Who gets to decide when to end life support when a person is brain dead?
The mother of 13-year-old Jahi McMath, who was declared brain dead Thursday, three days after undergoing surgery to remove her tonsils, said Tuesday that the family should make the call.
"I don't want her off life support because I really feel like she can wake up," Nailah Winkfield told CNN's Piers Morgan. "I feel like it's just been a rough week for her and, if they just give her some more time, then she'll be able to wake up."
Jahi's family has presented Children's Hospital & Research Center in Oakland, California, with a cease-and-desist letter aimed at preventing the hospital from taking her off a ventilator, attorney Christopher B. Dolan said Tuesday.
"If the hospital wants to terminate Jahi's life, they should go to court and get a judge to authorize that, not pressure a parent into signing a document in the middle of the night or telling them at 8:30 tomorrow morning your child will be (dead)," he told CNN.
Doctors had recommended the tonsillectomy to treat Jahi's sleep apnea, weight gain, inability to concentrate, short attention span and uncontrolled urination, her uncle Omari Sealey told CNN on Monday in a telephone interview.
"They said that she would have more energy, focus more, lose weight, and the urinating would stop," he said.
The surgery, which occurred December 9, initially appeared to have gone well, said Sandy Chatman, Jahi's grandmother who is herself a nurse and saw the girl in the recovery room.
"She was alert and talking, and she was asking for a Popsicle because she said her throat hurt," Chatman said.
But Jahi was then moved to the intensive-care unit, and her relatives were denied access to the eighth-grader for 30 minutes; when they finally were allowed to see her, they knew something was wrong. "Upon entry, they saw that there was way too much blood," Chatman said.
"We kept asking, 'Is this normal?'" Sealey said. "Some nurses said, 'I don't know,' and some said, 'Yes.' There was a lot of uncertainty and a lack of urgency."
Sealey said that when Chatman noticed that her granddaughter's oxygen levels were dangerously low, she called for help.
But Jahi went into cardiac arrest. The medical staff performed chest compressions to revive her and gave her clotting medications, but nothing worked.
On Tuesday, a CT scan revealed that two-thirds of Jahi's brain was swollen.
Sealey said that Jahi's brain had been deprived of oxygen. "Now she is 100% brain damaged," he said. "Medically dead."
CNN could not independently confirm Sealey's account.
When asked about the case, hospital spokeswoman Melinda Krigel cited privacy laws.
A statement from the hospital's chief of pediatrics, Dr. David Durand, read: "Our hearts go out to this patient and her family. Unfortunately, we have not been authorized by the family to share information with the public about this matter. Consequently, we are not able to correct misperceptions created about this sad situation.
"Nonetheless, we want to assure the community that we are doing everything in our capacity to provide support to the grieving family. We have been caring for children in this community for over 100 years and have a longstanding commitment to delivering the highest quality care for all."
Dr. Lisa Thebner, a pediatrician in private practice in New York who was not involved in the case, said excessive bleeding -- though rare -- is not unheard of in such operations, given that the tonsils are removed from the back of the throat, an area rich in blood vessels.
Still, she said, "This was a highly unusual complication."
When told that his niece was brain dead, Sealey said the entire family went into "complete devastation."
"We pray over her daily," Sealey said. "We kiss her. I charge her iPod and make sure it is in her ears every night when I sleep next to her."
But he said he had accepted that she was legally dead.
An official from the Oakland coroner's office told CNN that Jahi's death was reported Thursday to the office.
"Once a death is reported to us, we have a duty and responsibility to immediately proceed to where the body lies, examine the body, make identification, make inquiry into the circumstances, manner, and means of death, and, as circumstances warrant, either order its removal for further investigation or disposition, or release the body to the next of kin," the official said, quoting California law.
Sealey said that though the family hoped to keep Jahi on life support, hospital representatives had told them Monday that would not be an option.
That has left the coroner's office in a delicate position.
"Technically, we can go where the body lies and we can begin our investigation as to the causes of death," the official from the coroner's office said. "We have been gracious and we have allowed the parents and the hospital to maintain the child on life support."