life-long care.

What constitutes brain death?

The term “coma” and “brain dead” are often used interchangeably, but they mean two very different things, says CNN. Doctors can put a patient into a coma for a couple weeks to give the brain time to heal. The longer a coma lasts, the less likely the person is to regain awareness, says TIME Magazine. However, there are a few exceptions, as doctors found that some people in comas for years were miraculously awakened by the drug Ambien. Typically, at the end of a medically-induced coma, the patients can regain full consciousness or may transition into a “persistent vegetative state.”

In 1990, Terry Schiavo was diagnosed as being in a “persistent vegetative state,” meaning that her higher brain functions were lost, but she could still open her eyes and exhibit small movements. She could not respond to commands or speak, however. Doctors could not legally declare her “brain dead,” and so she remained on ventilators for 15 years. The National Institutes of Health says that some people can recover from this state, which is what causes much of the confusion for people dealing with the decision of whether to “pull the plug” or not.

On the other hand, the Uniform Determination of Death Act describes death as occurring when a patient “has sustained either 1) irreversible cessation of circulatory and respiratory functions, or 2) irreversible cessation of all functions of the entire brain, including the brain stem.” Brain death means a loss of functioning in both the upper brain, which controls the nervous system and senses, as well as the lower brain, which controls breathing, reflexes, heart beat and body temperature.

It can be difficult for the average person to understand how a person can be dead if the heart is still beating, but medical intervention can keep the body artificially supported for a few months – or, in rare cases, even a few years. “Dead is dead,” neurologist Dr. Richard Senelick told The Atlantic. “Brain death isn’t a different type of death, and patients who meet the criteria of brain death are legally dead. No one who has met the criteria for brain death has ever survived. No one.”

Surgical errors sometimes lead to brain death

Hospital malpractice can sometimes lead to brain death. These types of negligence include:

  • Complications from general anesthesia related to improper tubing
  • Surgical errors causing immediate cardiac arrest
  • Medication errors
  • Compression of the trachea
  • Early discharge if a patient appears disoriented
  • Failure to monitor and  treat a patient in distress
  • Failure to evaluate patient risk before performing surgery

Medical errors kill more than 200,000 people each year in the United States, according to a study cited by CNN. When added up, surgical errors and medical mistakes are the third-leading cause of death in the country. Whether machines keep a patient’s heart beating or the patient is declared legally dead, a hospital malpractice lawsuit can address any mistakes made by medical professionals to ensure the same errors do not happen again.    

Does the family of Jahi McMath have a hospital malpractice case?

According to Mercury News, the circumstances surrounding Jahi’s case echo what happened to “Rebecca Jimenez, of Rodeo, once a smart and vivacious elementary student [who] can no longer walk, talk or communicate with her family following her Sept. 6, 2011, elective tonsillectomy and adenoidectomy.”

The eight-year-old had come out of surgery disoriented, with her head slumped to one side and complaining, “It hurts.” She looked pale, her eyes could focus and her fingers were cold. Even so, the hospital discharged the girl, instructing her mother to give her pain medication. On the drive home, Rebecca’s eyes rolled back in her head, her heart began racing and she became extremely pale. Her mother called the post-operative hotline, but she was told to “call back in five hours if the symptoms did not improve.” After going back to the emergency room and finding her in critical condition, CAT scans revealed that he had suffered oxygen deprivation and severe brain stem swelling. Rebecca and her parents sued for hospital malpractice – and won an undisclosed sum that pays for the girl’s 24-hour-a-day care.

The difference in Jahi’s case is that she is not showing clear signs of brain activity, as Rebecca did. Even so, the family may have a wrongful death lawsuit on their hands, should the plugs be pulled. Jahi’s surgery was described by the hospital as “complicated,” even though it is the most common surgery with general anesthesia for children in America. The young teen began bleeding shortly after surgery, but the nurses in the PICU told her mother the bleeding was “normal” and left the girl’s mother and grandmother to control the copious blood flow. She eventually went into cardiac arrest, lost brain function and was placed on a ventilator.

Six doctor examinations concluded that she was legally “dead.” But Jahi’s mother, Nailah Winkfield, told reporters, “I would probably need for my child’s heart to stop to show me that she was dead. Her heart is still beating, so there’s still life there.” For now, court orders have allowed for the girl’s transfer from an Oakland hospital to an undisclosed location while the family contemplates what to do about the ethical dilemma on their hands, as well as the impending malpractice lawsuit.