Jahi McMath case

Winkfield v. Children's Hospital Oakland et al
Court United States District Court for the Northern District of California
Full case name Latasha Winkfield, an individual parent and guardian of Jahi McMath, a minor vs Children's Hospital Oakland, Dr David Durand M.D. and DOES 1 through 10, inclusive
Citation(s) Docket report[1]
Case history
Prior action(s) Alameda County Case No. RP-13-707598[2]
Holding
Settlement conference rendered mutually accepted agreement, motion denied as moot, VACATED

The Jahi McMath case involved a teenage girl who was declared brain dead in California following surgery in 2013 at age 13. This led to a bioethical debate engendered by her family's rejection of the medicolegal findings of death in the case, and their efforts to maintain her body using mechanical ventilation and other measures. Her parents considered these measures to constitute life support, while her doctors considered this to be futile treatment of a deceased person.[3][4][5][6][7][8] In October 2014, the McMath family attorney made the unprecedented request that Jahi McMath's brain death declaration be overturned. The attorney later withdrew this request, saying he wanted time for the court-appointed medical expert and his own medical experts to confer.[9][10][11][12][13] In March 2015, McMath's family filed a malpractice lawsuit against Children's Hospital Oakland and against the surgeon who performed McMath's surgery, indicating they were prepared to argue as part of the lawsuit that McMath is not dead, but profoundly disabled.[14] The family lawyer stated that a preliminary second death certificate was issued on June 22, 2018, listing extensive bleeding relating to liver failure as the cause of death.[15]

Background

According to court documents,[16] McMath was admitted to Children's Hospital Oakland on December 9, 2013, for an adenotonsillectomy, uvulopalatopharyngoplasty and submucous resection of bilateral inferior turbinates. It was hoped these procedures would provide improved airflow during her sleep at night. The hospital described these procedures as complicated. The family described the surgery as a routine tonsillectomy in media reports.[17][18]

After the surgeries were performed, McMath was conscious and according to her mother, Latasha "Nailah" Winkfield,[18][19][20] asked for a Popsicle while in the recovery room.[21] On December 9, 2013, McMath suffered massive blood loss and consequent cardiac arrest. According to McMath's doctors at Children's Hospital Oakland, the loss of blood circulation caused whole brain death. On December 12, 2013, her doctors declared her brain-dead.[3] Her family was informed that she was legally dead,[22] and that as a result, life support systems would be discontinued.[16] Her family refused to accept the medical declaration of death by neurological criteria, said that McMath was not dead, and initiated legal proceedings in an effort to require the hospital to continue treatment.[6][23][24][25][26][27]

On December 20, 2013, McMath's family filed a lawsuit in Alameda County Superior Court, petitioning the court to require Children's Hospital Oakland to keep McMath on life support. In a pretrial conference on December 23, Judge Evelio Grillo appointed Paul Graham Fisher, M.D., the chief of Child Neurology at Stanford University School of Medicine, to provide an independent medical opinion regarding the declaration of brain death. McMath's family also requested to have Paul A. Byrne, M.D., conduct a separate evaluation. Byrne, a neonatologist, has campaigned against the medical consensus of accepting brain death as death.[28][29][30] The court denied that request.[31]

Fisher examined McMath and affirmed the diagnosis of brain death, reporting that she had no activity on an electroencephalogram, no blood flow to the brain and did not breathe when removed from mechanical ventilation, all of which are standard clinical indications of total brain death.[32][33]

On December 24, 2013, Judge Grillo ruled that McMath was legally dead,[34] basing his decision on the medical evidence presented by physicians from Children's Hospital Oakland and from independent expert Paul Fisher, but ruled to require the hospital to continue mechanical ventilation until December 30, 2013,[32] later extending this order until January 7, 2014.[34] Grillo told the family "This has been very, very hard on you. No one anywhere would wish this to happen to anyone."[32]

