Mom of 13yo on vent fights for 2nd opinion- hate on display

[mmhmm]

Jan 6, 2014 20:59:01 GMT -5 justme said:

Jan 6, 2014 20:53:36 GMT -5 mmhmm said:

The ventilator will continue to keep the lungs working without the involvement of the brain.

Yes. I kept going around in circles trying to be clear and may have still not been. I meant to say that the lungs could stop working on their own (brain fine), the brain stops working (and therefore stops the lungs, but physically lungs are still ok), or both brain & lungs stop functioning separate from the other. But I think in all cases the lungs would keep working on a ventilator.

I don't know how damaged lungs would have to be for a ventilator to not work, that was what I was unclear on.

As long as the lungs are intact, the ventilator will do its job of supplying oxygen and maintaining the necessary positive pressure.  Now, if there were big holes blown in the lungs, that would be a different story.

[The Walk of the Penguin Mich]

Jan 6, 2014 20:13:46 GMT -5 mmhmm said:

Jan 6, 2014 20:09:21 GMT -5 achelois said:

Me too, mmhmm, I would love to know the cause for the bleed, but I doubt we ever will.

I don't know that we can know now, achelois.  There wasn't even any brain stem activity.  That brain is turning to mush as we speak, with the rest of the organs deteriorating as well. I'd put chances of determining what happened at pretty darned close to nil.  It really is a shame.

The mother said that she was encouraged to talk and laugh after surgery.  I thought that is was REALLY contraindicated, to keep from happening what happened.

Do ICU units have cameras in them?

[mmhmm]

As an anecdote, as nursing supervisor I always got a call when 911 was bringing in a cardiac arrest.  The message was: They're bringing one in on the "thumper".  That's a devise that delivers continuous compressions to the heart.  They called me because they knew they were going to have a dead person on their hands and I was the intermediary for the coroner's office and would be responsible for working with the family.

[mmhmm]

Jan 6, 2014 21:07:35 GMT -5 The Walk of the Penguin Mich said:

Jan 6, 2014 20:13:46 GMT -5 mmhmm said:

I don't know that we can know now, achelois.  There wasn't even any brain stem activity.  That brain is turning to mush as we speak, with the rest of the organs deteriorating as well. I'd put chances of determining what happened at pretty darned close to nil.  It really is a shame.

The mother said that she was encouraged to talk and laugh after surgery.  I thought that is was REALLY contraindicated, to keep from happening what happened.

Do ICU units have cameras in them?

Some ICUs have cameras in the rooms.  Others don't.  All, however, are set up to allow constant visualization of the patient by the staff.

[The Walk of the Penguin Mich]

Then if there was someone watching the child, why wasn't the mother told that trying to coerce her child to talk was a lousy idea?

[The Captain]

Given all the statements made by the family that contradict facts, who's to say they weren't warned.

Unfortunately HIPPA means it's a one sided media circus until we get to the courts.

[justme]

From talk, which is hearsay because the hospital can't talk, they did and the family ignored them. (Everyone is saying is SOP to give the post-op instruction to not talk/eat/whatever, even giving the patients whiteboards to communicate) It seems most of the talk is coming from patient's families and visitors. It seemed very much that the family knew best, some even saying that they took it upon themselves to start suctioning BEFORE contacting a nurse (a big, huge, incredibly stupid idea).

We're not really going to know what went on until the records are released - which probably won't happen until the lawsuit moves forward.

[Deleted]

Thanks you guys I really appreciate it, I am really terrible on trying to understand things and will ask until I think I understand, i think I understand, ok not completely but I am not a nurse so maybe I am not understanding thing completley. it is hard for me to grasp.

[mmhmm]

Jan 6, 2014 21:11:49 GMT -5 The Walk of the Penguin Mich said:

Then if there was someone watching the child, why wasn't the mother told that trying to coerce her child to talk was a lousy idea?

No clue, Mich.  I'd not have allowed it, had it been my patient.  You either sit quietly with the patient and encourage the patient to be quiet and rest, or you're welcome to leave the ICU.

[mmhmm]

Jan 6, 2014 21:18:52 GMT -5 nutty said:

Thanks you guys I really appreciate it, I am really terrible on trying to understand things and will ask until I think I understand, i think I understand, ok not completely but I am not a nurse so maybe I am not understanding thing completley. it is hard for me to grasp.

I never mind answering questions, nutty.  I taught nurses when I was working and always enjoyed that aspect of my job.  Some of this stuff really is pretty complicated and not just a snap to fully understand.

