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Related: Culture Forums, Support ForumsPatients declared brain dead - Any medical professionals that can answer some generic questions?
Why would a hospital glue the eyes shut on a patient that has been declared brain dead?
Why would a hospital continue to sedate a patient who had been declared brain dead?
When is a patient declared brain dead actually considered brain dead for the purpose of a death certificate? At the time they are declared brain dead or when their organs are harvested?
I heard about a local woman who had a stroke last week and there seemed to be some questionable activities in how they treated the woman and her family. A co-worker was with the family quite a bit at the hospital while the events transpired and she told us what went on. The one common reaction from those of us that she talked to was that the woman was most likely still alive when they took her organs.
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CaliforniaPeggy
(156,620 posts)I don't get why they would keep her sedated once she was declared brain dead.
And I don't know about the death certificate.
Organs are harvested after brain death has been officially declared. But the patient is being kept alive by means of mechanical ventilation, that is, on a ventilator, since they can no longer breathe for themselves. The organs stay in better shape that way.
avebury
(11,197 posts)eyes shut. They claimed it was the normal gunk that can build up but one of her sisters was trying to gentally wipe it away and realized it was glue. The funeral home verified that the woman's eyes had been glued shut.
You can't help but wonder if the combination of sedation and glueing her eyes shut were to keep her from letting her family know that she was not dead. A family friend who was a nurse did some basic nurological tests on the woman's legs and she was a lot more responsive then you would think for a person who was supposed to be brain dead. The woman's brothers heard brain dead and just assumed that the hospital was being truthful. Family friends who were there were like - wait a minute - something is not right here. The family friend who was a nurse asked questions of the hospital nurse who had a oh shit look on his face when he realized that she knew what she was talking about. Some of the comments made by the hospital nurse were pretty alarming if you didn't buy into what the hospital was saying. And this is a religiouly hospital.
The family members were not what I would call savvy people and they just didn't ask the questions that they should have asked. Only when it was way too late did the reality come home to roost. The people that were with the family that tried to get them to step back and ask questions had no authority to do anything about it. I told my co-worker that the family needs to get ahold of the woman's medical records and have them independently evaluated. I wonder if her daughter would have a case againt the hospital. She may be in a local correctional facility but she certainly could have been contacted. The hospital just didn't bother to try. They found someone stupid enough to sign on the dotted line so that they could take her organs, despite the fact that she did not want her organs to be donated.
CaliforniaPeggy
(156,620 posts)Did the woman leave an advanced directive? It doesn't sound as though she did.
It's this sort of shenanigan that gives organ donation a very bad name. Yikes.
And there is a desperate need for healthy organs.
avebury
(11,197 posts)room talked to the family twice saying how much she prayed for them and how wonderful it was for them to donate the sister's organs. They asked her what her husband was in for, it sounded like he was waiting for an organ transplant. Hmmm.
Why on earth was anybody in the hosptial talking to any other patients in the hospital about this woman and that her family had signed the transplant form. Unfortunately she did not have a directive but she had mad her wishes known. Neither of her sisters would sign it and they told the hospital that they knew that she did not want to be an organ doner. So the hospital went after the brothers. The hospital was informed that the woman had two children, the son's location was not known, the daughter is in a local correctional facility. The hospital made no effort what so ever to talk to the daughter. I think that it is pretty clear that it would have been pretty easy to find the daughter and talk to her because she was not going anywhere.
Even though they knew that the woman didn't want to be an organ donor (2 sisters told them that) and that they should have obtained permission from her daughter, they went behind their back and got a brother to sign the form. It seems to me that, if family memebers tell them point blank that they know that she didn't want to be an organ donor and the intentioally did not call the facility where the daughter was to talk to her, they don't have the right to keep asking people until they find someone to sign the form. I think that the daughter would have cause to sue the hospital. The sisters point blank made it an issue that they got the brother to sign the form and didn't even try to talk to the daughter.
magical thyme
(14,881 posts)Who manages the transplant system in the United States?
United Network for Organ Sharing (UNOS) is the private, non-profit organization that manages the nation's organ transplant system under contract with the federal government. In doing so, we bring together hundreds of transplant and organ procurement professionals and thousands of volunteers. This unique collaboration helps make 79 life-saving organ transplants possible each day. Our system serves as the model for transplant systems around the world.
http://www.transplantliving.org/community/patient-resources/frequently-asked-questions/
Nac Mac Feegle
(983 posts)When the higher brain functions shut down, some of the muscles go into spasm. It may be that the medications are for this type of effects.