On December 30, 2013, the family appealed the decision to the Second District, California Courts of Appeal[31] and the United States District Court for the Northern District of California, calling for the hospital to continue life support measures until other arrangements could be made by the family for the girl's care.[34] McMath's mother argued that applying the Uniform Determination of Death Act to the case was a violation of constitutional religious and privacy rights[35] and that because Jahi's heart was still beating, she was still alive.[36] Byrne stated in court documents that he witnessed McMath moving in the hospital and that he considered her to be alive.[37] The hospital stated that it would be unethical and "grotesque" to require the hospital and its doctors to provide further medical care to a dead body[38] and said that Byrne was "a crusader with an ideology-based bias"[3] The hospital also said that Lazarus signs are not uncommon in cases of brain death.[35] After the hospital and McMath's family engaged in settlement talks, an agreement was facilitated in which McMath could be released from Children's Hospital, with the ventilator and her intravenous fluid lines, to the custody of her mother, but the United States District Court for the Northern District of California denied the family's petition to require hospital staff to perform a tracheostomy and insert a feeding tube.[26]

Transfer

On January 5, 2014, Children's Hospital released McMath's body to the Alameda County coroner. The coroner's office had issued an official death certificate for McMath on January 3, 2014, with the date of death listed as December 12, 2013. The death certificate was incomplete, pending an autopsy to determine cause of death.[39] After receiving custody of her body from Children's Hospital, the Coroner then released her to the custody of her mother, who was warned of and assumed all risk regarding cardiac arrest during the transfer.[40][41][42] The family moved the girl to an undisclosed location where a tracheostomy was performed and a feeding tube was inserted.[43]

Commentary

This case has prompted some commentators to discuss the futility of life support in such cases and even refer to it as "death support".[44] Other questions that have been raised include how California law treats brain death and whether McMath's case could change existing laws and practices.[45] McMath's attorney, Christopher Dolan said, "There would have been no legal battle if Jahi had had her tonsils out in New Jersey”, referring to a New Jersey state law allowing religious objection to a declaration of death on the basis of neurological criteria.[46] Public confusion surrounding differences between brain death and cardiac death raised by this case led some doctors to voice concern about how the case could affect live organ recovery from brain dead patients.[47] The impact of this case on medical negligence awards in California has also been discussed, as there is no compensation limit if the patient is alive, while compensation is capped at $250,000 if the patient has died.[48]

Aftermath

In March 2014, the Terri Schiavo Life and Hope Network awarded McMath's family an annual award. The award recognizes "the unconditional love they have for Jahi, and their courage as they continue the fight for their daughter against overwhelming odds." McMath's mother stated she was honored to receive the award and referred to her daughter as “still asleep,” clarifying that she does not use the phrase "brain dead" to refer to her daughter.[49][50]

According to media reports,[51] McMath was at a Catholic hospital in New Jersey[52] until August 2014,[53] after which she was moved to a New Jersey apartment.[53][54]

In October 2014, McMath's attorney, Christopher Dolan, held a press conference where he said that recent medical tests had detected blood flow and electrical activity in McMath's brain and where he released videos which he said showed the girl moving on command.[10][12] At that time, Dolan also filed documents asking that the Alameda County Superior Court reverse their finding of brain death in the case.[9][10][11][12] Paul Fisher, M.D., the court-appointed independent expert who had confirmed McMath’s diagnosis of brain death in December 2013, said that the new evidence presented did not refute his earlier determination of brain death.[55][56] Dolan then withdrew the petition for the October 2014 court hearing[57] and requested that the involved doctors collaborate, stating that "with an open and transparent dialogue between health care professionals, only one conclusion can remain: that Jahi McMath is not brain dead."[13][54][55][56][58][59]

In March 2015, McMath’s family filed a malpractice lawsuit against Children’s Hospital Oakland and Dr. Frederick Rosen, the surgeon who performed McMath’s surgery.[60] The lawsuit alleges that the surgeon noted an abnormal artery in McMath’s throat but did not notify the nurses that this placed the girl at increased risk for serious hemorrhaging.[14] Additionally, the lawsuit alleges that McMath bled from approximately 7:30 p.m. to 12:35 a.m.,[14] that a doctor said “[expletive], her heart stopped” when he arrived hours after the family said they requested a doctor,[60] and that the family was given conflicting information from nurses regarding how to care for McMath’s bleeding.[14] The family also claims that the hospital pressured them to donate McMath’s organs.[61]

McMath's family and Bruce Brusavich, the family's malpractice attorney, have indicated that they are prepared to argue that McMath is not brain dead, so that the California state limit of $250,000 on medical malpractice lawsuits involving children who die does not apply in her case.[14]