[mmhmm]

Jan 6, 2014 21:16:53 GMT -5 justme said:

From talk, which is hearsay because the hospital can't talk, they did and the family ignored them. (Everyone is saying is SOP to give the post-op instruction to not talk/eat/whatever, even giving the patients whiteboards to communicate) It seems most of the talk is coming from patient's families and visitors. It seemed very much that the family knew best, some even saying that they took it upon themselves to start suctioning BEFORE contacting a nurse (a big, huge, incredibly stupid idea).

We're not really going to know what went on until the records are released - which probably won't happen until the lawsuit moves forward.

I hadn't read about the suctioning!  Good grief!  I don't know what really went down in there, but I sure hope excellent charting was done in this case.  I have a feeling this family was a PITA from the get-go and ICU nurses know to make sure their patient notes are beyond thorough.

[Deleted]

Thanks mmmm I really, really appreciate it. I am trying to understand the nurses side of what happens in these situations.

[justme]

The family has readily admitted that the grandmother (an LVN I believe, not a RN like the family claims), the uncle, and I believe the stepfather all suctioned the blood from her. Their argument was that the nurses weren't doing anything, but a lot have said they did it before contacting the nurse. I'm guessing the timing of events might be evident based on them talking to the press before getting wise to shut their mouth.

Granted I didn't have that extreme of a surgery, but when I had my tonsils out the Dr gave strict instructions that if I bled to make sure it goes into a container (so they could measure how much blood), but don't cough or spit up blood (basically let it dribble out) and to call if it's more than a teaspoon. It was more than a teaspoon by the time I realized I was bleeding and then the instructions was to put ice water in my mouth and kind of swish it around (without being violent) and then spit it out to stop the bleeding.

That was a week post-op and the office was very concerned about me (I had to come in and ended up getting surgery again to cauterize the bleeding, they were debating straight to hospital but the bleeding calmed down), I don't see a patient bleeding out enough blood to be transfused in the ICU and the nurses not paying attention. I just don't believe it - at the very least a nurse would have to be THERE to transfuse the blood.

[thyme4change]

I have been all over the map about this story, and I am not sure that anything I have thought is totally out of the realm of possibilities.  I have thought that maybe the mother just didn't understand the surgery and the risks.  Although, if Grandma is a nurse and they are clearly a close-knit family, you would think they would be able to grasp the risks.  I have thought they were so distraught they weren't thinking.  But a lot of people are distraught when a child dies - this is way out of the ordinary.  I wondered if this is part of a culture of distrust of authority figures.  I have thought they were being whipped up by the lawyer and the Schavio people.  I have thought they were being used by some political group trying to make some statement about "the state of healthcare today."  I have thought that it started one way, but they got addicted to the attention, so they kept it going.  And I have thought that maybe they know they f-ed up the post-op instructions, and they want to keep the body until any evidence will be destroyed one way or another, and then they can still reach a settlement with the hospital, and not have to admit anything - either to themselves or to the world.  And in some way - they all could be a little true at the same time.  

What a catastrophe.

[mmhmm]

Jan 6, 2014 21:41:27 GMT -5 nutty said:

Thanks mmmm I really, really appreciate it. I am trying to understand the nurses side of what happens in these situations.

The nurses' side of something like this isn't that far off the family's side, in the beginning, nutty.  All you want is to save that child.  Nothing else matters.  Your world narrows down to one objective and all focus is there.  I imagine this family, from what I'm reading, was in the room the whole time.  Frankly, they're in the damned way!  If something is going bad with a patient, that room should be cleared of anyone who isn't medically necessary.  With this family, I'd be willing to bet that wasn't possible - not because nobody tried, but because they didn't have time to deal with the family while trying to save that child.

The more I read of this, the more convinced I become there's a lot more to this story than that family is telling.  We won't know, though, until it reaches the courts.

[mmhmm]

Jan 6, 2014 23:04:30 GMT -5 @anne81 said:

The blog posted earlier had collated some of the comments that Jahi's family made to the press in various outlets.  From what they've said I doubt they have much of a case, although it doesn't look like it will stop this particular lawyer.

I'm learning a lot about brain death from this thread and the articles.  It's very, very sad, but the way the family is handling her death makes me wonder how they handled her health problems while she was living.  Apparently she had two previous surgeries for the same issue, had diabetes, and her family did not disclose a familial history of bleeding problems to the hospital.

Little Jahi was definitely obese.  I'd read something, somewhere, about the child being taken quite often to some ice cream joint to get her favorite ice cream.  All this stuff, though, is hearsay.  It might have been sugar-free ice cream if there is any truth to the story.  We just don't know. 

[justme]

The story I head was she was recently given permission to ride the bus to an ice cream shop that had a snickerdoodle ice cream sandwhich that she loved.

I'm interested to see what happens when the courts get involved more. There were several comments saying the family fed her a hamburger (!) instead of just a popsicle!

