Monday, 25 May 2015

Jahi McMath update...sort of

NOTE: If you have not heard the story of Jahi McMath, I've posted several updates including her full story here, here, here, and here.

When last we heard of Jahi McMath nearly 8 months ago, the startling revelation was made that she was not, in fact, brain dead, but rather very much alive.  Well, sort of.  Ok, not really at all.  This supposed miracle was merely the opinion of one very biased neurologist who does not actually believe in the concept of brain death, as well as a couple of other doctors who hadn't actually examined her and were basing their opinions on two very strange and vague videos of Jahi which seemed to show her moving.  Neither video was compelling or convincing in any way, and shockingly (not really) no new videos (or any other information, for that matter) have surfaced since then.

Then came the news about 2 months ago (which surprised exactly no one), that Jahi's parents were suing Children's Hospital Oakland and the surgeon who operated on Jahi.

And since then . . . nothing.

After waiting many breathless months for an update, we finally got one a few days ago!  And it's from none other than my favourite fundamentalist doctor quack, someone I've mentioned right here before, Doctor Paul Byrne.  In case you either haven't heard of him or have blissfully forgotten the folly of the good doctor, I'll give you the short version - he doesn't believe in brain death.  Full.  Stop.  That's right, he claims that life continues until the heart stops beating.  Even if the brain is completely and fully dead, he thinks a beating heart somehow equals life.

Regardless of how vehemently I (and the vast majority of the medical world) disagree with him, I still read his article voraciously.  I mean, just look at this titillating title:

Jahi is alive -- praise the Lord and pass the ammunition

If you're wondering, no, I haven't the foggiest notion what "pass the ammunition" is supposed to mean either, even after reading his article several dozen times.  And unlike me, Dr. Byrne unfortunately does not always make sure to clarify things by the end of his stupid articles.

But anyway, WOW!  AMAZING!   Jahi is alive!  Was I really wrong the whole time?  Does medical science need to revise every medical textbook and eliminate the diagnosis of brain death?

Now hold everything.  Before you critics get too excited and start penning your "Doc your so stupid I told you so lolololoooool!!1one" comments, remember that Dr. Byrne had said that exact same thing before without any real evidence.  But wait, this time is different!  He says, "Recently, I visited Jahi and her family in her home in New Jersey".  WOW!  AMAZING!  Surely he'll post some wonderful pictures of Jahi alive with her eyes open, or at least he'll share some evidence of why he claims she's alive, right?  Right??

Er, no.  Not at all.

NOT.  AT.  ALL.

Over the next few paragraphs he rehashes Jahi's tragic story, going so far as to put "brain death" in quotation marks, making no apologies for his his opinion that "these two nouns together are not indication of true death".  I'll at least give him credit for constancy.

And then, without further ado, he delves right into his non-medical garbage, throwing away any medical credibility he ever had and throwing around lies like an old baseball:
Three separate apnea tests were conducted on Jahi. Each time Jahi's life supporting ventilator was taken away for 10 minutes. Each time this caused carbon dioxide and acids to build up in Jahi's brain and body. These tests did nothing to help Jahi and very likely resulted in further swelling and damage to Jahi's brain. Yes. The doctors suffocated Jahi for 30 minutes as part of their declarations of "brain death."
No, Paul.  No, no, no.  An apnea test doesn't work that way at all.  I've described this before, but I'll do it again, and maybe Paul can learn something this time (though I have no doubt he will never see this, and even if he does he still won't get it).  For an apnea test, the patient is pre-oxygenated with 100% oxygen to increase the oxygenation of the blood as much as possible.  Then the ventilator is turned off.  As the carbon dioxide level in the blood rises, this stimulates a healthy functioning brainstem to initiate a breath.  If after 10 minutes the patient does not attempt to breathe, the brainstem is considered nonfunctional and dead, and the patient is declared brain dead.  However, if during the test the patient's oxygen level ever drops below normal at any time, the test is aborted and the ventilator is turned back on.

No one's brain is ever "suffocated" during an apnea test.  That's just ol' Paul using fallacious sensationalism at its very worst.  Moreover, it did not cause any additional swelling and damage to her brain.  Besides, her brain had already swelled to the point where it had lost its blood supply and died, which is why the test was being done in the first place.  For anyone, especially a doctor, to claim otherwise is an outright and deliberate lie.  But he goes on:
Everyone should understand that this dangerous test can only harm or even cause death of a patient. 
It is not a dangerous test.  It can not harm, and it can not cause death.  It is used to determine death.  You know this, Paul.  At least you should.  If you don't, you have no reasonable excuse whatsoever.  But he still goes on:
The apnea test is not beneficial for the patient.
Of course it isn't and no one ever claimed it was.  How could a test that is designed to assess death be beneficial??

