Walnut Creek hospital mistakenly diagnoses woman brain-dead

Anahita Meshkin

WALNUT CREEK -- A year ago, four John Muir Medical Center doctors told Mohammad Meshkin his daughter was brain-dead. The hospital refused to operate on Anahita Meshkin's infected, fractured hip because it said it would not be ethical to treat a dead person.

The Walnut Creek facility told the father they wanted to pull the plug on the then-29-year-old woman, who had been in a coma since 2007 after suffering a massive seizure while battling anorexia. But he wasn't ready to give up.

Before the hospital could stop treatment, Meshkin called the lawyer for Jahi McMath's family, Chris Dolan, who along with another attorney filed a temporary restraining order May 1, 2015, to block the hospital from withholding Anahita's treatment. Hours later, two UC San Francisco School of Medicine neurologists and professors conducted an independent test -- ordered by a Contra Costa Superior Court judge -- and determined Anahita was not brain-dead after all.

"She does not meet the clinical criteria for brain death," wrote physicians Wade Smith and Andrew Josephson, according to court records. They noted that she moved her head and elbow when they pinched her hands.

"You were all trying to kill her, and she's still alive," Meshkin recalled saying to hospital staff at the time.

Meshkin said he was inspired by the Jahi case to fight for his daughter, who remains in a coma in a long-term care facility. Jahi's family fought her brain-death diagnosis and won a court order to remove her from UCSF Benioff Children's Hospital Oakland.

Meshkin's case is an example of the post-Jahi medical world. Increasingly, brain-death diagnoses are no longer taken as certainties, and new legal options exist to prolong end-of-life decisions. Meshkin is clear -- he doesn't believe his daughter is a medical miracle who recovered from brain death; rather, he believes hospitals and insurance companies are often too quick to make the declarations.

"This is their job to clear beds, and our job is to fight back," Meshkin said Tuesday as he stood beside his daughter in a Walnut Creek care center near Rossmoor. "Mr. Dolan saved Jahi. He saved (Anahita) too. He's my hero and Anahita's savior."

Dolan, who helped get Jahi released from Children's Hospital in January 2014 so she could be taken to a New Jersey care facility, said Anahita's case is another example of hospitals making decisions based on bottom lines, not science.

"In my opinion, it is an example of a physician making a resource determination and using brain death as a way to legitimize their beliefs on the quality of life and how they see this as futile," Dolan said. "Then there is their belief that better utility can be gained by organ transplantation. ... These families have relationships with their loved ones. ...

"Who are we to determine whether or not that relationship is significant enough?"

After Meshkin won the right to keep his daughter on life-support machines, John Muir performed the surgery on her hip, and she has returned to her care facility. A hospital spokesman said because of medical privacy laws and out of respect for the family's privacy, he could not comment on specifics of the case.

"What we can say is that the highly trained specialists on our medical staff adhere to a detailed protocol for determination of brain death," spokesman Ben Drew said. "The protocol exceeds the requirements mandated by state law and directly incorporates the criteria adopted by the American Academy of Neurology."

Meshkin, a 72-year-old Moraga resident, on Tuesday showed a framed photograph of his daughter taken months before she fell into the coma.

The photograph sits at the foot of the bed where his daughter lies, her black hair braided in a ponytail. Meshkin sees her twice a day, and on a recent visit he showed a reporter how when he pinches her nail bed on her right hand, her head jerks back and forth.

Meshkin's wife overdosed and died in 2011 out of grief over their youngest daughter's condition, he said. He has no plans to stop his daughter's care, despite medical professionals who question the decision.

"I'll fight as long as she does," Meshkin said. "If she quits, I will quit. But I have my hope that she'll come back."  (Continue Reading)

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Walnut Creek hospital mistakenly diagnoses woman brain-dead

Jahi McMath's Mother Gives Update

Jahi McMath, the 13-year-old California girl who was declared brain dead after complications from tonsil surgery, is reportedly doing “much better physically.”

In her first public update in over a month, Jahi’s mother, Nailah Winkfield, released a letter on Facebook informing her followers of Jahi’s status, stating that she sees changes in her daughter that “give [her] hope.”

Winkfield said she has spent the past month focusing on Jahi’s health, and she had to withdraw from the public eye for safety and privacy reasons.

In the letter, Winkfield also thanked everyone who had supported her as she fought to move her daughter to another medical facility. “Because of your unselfish generosity I was able to do what I was afraid I would never be able to do, move my daughter from Children's Hospital Oakland before they removed her from her ventilator and stopped her heart,” Winkfield wrote. “This was itself a miracle. Please know that all of the support we received has been used towards helping Jahi.”