I kind of lost sympathy for the family (beyond the crapiness of losing your child) early on, but one article had comments of another family that was in the PICU while they were. All I could think of was how shitty is was that that family had to abide by the hospital rules while they realized the hospital was doing everything they can, while this family that pitched a fit got to bend all these hospital rules. You think every other family with a child in PICU wouldn't want to forget the rules and have a room set aside just for them? Oh wait, but they realize that CHO is doing everything they can to save every kid they can and that bitching and moaning does no one any good.

Seriously, that's who I feel sympathy and pity for - every other child and family that was in PICU at CHO while this mess was going on. Those that didn't bitch to have 8 family members 24/7, those that had to deal with the extra security, that had to combat people who questioned them for having their child at CHO while this was going on.

[thyme4change]

The more I read of this, the more convinced I become there's a lot more to this story than that family is telling. We won't know, though, until it reaches the courts.

I bet that there will be an out of court settlement.  Even if the hospital is sure the family doesn't have a case, they would much rather pay some amount of money and have this family sign a non-disclosure agreement then to have this go through the press again.  Plus, the cost of taking this to trial would likely be higher than a settlement.  Because the family doesn't want the medical records released, they might have a good reason to keep this out of the court room.  

[The Captain]

thyme4change - you know, I really hope you're wrong.  I hope all the details come out because it  seems to be becoming a pattern of folks going against medical advice, having something blow up in their faces, then not accepting any responsibility for their actions AND sueing those that tried to help in the first place.

From what is being reported by several folks who were there (not official hospital staff so just rumors until said under oath I know) what really happened is extremely different than what the family claimed.  THEN they create a media circus and cause even more scarce resources to be spent wasted on what was a lost cause.

I really like it how it's set up in many European countries, you bring a frivolous or unfounded lawsuit and the courts can hold YOU responsible for the other party's legal costs.

[thyme4change]

Jan 7, 2014 7:58:42 GMT -5 The Captain said:

I really like it how it's set up in many European countries, you bring a frivolous or unfounded lawsuit and the courts can hold YOU responsible for the other party's legal costs.

Even if we did have that law, I think we are in "blood from a stone" territory.  I doubt this family has any assets, so they could dance through the courts a million times, and be charged tons of money, and they still wouldn't pay and there isn't anything anyone can do.

I understand the concept behind that law, but I also understand that our court system already heavily favors the wealthy.  I think a law such as that would discourage truly wronged people that are afraid of that outcome from seeking justice, while wealthy people might be willing to take their chances.  So, I have mixed thoughts about that one.

[The Walk of the Penguin Mich]

I kind of lost sympathy for the family (beyond the crapiness of losing your child) early on, but one article had comments of another family that was in the PICU while they were. All I could think of was how shitty is was that that family had to abide by the hospital rules while they realized the hospital was doing everything they can, while this family that pitched a fit got to bend all these hospital rules. You think every other family with a child in PICU wouldn't want to forget the rules and have a room set aside just for them? Oh wait, but they realize that CHO is doing everything they can to save every kid they can and that bitching and moaning does no one any good.

When I was in the hospital, the nurse told me that they used the rules as guidelines, not hard and fast rules.  When the bell dinged that visiting hours were over (yes, I realize this was PICU) whether or not the visitor left was at the discretion of the nurse.  TD was allowed to stay with me overnight, as I wanted him there and he was not obtrusive.  But the nurse told me that more than once they had to boot family out because they were obtrusive and/or obstructive.

I do wonder if the race card was used.  That would likely cause a hospital back down faster than anything.

[Tennesseer]

The Captain - my former employer used to eat the legal costs of frivilous lawsuits filed against it.  Then it decided, 'Screw that.'  Now the plaintiffs pay the company's legal costs when frivilous lawsuits are decided in the company's favor.

When word got out plaintiffs would have to pay the costs for frivilous lawsuits, the numbers of lawsuits filed against the company declined.

[Opti]

I hope the family doesn't get a settlement because it will just encourage
more bad behavior in the future. I'm sure their lawyer wants to file as he's
been waiting for his payday.

[mmhmm]

I find myself hoping against hope our suspicions are wrong.  It makes me angry, and sick, and ashamed of mankind to think there are people who would circle like vultures around the dead body of an unfortunate child.  My mind knows these people exist, but my heart just doesn't want to accept it.

[The Captain]

Jan 7, 2014 9:14:11 GMT -5 Tennesseer said:

The Captain - my former employer used to eat the legal costs of frivilous lawsuits filed against it.  Then it decided, 'Screw that.'  Now the plaintiffs pay the company's legal costs when frivilous lawsuits are decided in the company's favor.