I paused, took a deep breath, and plodded on, surprised I had gotten this far without rupturing an aneurysm.  And as soon as I restarted I was instantly rewarded with the same stupid, erroneous argument that Dr. Byrne made before - that the ventilator can only work on a living patient.  I hate using YouTube videos as evidence, but, oh what the hell:
As you can see, these lungs are attached to a leaf blower, and they inflate and deflate without any living body (or any body, for that matter) attached.  Strike two, Dr. Byrne.

Paul's next argument is that Jahi was "starved" for a month between the time she was declared dead until a feeding tube was placed after Jahi was moved to an undisclosed facility.  While technically true, there are several things Paul fails to mention: first, the doctors had no legal or ethical requirement either to place a feeding tube or give her nutrition once she was declared dead, and second, humans can go weeks without food without starving as long as they are adequately hydrated (which Jahi was).  Three strikes you're out, right?

HAHA no, he wasn't quite finished.

Paul then says that her heart has beaten 60 million times since she was declared brain dead, which must mean she's alive.  As I've said here before, hearts don't need bodies (or life) to beat.  Don't believe me?  Watch:
Strike four?  Or is that five or six.  I had completely lost track.

But after all those lies, Paul finally got to the meat of his article.  The update!  Finally!
Recently I visited Jahi in her home. 
YES!  At long last, an update from someone who's actually seen her!  Is she moving?  Responding to her mother's voice?  Opening her eyes?  Tell us, Paul!  Tell us!
Jahi is beautiful.  The day that I visited Jahi she had on lip gloss like many teenagers.  A picture of Jahi's hand joined with my hand is enclosed.  Wristbands on both of us state "Jahi is alive" and "Prayer works."
Wh . . . wh . . . WHAT?  That's it?  THAT is your update?  THAT is your "proof" that Jahi is alive?  That she's wearing lip gloss and someone took a picture of you holding her hand with her contracted fingers?  Are you kidding me?  THAT'S FUCKING IT??!  Where's the convincing evidence, Paul?  God damn it, where's any evidence?  It's been a year and a half since she was declared dead, and this is the second time someone has tried to say she's alive without providing a whit of actual evidence.

If she were actually alive, how easy would it be to take a video of her responding to voice?  How straightforward would it be to show a video of her opening her eyes?  How simple would it be to prove that she followed even a simple command?

I will be the first to admit that absence of evidence is not evidence of absence.  The fact that these videos have not surfaced doesn't mean either A) that they don't exist, or B) that they couldn't exist.  But after the media circus that Jahi's family caused surrounding her untimely and tragic death, I will also be the first to submit that were there any real evidence, her family would get it thrown up on the 6 o'clock news faster than you can say "I BELIEVE".

As for you Dr. Byrne, people expect doctors to tell them the truth, even if it hurts.  It is our job, our obligation, our duty to tell people difficult truths, not comforting lies.  You are an insult to your profession, your community, and most of all to yourself.

323 comments:

  1. Thanks Doc. Someone needed to inject sense into the ranting from the lunatic fringe where Dr. Paul Byrne resides. If left unchecked, he will give false hope where there is none, and perhaps cause more than a few families to refuse or try to refuse the apnea test based on what at best can be described as 'misinformation', or at worst, down right lies and bullshit!

    All we ever see of Jahi are photos of a contracted, rotting hand here, or a foot there. Sometimes we see half of her face, eyes closed, or wearing Mom's Michael Kors sunglasses. We've even see Jahi posed sitting up cross legged with her head - for some reason (ahem) - cut out of the photo. What we NEVER see is a single photograph or video of the WHOLE of Jahi. There's a reason for this. It would be all to obvious - even to a blithering idiot - that she's dead

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  2. FYI, "Praise the Lord and pass the ammunition" was the title of a popular song during the Second World War, based on the story of a navy chaplain during the attack on Pearl Harbor who shouted encouragement to the men even as he helped load the big guns to return fire. It became a touchstone phrase, meaning you should give thanks to the Lord while simultaneously taking a militant part in the fight yourself. (I.e., Byrne is doing his part to carry on the struggle for the "proper' definition of death and encourages his followers to do likewise.)

