Legal counsel for a California hospital and the family of a 13-year-old girl declared brain dead after sleep apnea surgery began discussing the possibility of moving her to another facility, after a judge laid out the conditions for such a transfer.
The judge said Friday that the mother of the child may remove her from an Oakland hospital if she assumes full responsibility for the consequences.
Later Friday, lawyers for Children's Hospital Oakland and the mother of Jahi McMath emerged from a settlement conference with a federal magistrate offering few details about the daylong talks that followed the developments in state court. But Christopher Dolan, who represents Jahi's mother, said he was pleased with the progress that was made.
"Today has been about clarity. It's been about knowing exactly what path we have to walk down, what doors are now open, and what obstacles have been removed," Dolan said. "We know how to get from here to where we want to be, which is Jahi in another place where she is receiving care."
It was unknown when the girl might be moved or if she would be, since her family still is trying to finalize where she could be taken and find a medical team to carry out the transfer. A court injunction prohibiting Children's Hospital from removing the ventilator that has kept Jahi's heart pumping since her Dec. 9 surgery expires at 5 p.m. Tuesday, and Dolan said the family would work to get her relocated before then.
After spending weeks in a very public and tense fight with the hospital, Jahi's family does not plan to disclose any more about their plans for her continued care until she is resettled, her uncle, Omari Sealey, told reporters.
"It's been up and down, up and down, and now we finally have a blueprint of how to accomplish our objective, so we are very happy about that," Sealey said.
The potential breakthrough came earlier Friday when Alameda County Superior Court Judge Evelio Grillo said Jahi could be transferred under a deal with Children's Hospital that will hold the girl's mother, Nailah Winkfield accountable, for developments that could include Jahi going into cardiac arrest.
"She's definitely showing the improvements," Winkfield said Friday. "If I felt that my child was suffering in any type of way, I would not keep her on that machine. I love her that much that I would let her go. But because I see those improvements every day, I will fight for Jahi every day until my heart stops or her heart stops."
The hospital has argued since before Christmas that Jahi's brain death means she is legally dead and she should be disconnected from the ventilator. It also has refused to fit her with a feeding tube or a breathing tube that would help stabilize her during a move, saying it was unethical to perform medical procedures on a dead person.
Winkfield, refusing to believe her daughter is dead as long as her heart is beating, has gone to court to stop the machine from being disconnected. She wants to transfer Jahi to another facility and hoped to force Children's Hospital either to insert the tubes or to allow an outside doctor to do the procedures.
Grillo on Friday rejected the family's move to have the hospital insert the tubes, noting the girl could be moved with the ventilator and intravenous fluid lines she has now. He also refused to compel the hospital to permit an outside doctor perform the procedures on its premises.
Dolan said the family has located an unaffiliated physician to put in the tubes and that an outpatient clinic in New York that treats people with traumatic brain injures has expressed willingness to care for Jahi.
Jahi went into cardiac arrest while recovering from surgery to remove her tonsils, adenoids and uvula along with bony structures from her nose and throat and palate tissue.
Three doctors have declared the girl brain dead based on exams and tests showing no blood flow or electrical activity in either her cerebrum or the brain stem that controls breathing.
Multiple outside doctors and bioethicists observing the case have confirmed that a patient in that condition meets the legal criteria for death and has no chance of recovering.
The judge earlier this week ordered Children's Hospital to keep Jahi on the ventilator until Jan. 7 at 5 p.m. He said Friday that he would dissolve the injunction as soon as Winkfield assumes custody of her daughter's body.
Hospital spokesman Sam Singer said that if the girl is not transferred by the deadline, her family would have to seek an extension or the ventilator would be removed.
The Alameda County coroner's office issued a death certificate for the girl Friday but said the document is incomplete because no cause of death has been determined pending an autopsy.
Hospital lawyer Douglas Straus told reporters after Friday's state court hearing that he hopes the family will soon conclude the girl has passed away.
"It's horrible that this child has died. It's also horrible that it's so difficult for her family to accept that death," said Straus, choking up. "I constantly think that wouldn't it be great if they were able to come to terms with the terrible tragic event and that I didn't have to stand in front of you all time after time."
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