See decorticate and decerebrate for further info.
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If they DON'T 'recycle' what they can from me, I WILL come back to haunt you.
hlthe2b
(113,971 posts)avebury
(11,197 posts)see her medical chart and obtain a second opinion. The lady's nurse make comments here and there that should have put the family on notice that something might not have been right. It sounds like he didn't really think about what he was saying. There were signs that something was really off about the whole thing and that the hospital may very well have taken advantage of uneducated family members who had no clue what questions to ask to make sure that the hospital did right by their family member.
Heddi
(18,312 posts)2 separate neurologists, unaffiliated, at different times, separately, doing the same testing, must come to the same conclusion regarding brain death. only then can brain death be declared.
SHe had her second opinion. It was the 2nd concurring opinion that allowed her to be pronounced brain dead
magical thyme
(14,881 posts)magical thyme
(14,881 posts)the viability of the organs until they can be transplanted.
"However, brain death is often associated with marked physiological instability, which, if not managed, can lead to deterioration in organ function before retrieval. In some cases, this prevents successful donation. There is increasing evidence that moderation of these pathophysiological changes by active management in Intensive Care maintains organ function, thereby increasing the number and functional quality of organs available for transplantation.....
"Hypertension may be moderated with vasodilators, opiates, or volatile anaesthetic agents."
http://bja.oxfordjournals.org/content/108/suppl_1/i96.full#sec-22
As mentioned above, most likely the eyelids were glued shut to protect the eyes.
A family friend who was a nurse did some basic nurological tests on the woman's legs and she was a lot more responsive then you would think for a person who was supposed to be brain dead.
"The following manifestations are occasionally seen and should not be misinterpreted as evidence for brainstem function:
vi.
deep tendon reflexes; superficial abdominal reflexes; triple flexion response (Flexion at the hip, knee, and ankle, in response to stimulation of the sole of the foot)
vii.
Babinski reflex (a reflex action in which the big toe remains extended or extends itself when the sole of the foot is stimulated)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772257/
Unless the nurse is specifically trained and experienced in 1. diagnosing brain death and 2. maintaining organ viability in a brain-dead patient, she has no more idea what she is looking at than anybody else.
"Reflex actions" take place neurologically with the spinal cord, not the brain. That is, there are neurological circuits that link to the spinal cord and right back out to the limb.
I would advise against trying to interpret the expression on somebody's face; people tend to see what they want or expect to see. Your friends are headed itoward a murder charge without having any real knowledge of the processes involved.
It appears to me that the failure was one of adequate communication -- the doctors should have explained to the family far more about what to expect and why.
Heddi
(18,312 posts)Full disclosure, I'm a nurse. Have been for a decade. Have worked in ICU, ER, step down, progressive care. I have seen a lot of deaths, and worked in a lot of hospitals. Absolutely NOTHING in your story bears any resemblance to anything I have *ever*seen or *ever* heard from any other RN I know (my husband is an RN, all of my friends are either RN's or MD's, for the most part).
Firstly, there is no gluing of the eyes. I don't care what the funeral director told your friend's cousin's mom's sister. There is no "eye" glue and no reason to do it. As CP said, they often tape the eyes closed to prevent scratches to the cornea. I have been present for, maybe not hundreds, but easily DOZENS upon dozens upon dozens of brain dead, brain dying, dead on arrival, organ donation, organ not donation, medical examiner deaths, non-ME deaths. NEVER once EVER ever have I seen eyes glued shut or anything remotely like that.
Secondly, organ donation, not "harvesting"--it's a person, not an apple tree -- is one of *the* most regulated aspects of hospital care, across the board, hands down. People who are brain dead aren't automatic candidates for organ donation. There is a very lengthy process THAT IS HANDLED BY AN INDEPENDENT AGENCY -- not the hospital. The hospital nor anyone associated with the hospital makes the "call" regarding organ donation. Agencies like Donate Life, LifeCenterNW, etc, handle all aspects of organ donation. Patients with a history of cancer, hepatitis, AIDS, HIV, and other chronic diseases are not suitable for organ donation, even if they want to be. BLoodwork, medical history, chart notes, family history -- all of that is combed over with a fine toothed comb before the organs are removed
Thirdly, despite what your drivers license says, your organ donation status is SOLELY dependent upon the wishes of your family. The DL heart, or a card you carry in your wallet is only stating your wishes, and is not legally binding. If she didn't want her organs donated, and the family did, then they were. Equally, if she did want them donated and her family didn't, they wouldn't be donated, regardless of her wishes. Regardless if it was written in stone and signed by God. Family wants trump patient desires after death
FOURTHLY, donation does not EVER. EVER. EVER in this country occur without a meeting with the family by the organ donation agency, a THOROUGH discussion with the family, and the signature of about a billion papers. This isn't something someone could consent to accidentally. It is a multi-hour process of consents, signatures, discussions, questions, signatures, agreements.
