The family of a 13-year-old Oakland girl who was declared brain-dead after tonsil-removal surgery served a cease-and-desist order to Children's Hospital Oakland on Tuesday demanding that she be kept on life support, then said hours later that the hospital had agreed not to remove the ventilator.
However, the next steps remained unclear, and privacy laws left the hospital unable to comment on the case or "correct misperceptions created about this sad situation," the chief of pediatrics said in a written statement.
The move by relatives of Jahi McMath brought a potential legal element into an unusual -- though not unprecedented -- case that has captured widespread attention.
Tonsillectomies are one of the country's most common surgeries. More than 700,000 are performed each year, according to a recent study, and estimates of mortality in the U.S. and England range from 1 death in every 10,000 cases to 1 death in every 29,000 cases.
Jahi's family said she had a tonsillectomy at the hospital on Dec. 9 to correct her sleep apnea. She appeared to be fine after emerging from the operation, relatives said, but later blood began pouring out of her nose and mouth and she went into cardiac arrest. She was declared brain-dead Thursday.
Family members have been hoping for a recovery, though, and have accused doctors of pressuring them to remove Jahi from machines that are helping her breathe. The girl's uncle, Omari Sealey, hand-delivered a cease-and-desist letter to doctors on Tuesday written by San Francisco attorney Christopher Dolan.
The letter cited the California Patient Bill of Rights and asked top hospital officials to "refrain from any actions or activities which would remove Jahi from life support" until there is a "judicial determination" in the matter.
"If they move without our consent after having this letter in their hands," Sealey said, "they're just creating more problems for themselves."
On Tuesday afternoon, Dolan, surrounded by family members, said the hospital had agreed to keep Jahi on life support indefinitely, even as a second test Tuesday confirmed the girl had no brain activity. "There is no timeline currently," he said. "That gives the family time to hold a prayer vigil (Wednesday night) and seek to have some kind of divine intervention."
Dolan said Jahi's mother, Nailah Winkfield, had a "full and frank discussion" with doctors on Tuesday about her daughter's prognosis.
"The mother understands the progression that could take place," Dolan said. "The mother's aware of how conditions could deteriorate or stay the same. She is just of the mind that this is not something that should be rushed, and that it's something that she wants to talk to God (about)."
In a statement, David Durand, the hospital's chief of pediatrics, said, "Our hearts go out to this patient and her family. Unfortunately, we have not been authorized by the family to share information with the public about this matter. Consequently, we are not able to correct misperceptions created about this sad situation.
"Nonetheless, we want to assure the community that we are doing everything in our capacity to provide support to the grieving family."
Winkfield told reporters outside the hospital earlier Tuesday that she feared the hospital would "cover up" what happened to her daughter. She was angry, saying, "Thank you, Children's Hospital, for just ruining my child's life and my life."
Winkfield said she believes Jahi is trying to communicate with her, saying, "I feel her. I can feel my daughter. I just kind of feel like maybe she's trapped inside her own body. She wants to scream out and tell me something."
She said, "I want her on as long as possible, because I really believe that God will wake her up."
The case highlights the nuances and difficulties that surround end-of-life decisions. No two cases are the same, and even the term "brain-dead" can mean different things in different contexts, experts said.
Culture, religion, family dynamics and many other factors can affect how people handle such issues, said Kathleen Day-Seiter, a Berkeley elder attorney and former social worker.
"In some cultures, you don't give up, no matter what. You don't give up until the person is gone, gone," she said. "Plus, you're dealing with the emotions of losing a loved one. It can be very complicated."
Good question "Just Wondering." This family needs to let this young girl die with dignity. Brain dead is NOT the same as a coma where the body is healing itself. I'm a mother of two grown children and a grandmother and you have to know when to let go.
Same surgery I died on the table 2 days later where I started bleeding out they almost did not save me they need to do something with theses doctor my heart goes out to this mother and her daughter
Its hard to let go, but you have to let go some day. Its the right thing to do. And YES, I have buried a 7 yr old daughter and hated every moment of it. But now she is in heaven and watching over the rest of our family until we meet again. So move on and start the grieving process, nothings going to bring this little girl back to life.
I don't blame her, I have the same feelings as the mother. You never know maybe a miracle might happen.. If she wants to keep the daughter on life support, the hospital owes that to her. Let the mom call the shots it's her daughter, brain activity or not.
"Allegedly brain dead" would be the neutral headline. So-called "brain death" is an inexact assessment. Some supposedly brain dead patients make good recoveries.
Ok. Name one case where there was absolutely no brain activity and the person recovered.
I think you are confusing brain death with comas or vegetative states, in which the brain continues to function to some degree. But brain death means the brain has died. When it dies, it can never come back to life.