Tuesday, January 7, 2014

Experts: Clock Ticking for Calif. Brain Dead Teen

The family of a 13-year-old California girl who was declared brain dead after suffering complications from sleep apnea surgery has achieved its goal of moving the girl to a new facility for long-term care, but medical experts say the ventilator she's on will not work indefinitely.

Jahi McMath's uncle said Monday that she is now being cared for at a facility that shares their belief that she still is alive.

While the move ends what had been a very public and tense fight with the hospital, it also brings new challenges: caring for a patient whom three doctors have said is legally dead because, unlike someone in a coma, there is no blood flow or electrical activity in either her cerebrum or the brain stem that controls breathing.

The bodies of brain dead patients kept on ventilators gradually deteriorate, eventually causing blood pressure to plummet and the heart to stop, said Dr. Paul Vespa, director of neurocritical care at the University of California, Los Angeles, who has no role in McMath's care. The process usually takes only days but can sometimes continue for months, medical experts say.

"The bodies are really in an artificial state. It requires a great deal of manipulation in order to keep the circulation going," Vespa said.

Brain-dead people may look like they're sleeping, he added, but it's "an illusion based on advanced medical techniques."

The family and their lawyer would not disclose where the eighth grader was taken on Sunday night after a weekslong battle to prevent Children's Hospital Oakland from removing her from the breathing machine that has kept her heart beating for 28 days.

The uncle, Omari Sealey, told reporters Monday that Jahi traveled by ground and that there were no complications in the transfer, suggesting she may still be in California. Nurses and doctors are working to stabilize her with intravenous antibiotics, minerals and supplements while she remains on the ventilator, but her condition is too precarious for additional measures, lawyer Christopher Dolan said.

The new facility has "been very welcoming with open arms. They have beliefs just like ours," Sealey said. "They believe as we do ... It's a place where she is going to get the treatment she deserves."

The nearly $50,000 in private donations the family has raised since taking the case public helped cover the carefully choreographed handoff to the critical care team and transportation to the new location, Sealey said. The facility, where Jahi is expected to remain for some time, is run by a charitable organization that so far hasn't sought payment, Dolan said.

Both men refused to name the facility or reveal where it was located, saying they wanted to prevent staff members and the families of other patients from being harassed.

Jahi underwent surgery at Children's Hospital on Dec. 9 to treat severe sleep apnea, a condition where the sufferer's breathing stops or becomes labored while sleeping. Surgeons removed her tonsils and other parts of her nose and throat to widen the air passages.

While recovering in the Intensive Care Unit, she bled heavily from her mouth and nose and eventually went into cardiac arrest. Doctors at the hospital declared her brain dead three days later and moved Dec. 20 to remove her from the ventilator.

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