FIFTHLY -- don't rag on nurses. They aren't stealing organs and making living people appear dead. Real life does not resemble what we see on TV. Your friend was sedated because just because there is brain death doesn't mean that lower motor neurons, like those that cause shivering or muscle spasms, aren't working. They are. It is to keep the patient comfortable, even in death, and to make the dying process less gruesome to family members. TV tell us that everyone dies with a smile on their face and an angel on their shoulder. THis is not the case, even in brain death.
SIXTHLY, there are specific test done to examine brain death. Some of them are physiologic tests, such as dolls-eye movements and cold-water caloric testing. Some of them are electrophyiologic with EEG readings. No matter what, brain death is only declared when two INDEPENDENT PHYSICIANS go through the battery of tests SEPARATELY and at SEPARATE TIMES and come to the diagnosis of brain death.
Unless you're willing to implicate the ENTIRE hospital staff, from two sets of Neurologists, the nurses, the respiratory therapist, the OR team, the organ donation team, the medical examiner,...EVERYONE as being murderous thugs hellbent on stealing organs from the living, then you should realize that people at the bedside who are witnessing things tend to see and hear things selectively. This has been proven time and time again. Especially when faced with the trauma of unexpected death and all the hooplah surrounding it, the things going on, the doctors, the coming and going and all of that --- It's overwhelming to a trained professional who knows what's going on. It's absolutely mystifying to someone who is so emotionally wrapped up to the person laying in the bed that, even if they're a medical professional, they're not looking at the situation with an unbiased eye.
Your friends friend who is a nurse -- don't buy into the "that nurse gave her a look like he knew his goose was cooked." That's bullshit. The nurse was probably like "oh shit, not another one of these kooks" because believe it or not, hospitals (especially the ER) are frequently accused of either 1) not keeping people alive so that they can take the organs or 2) keeping people alive so they can take the organs or 3) not doing CPR for organs or 4) only doing CPR for organs.
If you truly believe that the entire medical establishment in that hospital is involved in an organ stealing and patient murdering conspiracy, then I heartily encourage you to contact your local news as well as every malpractice attorney you can find. But please don't be embarrassed when they laugh in your face.
avebury
(11,197 posts)1. Fact 1 - this hospital made no effort to contact the daughter who, while in jail, is in jail in the same city. She was the rightful next of kin.
2. A hospital should not just go down the family chain until they find someone to sign the forms. Her sisters were pretty clear in refusing to sign the forms because they knew that their sister did not want to donate her organs.
3. Their brother did go behind the family's back to sign the form. When the hospital was informed that the brother was not the next of kin and that they would need to obtain permission from the children the hospital indicated that they didn't know where the kids were. That was a true statement with regards to the son but for crying out loud, the daugher is in a correctional facility in the same time. I find it hard to believe that you cannot find someone who is in a correctional facility. The sisters did question the ability of the hospital's ability to accept the brother's signature.
4. The hosptial did flat out lie about gluing the woman's eyes shut. If there was a vaild reason, say so. The funeral home did verify that the eyes were glued shut.
This is a family that is black, uneducated and poor and they are feeling that the hospital pulled a fast one on them. The hospital was told point blank who was the next of kin whom they didn't talk to. They ignored the family members who told them that she didn't want to be an organ donor and they finally found a family member willing to go around everyone's back to sign the form. That flat out comes across as being highly underhanded. The sisters asked the brother why on earth he signed the form. His response was "Well they said that she was dead." That shows you just sophisiticated his thought process was.
I did work in a hospital back in my college years (which was a while ago). While it has been a while, I would know what questions to ask and I would expect them to show me the proof that my family member was brain dead.
Heddi
(18,312 posts)if she's in jail, she has no ability to come to the hospital to sign any forms, or to make any decisions. The Dr's not going to drive to county to have her sign papers.
It's usually next of kin as available. i'm my mom's next of kin. But I live 1500 miles away. If I can't be there at the bedside, it goes down the list.