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Mother of Brain Dead Teen Jahi McMath Gives Update on Daughter's Condition

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At Issue in 2 Wrenching Cases - What to Do After the Brain Dies

At Issue in 2 Wrenching Cases: What to Do After the Brain Dies

In one way, the cases are polar opposites: the parents of Jahi McMath in Oakland, Calif., have fought to keep their daughter connected to a ventilator, while the parents and husband of Marlise Muñoz in Fort Worth, Tex., want desperately to turn the machine off. In another way, the cases are identical: both families have been shocked to learn that a loved one was declared brain-dead — and that hospital officials defied the family’s wishes for treatment.

Their wrenching stories raise questions about how brain death is determined, and who has the right to decide how such patients are treated.

“These cases are quite different from those we’ve known in the past,” like Karen Ann Quinlan, Nancy Cruzan or Terri Schiavo, said Dr. Joseph J. Fins, director of the medical ethics division at NewYork-Presbyterian/Weill Cornell hospital. He explained: “Those patients could all breathe without a ventilator. They were in a vegetative state, not brain-dead, and that distinction makes all the difference.”

 A person who has received a brain-death diagnosis cannot breathe on his or her own and is legally dead, in all 50 states. In two states, New York and New Jersey, hospitals must take into account the family’s religious or moral views in deciding how to proceed in such cases. In all others, including California and Texas, hospitals are not required to consult the family in how to terminate care.

Doctors at Children’s Hospital in Oakland pronounced Jahi, 13, brain-dead on Dec. 12. She developed complications after surgery for sleep apnea and lost a large amount of blood. Ms. Muñoz , 33, got the diagnosis at John Peter Smith Hospital after she collapsed from a blood clot when she was 14 weeks pregnant. The hospital, citing a state law, refuses to remove the ventilator because it would harm the fetus, now in its 20th week.

The two cases are poignant in part because of a biological quirk of the body: The patients’ hearts continue to beat. Hearts have their own pacemaker, and with ventilation, the heart can continue to beat for days, even up to a week. But with more aggressive care, it can last months and longer after brain death, experts say, depending on the health of the patient and how much treatment is provided.

That ventilation saved the fetus in the Muñoz case, and probably in the nick of time, said Dr. R. Phillips Heine, director of maternal and fetal medicine at Duke University’s medical school. The diminished blood flow to the fetus when the mother collapsed — she is thought to have been passed out for about an hour before receiving care — “may lead to adverse effects over time, but we have no way to predict that,” Dr. Heine said.

A prolonged heartbeat has created the perception of life for Jahi’s family, while for Ms. Muñoz’s relatives it represents a denial of the right to die.

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At Issue in 2 Wrenching Cases: What to Do After the Brain Dies

Jahi McMath in 'Very Bad Shape' After Weeks of Starvation, Medical Neglect

The attorney for the family of Jahi McMath says the teenage girl is in “very bad shape” following three weeks of starvation and medical neglect while the family battled Children’s Hospital in Oakland over her fate.

Late Sunday night, Children’s Hospital Oakland released Jahi to her family after a protracted legal battle over whether the hospital had the right to remove her from life support.

On Friday, the hospital reached an agreement with McMath’s family to allow a medical team to enter the hospital to perform the procedures necessary to move her to a medical facility that will continue her care and treatment.

Although the hospital maintains McMath is “brain dead,” her mother and family say she is alive  following a tonsillectomy gone awry that has left her in an incapacitated state since early December. The family in the case says the hospital  has been starving Jahi for three weeks.  .

Family attorney Christopher McMath says that has taken its toll, according to the Los Angeles Times.

The family’s attorney, Christopher Dolan, told the San Jose Mercury News, however, that Jahi’s body has deteriorated badly in the weeks since she was declared brain-dead.

“She’s in very bad shape,” he said. “What I can tell you is that those examinations show that her medical condition, separate from the brain issue, is not good.”

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Jahi McMath in ‘Very Bad Shape” After Weeks of Starvation, Medical Neglect

Remember the Humanity of Jahi McMath

As in the case of Terri Schiavo, people with severe brain injuries are treated like second class citizens, often being denied the treatment, care, and love that their humanity demands

The tragic facts surrounding 13 year-old Jahi McMath are now well known. She underwent routine surgery at Children’s Hospital Oakland December 9 for removal of her tonsils and some other tissue to alleviate her sleep apnea. After surgery she was alert and sitting up in bed, chatting with her family. However, as her family watched, Jahi began bleeding profusely, the blood on her gown matching the pink popsicle she held in her hand. The bleeding went on for several hours before she went into cardiac arrest and was medically declared  brain dead on December 12.

