Family seeks medical consensus for California girl declared brain dead

A lawyer for the family of a California girl declared brain dead after complications from a tonsillectomy wants to broker a conference between several physicians who insist she exhibits signs of life and a court-appointed doctor who rejects their findings.

Relatives of Jahi McMath, aged 13 when she suffered cardiac arrest in December following surgery to treat sleep apnea, petitioned a judge weeks ago to revoke her death certificate and restore her status as a living person.

They cite statements from several doctors saying new medical tests performed on Jahi, who is on a ventilator in New Jersey, found unmistakable signs of brain function, even awareness, at odds with a brain death diagnosis.

"Jahi currently does not fulfill brain death diagnostic criteria. She is an extremely disabled but very much alive teenage girl," wrote Dr. Alan Shewmon, professor emeritus of neurology and pediatrics at the University of California, Los Angeles.

Those assertions were quickly challenged in a letter to the judge by a Stanford University pediatric neurology specialist appointed by the court to review the petition, Dr. Paul Fisher.

Fisher countered that the tests and findings were irrelevant for determining brain death in a child, and that a key exam for brainstem function, testing a patient's ability to breathe unassisted, was missing from the evaluation.

"None of the declarations provide evidence that Jahi McMath is not brain dead," he wrote.

Experts say the case's unusual circumstances, including the rarity of a patient being kept on life-support so long after brain activity was deemed to have ceased, could have implications for defining brain death in the future.

The opinion from Fisher, who originally confirmed the brain-death findings of two Oakland hospital physicians, came days before a hearing set for Thursday to consider the family's petition.

SEEKING CONSENSUS

Family attorney Chris Dolan responded by withdrawing the petition, halting further legal action to buy time for a thorough reply and seek permission for all the doctors to consult, outside of court, in hopes of reaching a medical consensus on Jahi's condition. Fisher was not immediately available for comment on Dolan's suggestion.

Dolan has objected to Fisher's reappointment by the court as a conflict of interest, noting it was Fisher's original determination that was now under scrutiny.

Still, Dolan said outside experts were not out to fault Fisher. Some have suggested the discrepancies between his findings and later medical tests stem from severe brain swelling, now subsided.

"What we do want to do is to bring all the evidence forward to be looked at critically, and not defensively," Dolan said.

Among the most compelling evidence is video that outside experts say clearly shows Jahi repeatedly moving her hands and feet in response to verbal requests from her mother, and the fact she has begun regular menstrual cycles.

The motor responsiveness demonstrated in the video, by itself, "proves that she is not brain dead, not even comatose," Shewmon wrote, adding, "Corpses do not menstruate."

They also cited tests showing electrical activity in the brain, cerebral blood flow and brain tissue left intact rather than liquefied, as would be expected months after death. Moreover, the girl's heart rate appeared to vary in response to her mother's voice.

Reversal of the death certificate would let the family bring Jahi home from New Jersey, which unlike California allows families to keep a relative on a ventilator on religious grounds after a brain death declaration, Dolan said.

(Reporting by Steve Gorman in Los Angeles; Editing by Cynthia Johnston and Lisa Shumaker)