Jahi McMath case in California

[bionicmlle]

Won't she eventually starve to death?

No. She is already dead.

[Stephanie66]

No. She is already dead.

Fair enough. I meant...won't her heart eventually stop beating from being starved? (Since her family is using this as the death standard)

(It's like that show, "1000 Ways to Die" at this point, only all with one poor little girl.)

[already hungover]

My mom had a tonsillectomy in the 60s and almost bled to death. The only part she remembers is vomiting blood all over a nun at the Catholic hospital and being worried that she'd go to hell as a result.

Poor Jahi. Give the poor girl some dignity.

[GawkingToo]

Here's a link to court documents, for those who are interested: http://www.thaddeuspope.com/futilitycases.html

(Let me know if anyone thinks the links should be broken)

Here's another collection of links (see top post): http://www.websleuths.com/forums/showth ... p?t=230571

Not sure if all the doc overlap with the ones above.

Also an interesting read: sprocket-trials.blogspot.com/2014/01/the-long-sad-death-of-jahi-mcmath.html

Some of the stuff in the blog post is based on anonymous comments to a newspaper article, so I don't put much stock in those portions. However it's still worth checking out. The comments are pretty interesting too.

EDIT: Adidas beat me to my sprocket-trials edit!

[adidas]

The mother identified as baptist, not JW. Also, the uncle said on tv that this is the child's third surgery fo sleep apnea.

According to this blog, Jahi had an adenotonsillectomy, uvulopalatopharyngoplasty and submucus resection of bilateral inferior turbinates. Definitely not a routine tonsil removal.

http://sprocket-trials.blogspot.com.au/ ... y.html?m=1

[feministing]

Doctor here. Tonsillectomy is a common, simple surgery. Doctor had to be either stupid or drunk to fuck that up. He or she deserves any humiliation he or she may incur.

I've seen one done. It is stressed to find all the important arteries before proceeding. Looks like a case of hubris on the doctor's part. That pompous, old-timer, "I can do this with my eyes closed, wanna see?"

Despicable. I know all docs make mistakes (myself included) but it takes a special kind of hubris or stupidity to mess up a tonsillectomy. The a-hole doc deserves what's coming.

[adidas]

But it was not a routine tonsillectomy.

Besides the complication rate runs at over 2% for a routine tonsillectomy with heavy bleeding the most common complication.

[Coconut Flan]

I like this article: http://www.mercurynews.com/science/ci_2 ... omplicates.

I was just coming to post that they seem to be members of an IFB or fundie leaning Baptist church: pbc5star.org/.

[gardenvarietycitizen]

The video from the Halachic Organ Donor Society (linked from the sprocket-trials site) was very informative, thanks for linking up that page.

Watching it, the explanation they gave (plus reading a few other pages) seems to imply that even if they leave the ventilator on, the heart still has a very limited "life" span in it, only for a few days to weeks. So it seems the rest of the body is going to die regardless of if they move her anywhere? And it certainly seems that a feeding tube would not be doing anything would it? The video explained that the heart is on autopilot by itself without a brain (for this short period) as long as oxygen comes in, but the digestive system isn't that way is it?

In true brain death, what's the record for keeping the body "alive"? I think I've heard of brain dead mothers being prolonged on ventilators to give the baby more time to develop, but even then, I presume they take the kid out ASAP (post viability line)? Or are those stories not actually about truly brain dead but more of the "deep deep coma from where there's likely no recovery so we terminate life support" stories?

Interesting stuff, anyway.

[feministing]

But it was not a routine tonsillectomy.

Besides the complication rate runs at over 2% for a routine tonsillectomy with heavy bleeding the most common complication.

Still, tonsillectomy struck me as one of the more simpler surgeries. Cataract operations are also very simple, but have a similar screw-up rate. Why? Because veteran surgeons (or maybe overly ambitious junior surgeons or residents) are more likely to exhibit hubris and flout the official protocol (using shortcuts) because "pssh, I won't screw this up, it's too easy!" I see that hubris a lot among pompous senior surgeons.

[mags]

Doctor here. Tonsillectomy is a common, simple surgery. Doctor had to be either stupid or drunk to fuck that up. He or she deserves any humiliation he or she may incur.

I've seen one done. It is stressed to find all the important arteries before proceeding. Looks like a case of hubris on the doctor's part. That pompous, old-timer, "I can do this with my eyes closed, wanna see?"

Despicable. I know all docs make mistakes (myself included) but it takes a special kind of hubris or stupidity to mess up a tonsillectomy. The a-hole doc deserves what's coming.

Are you serious? Maybe you should check your ego because real doctors don't make these kinds of comments. Real doctors have seen all sorts of situations go sideways, including routine tonsillectomies. That is a very vascular part of the body and I have personally seen a patient hemorrhage and code within a few minutes (despite emergent blood transfusion) from an arterial bleed in that area (though it was not a post-surgical situation.) Blood was everywhere and you can't really apply pressure to the throat. An ENT surgeon was on the floor evaluating the poor guy for surgery and immediately got on the phone to arrange an OR so there was no delay getting him to surgery. He didn't do well either (Edit: "He" meaning the patient didn't do well.)