I understand these people are your friends -- but you have to understand that reality and what is told as reality are so often two very different things. Say next of kin tree is like this:
Daughter -- oldest sister -- middle sister -- youngest brother
Daughter -- well, she's in jail. She can't come to the hospital and sign or consent for anything. The doctors aren't going to go to the jail. They're not going to spend endless time tracking someone down. I am my mother's NOK. If I can't be there at the hospital to sign papers, they're going to find someone who can (unless I have been formally designated as her Medical Power of Attorney, and the paperwork is valid and in hand, at which point I can make legally-binding decisions over the telephone if I can't be there in person).
This is not unique to this hospital, or your friend. It's SOP. If someone is dying, decisions need to be made ASAP. Not tracking down family members that are unreachable (in jail) or unlocatable (other children)
Oldest sister -- doesn't want to sign. That's NOT the same as refusing treatment. She could have signed the papers in the box that says NO ORGAN DONATION. That is an option.
Middle sister -- doesn't want to sign. Didn't REFUSE the donation, just refused to sign.
Youngest brother -- finally someone who is willing not to sign YES but to sign SOMETHING AT ALL
If the next of kin are refusing to make decisions then yes, they go down the line until someone is willing to make ANY Decision -- not just yes/no because they're often NOT yes/no questions. They're "yes, if" and "no, but for"
Here's the thing about death -- the living often find themselves guilt-ridden over it, even if the death isn't their fault. Why didn't I call more often, why did I say this, why didn't I say that.
At any time, these sisters and next of kins could have refused to allow them to take her off of life support. They could have taken the proclaimation of brain death and said "We want a third and fourth opinion" (since 2 MD's are needed to pronounce) and sent her to another hospital, a long-term care facility --- but they didn't. Now they're probably looking back to find ANYONE to blame for the death, or to pin their guilt on, rather than accepting that death is a part of life. It happens to all of us at some point or another.
Again -- if this is the hill you're going to die climbing, and you're taking these people's word at 100% unquestionable truth (not saying they're lying, but they're interpreting things to fit the trauma they just went through), then contact a lawyer. Contact the news media. It doesn't matter if someone is black or white, rich or poor. Malpractice is malpractice. Murder is murder. Get it out there, Have the medical records subpoenaed as well as everyone who was involved in the care of the patient. Get it on record. Show the world that this hospital murders people and steals their organs and pretty much breaks every traceable law in the books for...?? not sure. But whatever. If it's so egregious as you say, the staff so open with their out of line comments (that you didn't hear) and their guilty facial expressions (that you didn't see) and their breaking every state and federal law regarding organ donation and patient death (even though you're going second hand information on this), and bypassing legal next of kin status (even though you weren't there to hear what was said or who was contacted), then I heartily encourage you to make as big of a deal about this as you can! You don't know where these people will stop next!!!
MH1
(19,156 posts)that applies very widely in life.
Especially in highly emotional situations.
The one tweak I might make in that statement, is change "told" to "perceived". I think most people aren't intentionally fabricating, they are telling what they actually perceived, but their perceptions were distorted by emotion, physical and/or mental exhaustion, or potentially several other factors.
Heddi
(18,312 posts)I don't believe they're being deceptive. I believe they are tying to take what they heard, what they saw, what they felt, what they were told, what they wanted to be told, what they didn't want to be told, and trying to make all of these things fit into something that makes sense.
I've heard it with my own ears, as a Dr is at the bedside saying something like "your heart doesn't beat like it should, we need to put a pacemaker in and that's a machine that will make sure your heart beats as often as it needs to" and 10 minutes later the family or the patient has no idea what the doctor said, he never said anything about surgery, who said anything about a pacemaker, what do you mean I'm not going home....
It's very common. That's why education in the hospital is so important to be clear, concise as necessary, and most importantly, be repeated Again. and again. and again. Patients/families aren't going to hear it the first three times you say it. They're too focused on this or that and the stress and the pain and the meds.
Worst, though, is the news of impending death. I have seen it. A patient has an irreversible brain injury from a trauma (car accident, gun shot, etc), and the doctor says very clearly that the patient will die. And the family talks about what it will be like when the patient comes home, when is he going to be discharged.
It's very hard to hear these things and process them in the way our brain processes normal news. It's traumatic, it's emotional, it doesn't fit the plan of our day, it doesn't fit the plan of our life.
I don't blame the friends or the narrative they're telling the OP. I don't think they're being purposefully deceptive or trying to "get one over," but I do think that much of what the narrative is not reflective of the way the situations actually happened.
cleanhippie
(19,705 posts)Or you heard about it?