Girl at center of legal fight for life dies during surgery

Jahi McMath

A girl who was declared dead by California officials in 2013 after complications from a tonsillectomy, but remained in a coma, has died during surgery for an intestinal issue, according to her mother.

The Daily Mail reported Jahi McMath, who was diagnosed with irreversible brain damage, died June 22 from "excessive bleeding and liver failure."

Her mother, Nailah Winkfield, citing her Christian faith, had refused to accept the California decision. She fought for continued care for her daughter, who, she argued, showed signs of life by responding to voice instructions to move her toes or fingers.

WND reported a judge ruled that evidence indicated the death certificate should not have been issued and a jury would have to decide.

A malpractice lawsuit is pending against the hospital, and whether or not McMath is alive impacts the case.

An expert testified in court in the case that the girl still was alive.

In 2017, her family submitted court filings declaring she had been on life support in an undisclosed location the past few years, emphasizing she was alive.

The expert testimony came from Dr. Alan Shewman, professor emeritus of pediatrics and neurology at the David Geffen School of Medicine at UCLA, in Superior Court in Alameda County, California,.

"There is no question that in December 2013 at Oakland Children's Hospital, Jahi McMath fulfilled the widely accepted pediatric guidelines for determining brain death (hereinafter referred to simply as the Guidelines), as well as the adult guidelines, both regarded as the accepted medical standards," the doctor wrote in the court statement.

"There is equally no question in my mind that she no longer does, for the single reason that the first of the 'three cardinal findings in brain death,' – coma, absence of brainstem reflexes, and apnea – is not fulfilled. Rather, she is intermittently responsive, placing her in the category of 'minimally conscious state.'"

He continued: "The change took place round the spring of 2014, when Jahi's family members began to suspect that she sometimes seemed to respond to commands. When I first heard of this through the news media, I was as skeptical as everyone else, assuming that they were mistaking spinal reflexes or myoclonus (involuntary quick jerks) for voluntary movements.

"Because of my research interest in the phenomenon of chronic brain death, I contacted Jahi's family through her attorney, Christopher Dolan," said the doctor, who verified he has not and is not charging the family for any of his consultations.

"Realizing that no one was likely to believe them about Jahi's intermittent responsiveness, the family began making video recordings of what they believed to be responses to simple commands. They gradually formed the impression that Jahi's responsiveness tended to occur when her heart rate was above 80 beats per minute, and hardly ever when it was slower – suggesting the possibility of some sort of inner state differentiation, with responsiveness more likely during the more aroused state."

Besides impacting the outcome of a malpractice case, a ruling that the girl was alive meant the family could return Jahi to California, where her care would be mandated.

The family eventually was able to place Jahi in a care center in New Jersey. The Daily Mail reported Winkfield had quit her job, sold her Oakland home and used savings to pay for her daughter's care.

The state's Medicaid program and donations also helped.

Winkfield said she still is debating whether to continue the legal fight in California and "possibly set a precedent so other religious families don't have to go through the same situation," the Mail said.

The girl had been on a ventilator for four years since following complications during a tonsillectomy in 2013, and doctors declared her dead. Even though a death certificate was issued, her mother refused to take her daughter off life support.

The same issue arose in another case.

WND reported a mother is suing California, charging state laws allowed employees at a Los Angeles hospital to turn off her son's life support and let him die, even though he had shown signs of life.

The non-profit Pacific Justice Institute filed a brief with a federal appeals court on behalf of Jonee Fonseca and the Life Legal Defense Foundation.

The dispute centers on a diagnosis of PVS, persistent vegetative state, in which a patient is comatose but still shows signs of life. The hospital turned off life support for 2-year-old Israel Stinson because a death certificate had been issued.

The brief filed with the 9th U.S. Circuit Court of Appeals conceded the boy was dead.

"No human power can call him back to life," the filing stated. "But his dignity can be reclaimed, his family's fundamental rights to self-determination restored, and the statues that provided authority for the taking of his life rescinded."

The complaint challenged the application of the state's Uniform Determination of Death Act by Kaiser, arguing the boy "continued to show signs of life and responded to his mother's voice and touch."

He had suffered an asthma attack early in 2016 and doctors pronounced him dead. His mother kept him on life support, and when doctors sought to disconnect him, she moved him to Guatemala for treatment.

There, according to the complaint, he "remained biological alive with a chance of recovery."

"In the late summer of 2016, Israel's family was led to believe he could receive treatment at Children's Hospital of Los Angeles and brought him back to the United States. But when the hospital learned that the state had issued a death certificate months earlier, they sought to terminate life support. The hospital would not permit an independent examination by an eminent doctor from UCLA who was prepared to assist the family," Pacific Justice said.

The boy was moved to Kaiser, and then the hospital obtained permission to disconnect him from life support. Even as "an attorney frantically raced to the Second District Court of Appeals," he was cut off from life support.

"As that attorney was handing a clerk his credit card to process payment for an appeal and request for stay, the hospital forcibly removed life support and the child expired."