Ever since, Jahi’s family has been locked in a battle of attrition with Oakland Children’s: The hospital says she’s dead; her family says she’s severely brain-injured.

Oakland Children’s position is brutally cold: Because Jahi has been declared brain-dead, she is therefore completely dead, only staying warm via the life-giving oxygen being pumped into her system by a mechanical ventilator. The hospital leadership has taken every opportunity to make clear that they are following California's legal definition of brain death to the letter. For the hospital, Jahi is a hollow mass of flesh devoid of meaning; the administration has refused to refer to her as a child of a loving family. Instead, they have said that she is a “dead body” and a “deceased person.” Hospital spokesman Sam Singer rubbed even more salt into the wound, noting that “no amount of hope, prayer, or medical procedures will bring her back.”

The hard-nosed corporate line is very simple: Jahi is a mere shell, bereft of humanity, and using up precious resources only because of the naïve and uninformed hopes of her loving but pesky family.
Unsurprisingly, Jahi’s family sees things differently. They watched a vibrant young teenager morph into a starkly silent child, her hopes and potential dashed by a relatively simple medical procedure. They have also made clear that despite her current condition, Jahi is still their beloved child, not some washed-up husk ready for disposal. They have also been clear that Jahi is perhaps not as “dead” as Oakland Children’s Hospital would have us all believe. Jahi’s mother and several family members report that Jahi has responded to familiar voices. They have made the case that at the very least Jahi’s medical condition should be given some time before a radical hospital decision deprives her of her life for good.

For the hospital, Jahi’s medical diagnosis is certain and final, a diagnosis they want to leverage to close the book on a public relations crisis that has already badly diminished the reputation of the facility.

It’s not that simple, however, because no medical diagnosis is absolute. The research literature is rife with clinically observed instances of patients outstripping their physicians’ dire predictions by months, years, and even decades.

And that includes diagnoses of brain death.

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Remember the Humanity of Jani McMath

Girl brain dead after surgery: Terri Schiavo family joins fight over Jahi McMath

The family of Terri Schiavo has joined the battle over Jahi McMath, a 13-year-old girl on life support who has been declared dead by doctors.

"Together with our team of experts, Terri's Network believes Jahi's case is representative of a very deep problem within the U.S. healthcare system -- particularly those issues surrounding the deaths of patients within the confines of hospital corporations, which have a vested financial interest in discontinuing life," the Terri Schiavo Life & Hope Network said in a prepared statement.

The organization said it has been overseeing the efforts of several groups to help get Jahi transferred out of Children's Hospital Oakland and brought "to a safe place."

Jahi's family said Tuesday it had found a facility in New York willing to take her. The Oakland hospital "refused to agree to allow us to proceed in that matter," Jahi's uncle Omari Sealey said.
The hospital denied the accusation.

"We have done everything to assist the family of Jahi McMath in their quest to take the deceased body of their daughter to another medical facility," hospital spokesman Sam Singer said.

"To date, they have been unwilling or unable to provide a physician to perform the procedures necessary, transportation, or a facility that would accept a dead person on a ventilator. Our hearts and thoughts go out to them in this tragic situation, but the statements being made by their attorney and some family members are misleading and untrue."

Family attorney Christopher Dolan had accused the hospital of being "hell bent" on ending Jahi's life.
A judge has declared Jahi brain dead as well. Doctors say there's no chance she will come back to life.

Omari Sealey, Jahi's uncle, said Wednesday that the family still hopes to move her to another facility.
He accused the hospital of starving his niece by not using a feeding tube to provide her with nutrients.

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Girl brain dead after surgery: Terri Schiavo family joins fight over Jahi McMath

When 'life support' is really 'death support'

(CNN) -- Two young females, both brain dead without warning, remain on ventilators while their devastated families challenge the judgments of their hospitals.

In one situation, the family believes a miracle is possible, and wants to prolong the patient's biological functioning. In the other case, the family wants to disconnect the patient to honor her wishes. But both families are facing obstacles.

 

The way we talk about neurological death has created a misperception, ethicists say: that "brain death" is somehow not as final as cardiac death, even though, by definition, it is.

 

The term "life support" exacerbates the problem, too, because those who are brain dead do not have a life to sustain, said Arthur Caplan, director of the Division of Medical Ethics at NYU Langone Medical Center. This seems to be a fundamental problem in both cases that have entered the national spotlight, he said.

 

"I think these cases have been botched, horribly," he said. "They're giving the impression that dead people can come back to life."

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When 'life support' is really 'death support'