Tonsillectomy Death at the Oakland Children’s Hospital and Why Americans Shouldn’t Trust their Doctors

Jahi-McMath

Clusivius:

Clusivius-sqA 13-year-old girl named Jahi McMath went to the Oakland Children’s Hospital on December 9 for a tonsillectomy to treat her sleep apnea. Hours later she died at the same hospital from profuse bleeding and cardiac arrest caused by the procedure. The hospital managed to keep her on life support, but their tests showed no brain activity, and they declared her legally dead.

The public controversy of this case arises from the hospital’s desire to cut off the life support on this “dead body” and the family’s attempts to keep her body alive in their hope for a miracle. So far a judge has twice intervened to extend her life support, now to January 7. But complicating the case is the potential complicity of the hospital in her death and the cold-hearted eagerness of the hospital to pull the plug.

Children’s Hospital Oakland has a very good reputation where I live in the Bay Area. But its public communication around the tragedy of Jahi McMath’s ”brain death” has been astoundingly insensitive, bordering on arrogant.

The hospital’s statements quoted in today’s San Francisco Chronicle continues the maladroit insensitivity. The hospital states it will remove the ventilator the moment that can be done legally. From the story:

Children’s Hospital Oakland officials confirmed Sunday they will turn off the machines sustaining Jahi McMath’s body as soon as a legal injunction expires at 5 p.m. Monday unless otherwise ordered by a court. “Barring any other court-order legal action by the family, the ventilator will be shut off at 5 p.m. tomorrow,” said hospital spokesman Sam Singer. “It’s tremendously sad, but that’s what’s going to occur.”

Not five minutes after five. Not sometime after five. Not one second after five. At five! I can picture a doctor looking at his watch counting down the seconds, “three, two, one…”.

Then there’s this:

“Children’s Hospital Oakland continues to support the family of Jahi McMath in this time of grief and loss over her death,” the hospital said in a statement Sunday. “We continue to do so despite their lawyer’s criticizing the very hospital that all along has been working hard to be accommodating to this grieving family.

Gee, that’s big of you. Why have hospital spokespersons acted throughout this sad saga as if the institution is the victim?

Much of the nastiness comes from the hospital’s PR consultant Sam Singer, who seems ill suited for his job of sugar-coating the hospital’s eagerness to not only pull the plug on this girl but to prevent any other facility from taking her in her present condition.  The coldness of the hospital’s lawyer, Douglas Straus, only adds to this nasty impression.

singer-straus

The insensitivity and arrogance of Oakland Children’s Hospital spokesman Sam Singer and the hospital’s attorney Douglas Straus has created a PR disaster for the California hospital.

Meanwhile, the fact that Jahi McMath died because of a failed surgery performed at this same Oakland Children’s Hospital seems to have little bearing on anyone’s behavior in this case and isn’t widely highlighted in the news. One gets the impression that this sort of death just happens sometimes, like hail storms, and there is nothing that anyone can or should do about it.

While hospitals are quick to say that any surgery is risky, death from tonsillectomy is rare, occurring in 1 case for about every 15,000 performed.[1] [2] Each tonsillectomy death that happens ought to be carefully scrutinized, and maybe this one was. But that doesn’t excuse the callous treatment by the hospital.

According to reports, this family’s insurance is willing to pay to keep her on life support for some time, so it doesn’t appear that the hospital will lose money. (And would these sprawling medical palaces with their indoor waterfalls and botanical gardens ever allow themselves to lose money?) So why is the hospital placing so many roadblocks for other facilities to accept her? The hospital’s lawyer, Douglas Straus, issued a statement that rather coldly outlines all of the conditions that they require for another facility to accept the girl. Callous experts seem to think that the hospital is fighting against the possibility that brain deaths will be harder to declare in the future.

The moral of the story: we should not trust our doctors. Doctors, for all of their fancy and rigorous qualifications, aren’t much better at diagnosis and repair than the local grease monkey at the auto shop.

Like any businessmen, doctors have an incentive to make money with the minimal effort possible. If that means rushing a patient through a five minute interview and telling the nurse to prescribe some pills to shut him up, then so be it.

Doctors often inflate the value of their own knowledge and abilities, achieved through their qualifications and experience, a knowledge that they believe trumps any doubts or complaints (or even questions) that their patient may have. They hear all sorts of babble from hypochondriacs, and this can make them cynical. But they haven’t lived with their patient’s body for decades, either.

And doctors, especially in hospitals, also tend to take a possessive attitude towards their patients, considering them to be wards in their custody. Doctors know what’s best, and they aren’t inclined to allow a patient to leave their care once that patient is admitted. Just try to leave a hospital without their proper discharge. This conceit especially applies to children, as the recent example of the Amish girl with cancer highlights.

CVC-garden-from-above-21-1024x682

Would these sprawling medical palaces with their indoor waterfalls and botanical gardens ever allow themselves to lose money?