Those "pompous, old-timers" are very few and very far between, probably because they have seen it all and don't take many chances. I would also like to remind you that you have no idea what kind of surgery Jahi had and what happened that caused the bleed (if anything) because NO MEDICAL RECORDS have been released. Probably best not to judge the surgeon until you have a look at those records.

[sparkles]

Still, tonsillectomy struck me as one of the more simpler surgeries. Cataract operations are also very simple, but have a similar screw-up rate. Why? Because veteran surgeons (or maybe overly ambitious junior surgeons or residents) are more likely to exhibit hubris and flout the official protocol (using shortcuts) because "pssh, I won't screw this up, it's too easy!" I see that hubris a lot among pompous senior surgeons.

Yes, doctors can screw up. But patients and/or their families in the case of a minor also have a responsibility to provide complete histories and to follow post-op instructions. If the information in the sprocket link (excellent wrap-up BTW, thanks) is true, then Jahi's family did neither. I was shocked to read that her family encouraged her to talk, in direct opposition to what they were told. After his surgery, Mr. Sparkles had to refrain from talking or whispering altogether for a full week and had to keep it to a minimum for another couple of weeks, and we did everything possible to help him stick to it. If Jahi's family did indeed go against what they were told and weren't truthful about her history, then they're as responsible for her demise as anyone. Doctors certainly aren't gods but they're not mind readers or overseers either.

[GawkingToo]

Actually, I now realize there are at least two Sprocket-Trials posts:

http://sprocket-trials.blogspot.com/201 ... egacy.html

http://sprocket-trials.blogspot.com/201 ... cmath.html

Again, someone please let me know if you think I should break the links.

[adidas]

Feministing, maybe so but in this case there is evidence to suggest that the surgery itself went smoothly and it was a few hours later that post op bleeding started. Not unusual or unexpected. From there details are murky. But from what the family has said, we have the mother fainting and being admitted (and moved to a different section of the hospital - so her recollections could be hazy), we have the family saying Jahi was talking and laughing (which is discouraged so that the surgical sites can be protected), and we have the grandmother confirming that she, her daughter and Jahi herself were all suctioning blood which could have led to the accidental dislodging of any clots at the wound site - leading to further bleeding

Now all of this could be untrue. However the family has gagged the hospital from giving any details so I'm reluctant to blame the doctor until both sides of the story are heard. Just from what we can piece together from the family's words there is enough doubt in my mind to place blame on the surgeon at this stage.

I'm cross posting, hopefully not repeating too much.

[RosyDaisy]

What Adidas said.

[GawkingToo]

Doctor here. Tonsillectomy is a common, simple surgery. Doctor had to be either stupid or drunk to fuck that up. He or she deserves any humiliation he or she may incur.

I've seen one done. It is stressed to find all the important arteries before proceeding. Looks like a case of hubris on the doctor's part. That pompous, old-timer, "I can do this with my eyes closed, wanna see?"

Despicable. I know all docs make mistakes (myself included) but it takes a special kind of hubris or stupidity to mess up a tonsillectomy. The a-hole doc deserves what's coming.

It wasn't a "simple" "tonsillectomy." Just because the family characterized it as such in court and to the media, doesn't make it true. They have said multiple things that turned out to be questionable.

At the very least, consider how the hospital has characterized the operation:

a complicated surgical procedure consisting of an adentonsillectomy, uvopalatopharyngoplasty, and submucous resection of bilateral inferior turbinates

Source: http://thaddeuspope.com/images/Winkfiel ... _2013_.pdf, page 4 (labeled page 2)

Also, the hospital saw fit to plan ahead for her to be transferred to PICU post-surgery. And there are reports that she was obese and had obstructive sleep apnea.

I'm not a doctor. I don't know whether death was predictable based on the type of surgery she did have, but can we at least stop repeating the line that it was a "simple tonsillectomy"?

[adidas]

Also I would refute the notion that tonsillectomies are common surgery these days. I usually shy away from giving any personal details about my family but after the eighth bout of tonsillitis for one of them as a toddler I begged for the procedure to be done. The constant antibiotics were wreaking havoc and I hated seeing my baby suffering with a new resurgence every few weeks. My request was refused and I was told that it's rarely done because the risk of complications is so high. We were referred to an ent who had tests done on the bacteria and found that it was a type particularly resistant to abx and it needed a longer, stronger course. That would have been good to know about 6 months ago :/. We were advised at that stage (because we were a week into another bout) to be cruel to be kind and to give it another week of no treatment to see if the body would kick in and start fighting the bacteria. The week was hell but once the body was able to conquer it, things improved. I'm so thankful we saw the ent who investigated it a bit more fully instead of giving us yet another course of abx.

[GawkingToo]

Doctor here.

On Nov. 24, 2013, you said the following:

I also went blind in one eye as a kid and gym class was a nightmare. Now I'm in medical school.

viewtopic.php?f=81&t=20136&p=656183#p656183

Did you graduate over the Christmas break?

