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Jahi McMath case opens questions about routine tonsillectomies

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Many eyes are on Oakland, California right now and specifically on Children’s Hospital where the family of a young girl waits for a miracle. When the family of Jahi McMath took her to the hospital for a routine tonsillectomy on December 9, 2013 to help with her sleep apnea, they certainly expected to bring her home soon after. Instead, the 13-year old girl has been declared brain dead after complications resulting from the operation. Normally, a person declared brain dead is soon removed from life support. However, on Friday, December 21, an Alameda County judge ruled that Jahi must be kept on a ventilator until an independent neurologist can examine her to determine if her brain is showing signs of activity.

This result was never expected after Jahi woke up from the operation seemingly alert, talking and even eating a Popsicle. But things took a turn for the worse when about 30 minutes later, Jahi started bleeding so profusely from her mouth and nose there were soon containers of her blood in the room. Despite efforts of hospital staff to stem the bleeding, even giving her blood transfusions to counteract the blood loss, Jahi passed out and was soon declared brain dead. This declaration was made after several extensive tests done in the hospital to verify brain death. But the tests, and the reality of the situation are no comfort for a family with no answers to this confusing situation.

This case leaves many unanswered questions for the family and for others who wonder what went wrong with what is usually a routine operation. I remember when we were young and my brother and sister went into the hospital together to have their tonsils removed. Fortunately, they came home in a few days with no complications. That's what most families expect to happen. Tonsillectomy is the surgical removal of masses of lymphoid tissues located in the back of the mouth. In the 1950’s to 1970’s, over a million tonsillectomies were performed in the United States. Since then, the operation has declined to about 250,000 per year.

A 2004 study by Dutch researchers published in the British Medical Journal showed that “most tonsillectomies might be unnecessary, with tonsillectomy having no major clinical benefits over ‘watchful waiting’ in children aged two to eight with mild symptoms of throat infections, or mild breathing difficulties due to enlarged tonsils.” However there are some instances in which tonsillectomy is recommended. These include when tonsils cause or attribute to sleep apnea, obstruction of the airway, difficulty swallowing, five or more throat infections per year, or unusually severe infections to name a few.

Despite the facts, what matters in this case is knowing what went wrong with Jahi and why a family might suffer the loss of their beloved 13 year old daughter who was just beginning her life. The case leaves everyone watching in bewilderment and wondering how something like this could happen in a modern society with modern day medicine.



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