When word got out plaintiffs would have to pay the costs for frivilous lawsuits, the numbers of lawsuits filed against the company declined.

Yes, but they have to go the full court route and win the lawsuite in order to get a settlement (which is, I think a good thing). 

There are significant costs even in bringing a case to trial/a judge.  If my understanding of how some EU countries work (it's been explained to me by UK and SZ lawyers) a judge has the right to determine a lawsuite is frivilous and charge the plaintiff with the defendant's costs at that point.  There are checks and balances built in, but there is a very good reason the US is the most litigious county in the world, some is cultural, but some is because there is almost no downside for these lawyers to bring the long-shot lawsuites hoping for the big payday.

I also think this is the reason some of our medical costs are so out of control.  Yes mistakes are made, but it's a tragedy and should not be the big payday for those impacted.  I support caps on medical malpractise suites. 

[thyme4change]

I do wonder if the race card was used. That would likely cause a hospital back down faster than anything.

Maybe - but Oakland is like 30% African-American, so this isn't a one-off case.  I hear the hospital has a great reputation for serving all of the population, and has a great track record that wouldn't raise any race-relation eyebrows.  

[The Walk of the Penguin Mich]

Jan 7, 2014 9:55:05 GMT -5 The Captain said:

Jan 7, 2014 9:14:11 GMT -5 Tennesseer said:

The Captain - my former employer used to eat the legal costs of frivilous lawsuits filed against it.  Then it decided, 'Screw that.'  Now the plaintiffs pay the company's legal costs when frivilous lawsuits are decided in the company's favor.

When word got out plaintiffs would have to pay the costs for frivilous lawsuits, the numbers of lawsuits filed against the company declined.

Yes, but they have to go the full court route and win the lawsuite in order to get a settlement (which is, I think a good thing). 

There are significant costs even in bringing a case to trial/a judge.  If my understanding of how some EU countries work (it's been explained to me by UK and SZ lawyers) a judge has the right to determine a lawsuite is frivilous and charge the plaintiff with the defendant's costs at that point.  There are checks and balances built in, but there is a very good reason the US is the most litigious county in the world, some is cultural, but some is because there is almost no downside for these lawyers to bring the long-shot lawsuites hoping for the big payday.

I also think this is the reason some of our medical costs are so out of control.  Yes mistakes are made, but it's a tragedy and should not be the big payday for those impacted.  I support caps on medical malpractise suites. 

Why should the hospital be penalized if the wrongdoing was not their fault, but non-compliance of the patient, encouraged by the family?  

I really hope the nurses in PICU kept really good records.

But my gut says that if a suit arises from this, their insurance company is going to pay the parent off.

[justme]

Jan 7, 2014 9:11:24 GMT -5 The Walk of the Penguin Mich said:

I kind of lost sympathy for the family (beyond the crapiness of losing your child) early on, but one article had comments of another family that was in the PICU while they were. All I could think of was how shitty is was that that family had to abide by the hospital rules while they realized the hospital was doing everything they can, while this family that pitched a fit got to bend all these hospital rules. You think every other family with a child in PICU wouldn't want to forget the rules and have a room set aside just for them? Oh wait, but they realize that CHO is doing everything they can to save every kid they can and that bitching and moaning does no one any good.

When I was in the hospital, the nurse told me that they used the rules as guidelines, not hard and fast rules.  When the bell dinged that visiting hours were over (yes, I realize this was PICU) whether or not the visitor left was at the discretion of the nurse.  TD was allowed to stay with me overnight, as I wanted him there and he was not obtrusive.  But the nurse told me that more than once they had to boot family out because they were obtrusive and/or obstructive.

I do wonder if the race card was used.  That would likely cause a hospital back down faster than anything.

Oh, I'm sure they're guidelines and less strict rules - I think one of the rules is only one person can stay overnight with the child. But I don't think anyone would agree it's a good thing to have 8 people crammed in one ICU room and using another room (I hope it wasn't an ICU room just on the same floor) for them to gather and eat in when they weren't in her room. Now, since she was dead I suppose it didn't matter - but if the child was alive I would think all that activity and outside visitors wouldn't be good for someone trying to recover.

[The Captain]

The Walk of the Penguin Mich I think we're in agreement.  I can't speak to what goes on in a hospital but know in the corporate world how much time, effort, and money is spent by corporations defending (what at least I consider to be) frivilous lawsuites.

I was personally involved in one case that was so far off the charts a "reasonable" person would shake their head.  Unfortunately big companies have big pockets and the vultures out there know the darts will hit the target sometimes.

[justme]

But my gut says that if a suit arises from this, their insurance company is going to pay the parent off.
 

Part of me thinks it'd have to be a really large pay out to make this family go away. The uncle already stated that he thinks $30M *might* be enough.