    Thanks, Doc, for the update and clarification. The mainstream press seems to have utterly abandoned this story, and it is very useful to have somebody with knowledge to cut through the misinformation emanating from Jahi's camp (or, rather, the camp of those who would benefit from her case).

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    1. I suppose I could/should have googled that. Damn.

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    2. doc: Are you familiar with pseudoaneurysm after tonsillectomy?

      When you have massive bleeding s/p tonsillectomy, followed by temporary cessation of bleeding, would this scenario contribute to a fatal misdiagnosis?

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    3. Benton, is that you throwing another googled DDx at the wall to see if it sticks?

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    4. seems so, the pattern fits. he's not worth the time to respond.

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    5. To Anon June 4, 2015 at 9:51, Are you familiar with Eric's google skills/obsessions?

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  3. I feel like the majority of media outlets and most people have moved on, so why is this still being dragged out?

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    1. It's still being "dragged out" because a dead child is being kept from burial by a guilt - crazed mother. It needs all of the media attention it can get because this whole situation is desecration of a corpse and it's macabre.
      The Mcmath camp needs to get some serious therapy and learn a little medical terminology before they drag this into another court room. They need to understand the difference between brain death and coma, life and death, simple tonsillectomy and complicated surgeries, life support and corpse maintenence, etc. Her body will recover just as well, and as soon, if she were in the ground, in a freezer drawer, or in a New Jersey apartment.

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    2. they need to go to court with a judge who isn't afraid of mama nails and her followers.

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    3. As Anonymous at 4:14 says, it's being dragged out because the family has dragged out the drama.

      But I DO agree that, newswise, it has become a nonstory outside of, maybe, Calif, which has an unfortunate proprietary interest since the drama began there and its court started the caravan rolling. Outside of Calif. (and right-to-lifeish media) it's a filler short.

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    4. I personally don't think the mother has any guilt at all. That dead girl is her cash cow, and keeps her in designer purses and dining like a queen. Please read this blog too:
      http://kesselrunin12parsecs.tumblr.com/

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  4. "doctor" Byrne also does not believe in having comment sections where we can point out his falsehoods - like his claim she has respiration. if she had respiration, the apnea test could not have suffocated her.

    but as for pictures - I don't believe a single picture has been taken of her in over half a year, because any recent picture would leave it clear to anyone but an idiot that she's not just dead, but dead, dead, dead.

    in fact, I no longer believe she is not stuck in a deep freeze somewhere, unless I see proof - and pictures of "doctor" Byrne holding SOMEBODY's hand are not proof.

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  5. The most compelling argument yet that Jahi is alive? She's taking selfies!

    http://www.gofundme.com/Jahi-Mcmath

    I don't mean to sound crass, but if only there were a brain function test for her mother. As a parent, I cannot fathom doing this to my child. What motivates her? How, on any given Thirsday at 3:34 pm, can she look at her child, their surroundings, what has become of them, and confirm to herself, "I am doing the right thing. This is how I envisioned this. I am content and at peace with my decisions. What I am doing is in the best interest of this child and my others."

    Where does pragmatism enter in?

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    1. As unfeeling as this may sound, the motivation is MONEY. I believe Jahi's family knew very early on that she was dead, but carried on because shyster attorney Christopher Dolan lead them down the primrose path of a possible multi-million dollar settlement. From her social media postings, it's clear Jahis's mother spent a good deal of the GoFundMe donations on designer shopping sprees. expensive meals and wines. Dolan himself used Jahi to further his agenda of passing California Proposition 46, which would have raised the personal injury cap, and put a lot of money in his pocket. It failed. The public is out of patience, and hopefully Dr. Byrne's new rosy bullshit report of how Jahi's corpse is doing will not encourage more fools to soon be parted from their money. How sad and cynical that all the major participants in this travesty have agendas of their own. Meanwhile, poor Jahi's corpse remains un-buried. She has become nothing more than a pawn in their big money grab.

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    2. I think if it were JUST about the money, they would have put her to rest and done their lawsuit earlier. Why waste money maintaining a corpse (which is not cheap), if you only want to cash in on your child's death? Certainly a botched surgery is enough for a malpractice suit, and hospitals carry enough malpractice insurance to settle more often than not.

      I'm certainly not defending this family, but there's a lot of knock off clothing and designer bags for cheap. I'm broke and I still manage to look fabulous thanks to thrift stores. You just never know based on appearances, that's all.