After viewing over four dozen independent videos of McMath, Dr. Alan Shewmon, a UCLA pediatric neurologist, declared her technically alive in a June 29, 2017, court filing, stating that the girl follows movement commands and exhibits other proof of life. Children’s Hospital Oakland maintained that the original diagnosis of brain death was correct and that the videos do not meet the diagnostic criteria for brain death.[62]

Dolan issued a statement in June 2018 that McMath had died on June 22, 2018. She was having internal bleeding due to kidney and liver failure, so her doctors removed her from life support, allowing her to die.[15][63]

Court cases are ongoing; Dolan stated that he intends to continue his pro-bono case to have McMath's California death certificate revoked and her date of death established as June 22, 2018.[15]

See also

References

  1. ↑ "Winkfield v. Childrens Hospital Oakland et al Docket Report". 30 December 2013.
  2. ↑ "Winkfield v. Childrens Hospital Oakland et al - Document 18". 6 January 2014.
  3. 1 2 3 Simon; Schoichet, Catherine E. (24 December 2013). "Judge: California teen is brain dead after tonsil surgery". cnn.com. Retrieved 9 January 2014.
  4. ↑ Grossman, Cathy Lynn (3 Jan 2014). "Family, ethics, medicine and law collide in Jahi McMath's life - or death". Washington Post.
  5. ↑ Sabo, Liz (10 January 2014). "The Ethics Of Being Brain Dead: Doctors And Bioethicists Discuss Jahi McMath And Marlise Munoz". USA Today.
  6. 1 2 Banks, Sandy (January 3, 2014). "In Jahi McMath saga, science and religion clash". latimes.com. Retrieved January 9, 2014.
  7. ↑ Veatch, Robert (2 January 2014). "Let parents decide if teen is dead". CNN Opinion. Retrieved 27 February 2014.
  8. ↑ "Jahi McMath: Expert criticizes keeping girl on ventilator". Los Angeles Times. 13 January 2014. Retrieved 7 October 2014.
  9. 1 2 DeBolt, David; Bender, Kristin J. (1 October 2014). "Jahi McMath: Family seeks to have brain-death ruling overturned, girl declared alive". San Jose Mercury News. Retrieved 1 October 2014.
  10. 1 2 3 Matier, Phillip; Ross, Andrew (3 October 2014). "Videos show Mom coaxing, Jahi McMath moving". SF Gate. Retrieved 7 October 2014.
  11. 1 2 DeBolt, David (2 October 2014). "Jahi McMath: Attorney shows video he says proves Oakland girl moves feet, hands at mother's commands". San Jose Mercury News. Retrieved 2 October 2014.
  12. 1 2 3 Romney, Lee (2 October 2014). "Tests show Jahi McMath has brain activity, lawyer says". Los Angeles Times. Retrieved 4 October 2014.
  13. 1 2 "One Year Later, Jahi McMath Remains On Ventilator, Feeding Tubes After Fateful Tonsillectomy". CBS San Francisco. The Associated Press. 15 December 2014. Retrieved 27 December 2014.
  14. 1 2 3 4 5 Debolt, David (3 March 2015). "Jahi McMath: Oakland girl's family sues hospital, surgeon". Contra Costa Times. Retrieved 20 March 2015.
  15. 1 2 3 Goldschmidt, Debra. "Jahi McMath, California teen at center of brain-death controversy, has died". CNN. Retrieved 29 June 2018.
  16. 1 2 Bender, Kristin J.; Alund, Natalie Neysa (21 December 2013). "Judge grants restraining order keeping brain dead Oakland girl on ventilator through Monday". San Jose Mercury News. Oakland Tribune. Retrieved 27 February 2014.
  17. ↑ Collins, Terry (21 December 2013). "Jahi McMath, Girl Left Brain Dead From Routine Tonsillectomy, To Be Kept On Life Support". Huffingtonpost.com. Retrieved 19 February 2014.
  18. 1 2 Fernandez, Lisa; Smith, Christie (17 December 2013). ""Urgent" Request to Keep 8th Grader Jahi McMath on Life Support After Tonsillectomy". NBC Universal Media. Retrieved 7 October 2014.
  19. ↑ "Statements in Response to Media Coverage December 2013". Retrieved 7 October 2014.