[feministing]

Are you serious? Maybe you should check your ego because real doctors don't make these kinds of comments. Real doctors have seen all sorts of situations go sideways, including routine tonsillectomies. That is a very vascular part of the body and I have personally seen a patient hemorrhage and code within a few minutes (despite emergent blood transfusion) from an arterial bleed in that area (though it was not a post-surgical situation.) Blood was everywhere and you can't really apply pressure to the throat. An ENT surgeon was on the floor evaluating the poor guy for surgery and immediately got on the phone to arrange an OR so there was no delay getting him to surgery. He didn't do well either (Edit: "He" meaning the patient didn't do well.)

Those "pompous, old-timers" are very few and very far between, probably because they have seen it all and don't take many chances. I would also like to remind you that you have no idea what kind of surgery Jahi had and what happened that caused the bleed (if anything) because NO MEDICAL RECORDS have been released. Probably best not to judge the surgeon until you have a look at those records.

I know they are few and far in between. I never once implied that screwed up tonsillectomies occur often.

I'm just in clerkship. I've seen one tonsillectomy. The attending told me it is a simple procedure. Yes, there are individual variations in vasculature but the attending emphasized a attempting to locating the important vessels before proceeding. He was the one who brought up the old-timer hubris bit. I figured you would be discerning enough to realize that it is the exception, not the norm. My attending claims to have never botched a tonsillectomy in a way that resulted in severe complications or death, and he has only heard of one case of post-tonsillectomy death; the surgeon met the hubris description.

I know n=1 is not enough to come to conclusions, but the attending has his hunches.

[feministing]

On Nov. 24, 2013, you said the following:

http://www.freejinger.org/forums/viewto ... 83#p656183

Did you graduate over the Christmas break?

I lied about being an intern because I felt nobody would take a student seriously. I am willing to provide proof to the mods that I am in medical school. I started my clerkship in July.

Apologies, I shouldn't do that again.

[feministing]

Also I would refute the notion that tonsillectomies are common surgery these days. I usually shy away from giving any personal details about my family but after the eighth bout of tonsillitis for one of them as a toddler I begged for the procedure to be done. The constant antibiotics were wreaking havoc and I hated seeing my baby suffering with a new resurgence every few weeks. My request was refused and I was told that it's rarely done because the risk of complications is so high. We were referred to an ent who had tests done on the bacteria and found that it was a type particularly resistant to abx and it needed a longer, stronger course. That would have been good to know about 6 months ago :/. We were advised at that stage (because we were a week into another bout) to be cruel to be kind and to give it another week of no treatment to see if the body would kick in and start fighting the bacteria. The week was hell but once the body was able to conquer it, things improved. I'm so thankful we saw the ent who investigated it a bit more fully instead of giving us yet another course of abx.

I have been told that tonsillectomies are quite routine, but opinion might differ from doctor to doctor.

Moore (clinically oriented anatomy, p. 1047) says that bleeding is common due to the rich vasculature to and around the palatine tonsil, but it is usually controlled and rarely results in long-term complications or death.

[feministing]

It wasn't a "simple" "tonsillectomy." Just because the family characterized it as such in court and to the media, doesn't make it true. They have said multiple things that turned out to be questionable.

At the very least, consider how the hospital has characterized the operation:

Source: http://thaddeuspope.com/images/Winkfiel ... _2013_.pdf, page 4 (labeled page 2)

Also, the hospital saw fit to plan ahead for her to be transferred to PICU post-surgery. And there are reports that she was obese and had obstructive sleep apnea.

I'm not a doctor. I don't know whether death was predictable based on the type of surgery she did have, but can we at least stop repeating the line that it was a "simple tonsillectomy"?

Did not see that. That would definitely change the story (and my opinion).

[feministing]

Feministing, maybe so but in this case there is evidence to suggest that the surgery itself went smoothly and it was a few hours later that post op bleeding started. Not unusual or unexpected. From there details are murky. But from what the family has said, we have the mother fainting and being admitted (and moved to a different section of the hospital - so her recollections could be hazy), we have the family saying Jahi was talking and laughing (which is discouraged so that the surgical sites can be protected), and we have the grandmother confirming that she, her daughter and Jahi herself were all suctioning blood which could have led to the accidental dislodging of any clots at the wound site - leading to further bleeding

Now all of this could be untrue. However the family has gagged the hospital from giving any details so I'm reluctant to blame the doctor until both sides of the story are heard. Just from what we can piece together from the family's words there is enough doubt in my mind to place blame on the surgeon at this stage.

I'm cross posting, hopefully not repeating too much.

Bleeding is typically controlled during the surgery, but bleeding may occur after. Tonsillectomies are typically an outpatient procedure so I assumed complications, if they happened, were probably very rarely serious.

I'll email my attending for clarification and get back to you.

The allegations from the patient's family do sound suspect.

[adidas]

Did not see that. That would definitely change the story (and my opinion).

I posted the same information right before your "drunk as fuck a-hole doctor deserves what's coming" post.

[feministing]

I posted the same information right before your "drunk as fuck a-hole doctor deserves what's coming" post.

I didn't read the entire thread before replying, just an article in the Miami Herald over the break.