      Unfortunately this isn't just a black and white situation, and these aren't just one dimensional characters in a movie.

      Look at some of the fanatical believers of any religion. You could provide them all the evidence in the world against their teachings and they simply wouldn't see it, because they WANT what they believe to be their reality no matter how absurd it is to the outside believer.

      They're not going to get millions in a settlement, that's wishful thinking. Even if they do, appeals will bring that number way down. The hospital will likely settle for a couple hundred thousand (if they're lucky) on the condition of a gag order where they are not allowed to talk about the case ever again. This is likely why they aren't pushing so quickly.

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    3. The mom posted pictures of her shopping sprees and fine dining. The shoes and purses had the tags on them. She said she went to Michael Kors. She had steak and lobster. Bragged about dining in steak houses.

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    4. they delayed because there was a measure going on the november ballot to do away with the cap on profit from medical malpractice (currently capped at a quarter million dollars above actual expenses.)

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    5. @Shark - This is where Dolan comes in. He encouraged, aided, and abetted this family to continue the charade that Jahi was alive because the personal injury cap was coming up for a vote. She would be worth more "alive" from a personal injury standpoint, than she would be dead. Uncle Omari aspired to an acting career, so he enjoyed face time in front of the cameras. Mom could have bought Michael Kors for cheap at Marshall's (yes, the MK tags are still attached along with the Marshall's price tags), but Marshall's doesn't give you MK's boxes. If you're living on the road with a corpse, and have a whopping (not) $60K in donations that might cover a month or two of expenses, you maybe want to eat at cheaper places than the fine dining establishments Mama Nails chose. Look at early interviews with the family on YouTube. There is no mention of God or religion. All that came after Dolan got on board. And as has been pointed out before, what religion did/ does the McMath family ascribe to? We have never seen them even once on camera with a family pastor. All Mama Nails has ever shown is an affinity for Bacchus.

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    6. She said at the outset that she felt terrible guilt for pushing Jahi's surgery. When Dolan offered CHO as an alternative target of blame, she embraced that narrative (for complex reasons not limited to money). That narrative -- the switch from guilt to outrage -- is so important to her that she absolutely can't go back on it. She sees everything through it and ignores or spins what doesn't fit.

      Jackals like Byrne, the Schindlers, and the anti-Choice lobby have encouraged this, as have all of those prayerful GoFundMe and FB delusionals. If she rethinks her position she loses face bigtime and loses every shred of sympathy and support.

      I don't think she's evil or manipulative -- just (initially) desperate, and (consistently) lacking in foresight, and her self-protectiveness has made her delusional.

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    7. California law provides for the family of a who dies in a medical procedure a maximum of a quarter million if they are successful in a malpractice suit. A child who is left disabled has no cap, the payout can be millions. So, yes! It is about money!

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    8. Anonymous said - referring to Mama Nails, "I don't think she's evil or manipulative". Have you seen her Instagram and social media postings? This women repeatedly went on F word rants threatening to kill her neighbor and her neighbor's kids, made veiled threats against her children's teachers, promised to seriously F up a co-worker, and the worst, posting the phone number to CHO's ICU and Jahi's doctor, telling her followers to "blow up their phones". Then she bragged about her family bringing in stinky food to CHO's ICU to intentionally stink up the ICU. Can you imagine ICU having its phones constantly ringing, and the upheaval this strident, self-entitled family caused? Instead of grief, they did all this acting out. Complete, wanton disregard for other sick children and their families! Painfully obvious from her own postings that Nailah Winkfield, her ex-con hubby, and her brother Omari are not nice people: http://kesselrunin12parsecs.tumblr.com/

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    9. Misty -- I'm aware of all of that. I didn't say that she was nice. But while I beyond-strongly oppose this circus and think its proponents are nuts, I also don't think that Nailah W is the devil incarnate. imo, too much of the public debate since Dec 2013 has become a breathless hyperbolic vent-fest about family personalities and perceived fitness. I don't think that's relevant to the medical/legal issues involved.

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    10. No one is a saint. No one is evil.

      But, I do think she has been backed into a corner that even if she does think that Jahi is dead and it's time to let go, she'll have made "enemies" on both sides. Could you imagine if she was like "You're right, let's put the girl to rest"? Her supporters would cry foul, the people against her would mock her. She created a media circus and for better or worse has the spotlight on her.

      The best thing she can do is just stop posting and quietly let it rest.

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    11. I agree.