  20. ↑ Fernandez, Lisa (2 January 2014). ""Burning Up the Phones" to Find Center for Jahi McMath: Attorney". NBC Universal Media. Retrieved 7 October 2014.
  21. ↑ "Document: Appeal describes Jahi McMath's post-surgical bleeding before heart attack, brain death". Contra Costa Times. 30 December 2013. Retrieved 27 February 2014.
  22. ↑ Gafni, Matthias (21 December 2013). "Oakland: Emotional letter from Jahi McMath's mom to keep daughter 'warm'". San Jose Mercury News. Contra Costa Times. Retrieved 14 August 2014.
  23. ↑ Mungin, Lateef; Condor, Chuck (4 January 2014). "Jahi McMath's family, Oakland hospital discussing girl's transfer". CNN.com. Retrieved 9 January 2014.
  24. ↑ Fernandez, Lisa (21 December 2013). "Judge Orders Oakland Hospital to Keep Jahi McMath on Life Support". NBC Universal Media.
  25. ↑ Lee, Henry K. (3 January 2014). "Hospital agrees to let Jahi McMath family take girl". SFGate. Retrieved 9 January 2014.
  26. 1 2 "Jahi McMath Family Cleared to Take Brain-Dead Teen From Hospital". NBC Universal Media. Associated Press. 4 January 2014. Retrieved 27 February 2014.
  27. ↑ Branson, Hailey (5 January 2014). "Jahi McMath, brain-dead teen, transferred to undisclosed location". Los Angeles Times. Retrieved 9 January 2014.
  28. ↑ "OPPOSITION TO PLAINTIFF'S MOTION TO COMPEL FURTHER LIFE SUPPORT AND THE INSTALLATION OF A TRACHEOSTOMY TUBE AND GASTRIC FEEDING TUBE TO ALLOW TRANSPORTATION OF JAHI MCMATH" (PDF). United States District Court for the Northern District of California. 7 January 2014. Retrieved 7 October 2014.
  29. ↑ Vincent, Stephen (14 January 2014). "Jahi McMath Case Renews Moral Debate Over Brain-Death Diagnoses". National Catholic Register. Retrieved 7 October 2014.
  30. ↑ "Calif. judge: Brain-dead teen can be taken off life support". CBS News. Associated Press. 24 December 2013. Retrieved 7 October 2014.
  31. 1 2 "Children's Hospital Oakland, Petitioner's Writ Petition Mcmath-12302013".
  32. 1 2 3 DeBolt, David; Hurd, Rick (24 December 2013). "Jahi McMath: Judge denies petition to keep girl on ventilator past Dec. 30". San Jose Mercury News. Retrieved 27 February 2014.
  33. ↑ "Document: Hospital's petition opposing an independent expert, asking to lift the order to keep Jahi McMath on life support". San Jose Mercury News. December 24, 2013. Retrieved February 27, 2014.
  34. 1 2 3 "Extension Granted to Keep Jahi McMath on Life Support". NBC Universal Media. 31 December 2013. Retrieved 27 February 2014.
  35. 1 2 Romney, Lee (30 December 2013). "Hospital says conditions must be met for Jahi McMath's transfer". Los Angeles Times. Retrieved 27 February 2014.
  36. ↑ Ford, Dana (27 December 2013). "Jahi McMath's family seeks to move brain-dead girl to another facility". CNN. Retrieved 27 December 2013.
  37. ↑ Fernandez, Lisa (9 January 2014). "Catholic Organization Says Jahi McMath "With Jesus Christ"". NBC Universal Media. Retrieved 6 March 2014.
  38. ↑ Gafni, Matthias; O'Brien, Matt; Neysa Alund, Natalie; Bender, Kristin J. (3 January 2014). "Jahi McMath: Mom can remove brain-dead daughter from hospital, judge rules". San Jose Mercury News. Retrieved 10 October 2014.
  39. ↑ Mungin, Lateef; Condor, Chuck (4 January 2014). "Jahi McMath's family, Oakland hospital discussing girl's transfer". CNN. Retrieved 7 October 2014. The coroner's office said that the death certificate -- which still needs to be accepted by the health department to become official -- has a date of death of December 12, 2013
  40. ↑ Branson, Hailey (5 January 2014). "Jahi McMath's body released from hospital". Los Angeles Times. Retrieved 9 January 2014.