Provisions in ObamaCare to gather a variety of impertinent information on medical patients, such as sexual relations and history of psychological issues, could impact our lives in unknown ways. Surely the government will use this information for its own purposes, which may be simple data analysis or the typical social engineering, but certainly could be used for outright gun confiscation or political blackmail.

As the government intrudes ever more deeply into the medical industry, Americans can expect a shift from a system whose primary customers are insurance companies to one where doctors show the most concern for satisfying the government. And while insurance companies must at least somewhat consider the wishes of their paying customers, government bureaucracy has little incentive to do so. Unfortunately, it’s easier—a little—to change our insurance companies than to change our government. The end result is a medical system that cares less about the well-being of its patients and more about staying out of trouble with the government. In that case, we can expect more cases like that of Jahi McMath.

One way or another, we mustn’t blindly trust our doctors. Especially now.

Patulcius:

Patulcius-sqThe Oakland Children’s Hospital is definitely showing a lack of sensitivity to the family of a child who died because of their own failed procedure, and as Wesley J. Smith said in the above-quoted article, it is a PR disaster for them. But the hospital is correct to try to move this case along, even if they aren’t doing it with the greatest finesse.

The grieving mother will never willingly pull the plug on her daughter’s body. She sees a child who appears to respond to her voice and touch and doesn’t care what anyone says about it. Who could blame her? Most mothers would behave the same way in this situation.

But the child is showing no brain activity at all. She’s not in a coma and she’s not in a vegetative state, she’s dead. According to some of these news stories, the state of California requires two doctors to confirm brain death with two separate tests three hours apart from one another. Additionally, the family (rightly) brought in three additional doctors to confirm the condition, and all five doctors found the child to be brain dead. While a miracle from God could certainly save her, we can’t expect the hospital to keep her on life support on the basis of a miracle when she is already clinically dead.

Bluntly said, hospitals are intended to save lives, not cater to corpses. It’s an unpleasant truth, but those who deal with death so frequently must address this unpleasant subject.

This is one of those cases where technology has muddied what once was a clear-cut matter.

As far as trusting doctors, a second opinion can be a good idea, but we should weigh a doctor’s opinion pretty heavily. They have experience and knowledge that we typically don’t. But maybe we don’t have to run to a doctor for every sneeze or runny nose, or to request the latest prescription for restless leg syndrome that we saw on a one-minute commercial.

Considering ObamaCare, we should resist sharing information to doctors or to the government that has nothing to do with our particular cases. It isn’t necessary to openly defy them (this can cause even more unnecessary troubles). If it’s possible to say nothing, we should say nothing; if an answer is required, a quiet “N/A” should suffice.

Concorditas:

ConcorditasAs terrible as many of California’s ideas about laws and rights may be these days, it seems like matters are proceeding as they should in the case of Jahi McMath.

The mother is rightly fighting for her child’s life. She sees her child responding to her touch and her voice, and she’s right to challenge the hospital in every way she can.

The hospital is justifiably, if heartlessly, trying to pull the plug on the girl. They see a brain-dead corpse, and they want to avoid a precedent that will make it harder to declare a person dead. They might have chosen a callous way to push their case, but they are justified in doing so.

And the legal system is allowing time for this case to get settled in a just way by extending her life support until January 7. McMath’s mother has more time to either find a facility that can comply with the hospital’s conditions for removal and/or for doctors to observe her case over a period of time. Or for her lawyer to determine if the hospital is trying to hide its complicity in McMath’s death.

The system seems to be working in this case. Meanwhile, my prayers and best wishes go out to McMath and her family.

[Update: On January 5, Jahi McMath was moved from the Oakland Children’s Hospital to an undisclosed facility where she will remain on life support.  Medical “ethicists” howl and scream in indignation.]

[1] Windfuhr, Schloendorff, Sesterhenn, Prescher, and Kremer. “A Devastating Outcome after Adenoidectomy and Tonsillectomy: Ideas for Improved Prevention and Management.” Otolaryngology–Head and Neck Surgery (2009). Metro Atlanta Educational Society for Otolaryngology, Apr. 2009. Web. 1 Jan. 2014. http://www.metroatlantaotolaryngology.org/journal/apr09/Devastating%20T%20%26%20A.pdf>

[2] Encyclopedia of Surgery. “Surgery.” Tonsillectomy. Advameg, Inc., n.d. Web. 01 Jan. 2014. <http://www.surgeryencyclopedia.com/St-Wr/Tonsillectomy.html

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2 Comments

  1. I always assume the hospital is trying to cover up malpractice when they work so hard to pull the plug. They are giving up revenue in order to avoid a potential law suit.

    My quick google search didn’t reveal the name of the doctor who performed the tonsillectomy.

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    Reply
    • Good luck getting the name of the doctor. Hospitals are very concerned for their patients’ privacy, you know.

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      Reply

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