The mother of a California girl declared brain dead after complications from a tonsillectomy pleaded for prayers and time to keep her daughter on a ventilator past Monday, when a temporary restraining order barring a hospital from disconnecting life support expires.
"Despite what they say, she is alive. I can touch her, she is warm. She responds to my touch," Nailah Winkfield wrote about 13-year-old Jahi McMath Saturday.
"Given time I know (God) will spark her brain awake," she wrote in the open letter.
Children's Hospital of Oakland's responded in a statement that while it sympathizes with Winkfield's wishes, "it would be unfair to give false hope that Jahi will come back to life."
Winkfield said her daughter bled profusely and went into cardiac arrest after undergoing a "simple procedure" to remove her tonsil to help with her sleep apnea. She criticized the hospital for initially giving her a cup, then a "bigger bucket" as her daughter continued to bleed in a recovery room.
"They did not answer our pleas for a doctor. Her surgeon never came back," Winkfield wrote.
Jahi was declared brain dead on Dec. 12.
The hospital statement contends the surgery was complicated, and that it was committed to fully investigating what caused "this catastrophic outcome."
A judge ruled Friday to keep Jahi on a ventilator and continue giving her intravenous fluids through Monday, when a court-approved neurologist will examine the girl for any signs of brain activity.
The family's attorney, Christopher Dolan, told Alameda County Superior Court Judge Evelio Grillo the family wanted independent tests because they do not believe the hospital's physicians are sufficiently independent.
The hospital said in documents presented to the court Friday that a staff neurologist and Jahi's attending physician conducted separated exams, both of which determined that Jahi's entire brain, including her brain stem, stopped functioning.
"There is absolutely no medical possibility that (Jahi's) condition is reversible or that she will someday recover from death," declarations from the doctors said. "Thus, there is no medical justification to provide any further medical treatment whatsoever to (her)."
Hospitals do a barrage of sophisticated tests to determine brain death, said Dr. Cristobal Barrios, an associate professor and a trauma and critical care surgeon at the University of California, Irvine. He is not involved in Jahi's care and spoke about general hospital protocols.
The tests include touching a patient's cornea to elicit a blink, moving a breathing tube to stimulate a gag reflex, tickling the back of the throat to bring on a cough, and applying pressure or pain.
If the patient fails to respond to all of those tests, doctors remove the breathing tube for a few minutes. If there is any brain activity, the patient should begin breathing within a few minutes, he said.
In some cases, doctors will also draw a blood sample, add radioactive tags and re-inject it into the body to track where it flows. If the blood doesn't flow to the brain, Barrios said, there is no brain activity.
Generally, two teams of specialists must run the tests and determine independently that the patient is brain dead, he said. At UC Irvine, those evaluations must take place 12 hours apart if the patient is a child.
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