  41. ↑ DeBolt, David; Bender, Kristin J.; Hurd, Rick (5 January 2014). "Jahi McMath: 13-year-old brain-dead Oakland girl moved by family from hospital". Contra Costa Times. Retrieved 27 February 2014.
  42. ↑ Payne, Ed; Shoichet, Catherine E.; Hanna, Jason (7 January 2014). "Brain dead girl Jahi McMath released from California hospital". CNN. Retrieved 27 February 2014.
  43. ↑ Golgowski, Nina (8 January 2014). "Lawyer for Jahi McMath's family says brain dead teen is on feeding tube and 'improving'". New York Daily News. Retrieved 17 April 2015.
  44. ↑ Landau, Elizabeth (29 December 2013). "When 'life support' is really 'death support'". CNN. Retrieved 15 August 2014.
  45. ↑ Gafni, Matthias (25 January 2014). "Jahi McMath: Could her case change how California determines death?". San Jose Mercury News. Retrieved 3 March 2014.
  46. ↑ Dolan, Christopher (21 January 2014). "McMath attorney: Jahi's family aren't fools; they deserve better than ignorant attacks". Los Angeles Times. Retrieved 10 April 2014.
  47. ↑ Eachempati, Soumitra R. (4 January 2014). "A Tragedy Compounded: The Heart-Wrenching Case of Jahi McMath May Have Devastating Consequences to Organ Donation". The Daily Beast. Retrieved 10 October 2014.
  48. ↑ Fagel, Mari (24 January 2014). "How an Outdated California Law Is Impacting the Jahi McMath Case". Huffington Post. Retrieved 10 October 2014.
  49. ↑ Gafni, Matthias (27 February 2014). "Jahi McMath's family to get award from Terri Schiavo foundation". Contra Costa Times. Retrieved 1 March 2014.
  50. ↑ Fernandez, Lisa (27 March 2014). "Jahi McMath's Family to Be Honored by Terri Schiavo Network". NBC Universal Media. Retrieved 5 April 2014.
  51. ↑ Ioffee, Karina; DeBolt, David (18 June 2014). "Jahi McMath being kept at New Jersey hospital". Retrieved 7 October 2014.
  52. ↑ Vazquez, Joe (8 June 2014). "13-Year-Old Jahi McMath Moved To New Jersey Hospital, Lawyer Says Condition Improving". CBS Local Media. Retrieved 7 October 2014.
  53. 1 2 Lupkin, Sydney (16 December 2014). "Why Jahi McMath's Mom Is Sure Her Daughter Isn't Brain Dead". Yahoo News. Retrieved 26 December 2014.
  54. 1 2 "Doctor: No evidence of life in brain-dead girl". CBS News. 9 October 2014. Retrieved 26 December 2014.
  55. 1 2 Debolt, David (9 October 2014). "Stanford doctor who examined Jahi McMath last year sticks by diagnosis that she is brain-dead". Contra Costa Times. Retrieved 9 October 2014.
  56. 1 2 Lagos, Marisa (9 October 2014). "Jahi McMath hearing postponed after doctor's determination". SFGate. Retrieved 9 October 2014.
  57. ↑ Gorman, Steve (10 October 2014). "Family seeks medical consensus for California girl declared brain dead". Reuters. Retrieved 15 October 2014.
  58. ↑ Morozova, Daria (October 9, 2014). "New Documentation presented by Jahi's Attorney is not enough, says Dr. Paul Fisher". Maine News. Archived from the original on October 11, 2014. Retrieved October 10, 2014.
  59. ↑ Vitez, Michael (23 October 2014). "Teen's case adds to debate over brain death". The Philadelphia Inquirer. Retrieved 23 October 2014.
  60. 1 2 Rocha, Veronica (3 March 2015). "Family of Jahi McMath sues doctor, Oakland hospital over brain damage". LA Times. Retrieved 20 March 2015.
  61. ↑ Hutchinson, Dave (6 March 2015). "Family of N.J. girl declared dead files malpractice suit claiming hospital pressured them for organs". NJ.com. Retrieved 17 Apr 2015.
  62. ↑ Debolt, David (6 September 2017). "Judge weighs in on whether Jahi McMath is brain dead". East Bay Times. Retrieved 20 March 2018.
  63. ↑ "Jahi McMath death could have costly implications in civil case against hospital, doctors". The Mercury News. 2018-06-30. Retrieved 2018-07-01.
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