      She privatized her social media long ago and hasn't publicly posted in ages. The rare, brief and basically informationless updates have come from a few other relatives.

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    12. She privatized her social media when the good folks at kesselrun started pointing out how she was misusing the gofundme dollars, and how she had provided evidence of the family's culpability in Jahi's death, and that the pictures she was posting were showing signs of necrosis and bad retouching/makeup.

      I, too will not declaim her as evil, but she sure loves money.

      the other side is, we haven't seen ANY picture of Jahi that anyone can confirm was taken since they did the abortive attempt to prove her alive. - and we know those videos were already months old when they did that.

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    13. At this point they really have no reason to release more Jahi pics. They certainly don't need more publicity and what happens next is between them + arbitrator and-or court. To me the focus now shouldn't even be on them personally but on quashing quackery, educating folks about brain death and avoiding future circuses.

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    14. well, true, the pictures won't prove she's alive, and nothing will dissuade the Jahi worshippers. but at the same time, we have no evidence that Jahi hasn't been stored in a freezer for the past 6 months while the family lives it up.

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    15. I have no evidence you don't grind up puppies for breakfast. You can't assume something on lack of evidence. It has to be the other way around.

      We can't assume she is in a freezer until proven otherwise. I can't assume you eat puppies until it's been proven you do.

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    16. I can certainly assume something for lack of evidence. I am not acting in a judicial capacity, so my right to an opinion is not restricted by their right to presumption of innocence.

      and you can certainly assume i eat puppies, but that is a foolish assumption. piglets taste much better.

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  6. I should have updated myself better before I commented so that I wouldn't take two slots.

    Apparently some photo editing savy folks have taken some of the photos Mom posted of her and Jahi and have peeled away the amateur photo editing to reveal stages of necrosis consistent with what one would expect of a brain dead patient. The photos of her with sunglasses attempt to disguise this with those shades and filters. Others reveal evidence of heavy makeup.

    It would seem Mom has drowned her grief in expensive meals out, designer purses and shoes and gifts for immediate family members. She documented these on social media and deleted her account when she saw they were being mined by those watching her. Footprints, though. And screenshots. Sickening.

    Do we know whether the lawsuit has been filed by the family against the hospital? It seems it has not.

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    1. there are a few people tracking the situation, and the best they know is that there is currently no paper trail. people are hoping the lawsuit will go forward, because at that point the gag order the family has placed against the hospital goes away, and what ACTUALLY happened in the ICU is seen, instead of the one sided story presented by the family's sleazy lawyer.

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    2. Yes the family are suing. Dolan said he would not sue, so he got an attorney friend to file the lawsuit for him. In a total cover their ass move, the family are suing on two fronts. Firstly, they are suing for possible lost wages on Jahi's behalf - BUT - if Jahi is found by the court to be deceased (DUH!) - they are suing for wrongful death, and pain and suffering. So far CHO has not responded to the suit which makes me wonder if it will be easier for them to settle with the family. Jahi's family are also suing the doctor, and he may not be so quick to settle and walk away, since his reputation is at stake.

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    3. Doctor carry malpractice insurance for this reason. They won't be suing him, they'll be filing a claim with his insurance, which is a little different.

      I'm not sure how it works exactly, but it's probably like homeowners or car insurance, where if someone files a claim, the insurances handle it and just raise your premium if you lose. He may not personally have much say in the matter.

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    4. Not quite, Shark. You name the doctors and the hospital in the wrongful death suit. Nth insurers fund the defense and pay the settlement or judgement, but the doctors, nurses, etc., are active participants in the litigation. And professional liability policies commonly contain a "consent to settle" clause, where the insurer cannot settle the lawsuit without the doctor's consent.

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    5. The family's attorney fed the complaint to the news media. There hasn't been any evidence of proof of service to CHO or the doctor posted on the court's website.

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    6. the family has been feeding everything to the news media and select members of the media have been cheerfully declaring everything they are fed to be the truth, whether it holds up under even the blindest scrutiny.

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    7. Irresponsible reporting at its finest. Everything has been in the media as if they are trying their case in public. Let's see all of the evidence in a court of law.

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    8. I think she IS evil. She is desecrating a corpse by keeping it above ground, putting makeup and nail polish on and all the other shenanigans, not to mention making money off of it. They have to keep up the pretention that the girl is still alive to fit with the grounds of the lawsuit. She can never say that the girl has died, as the death would have to be declared again and the examiners would get a very good look at an already dead person. If the examiners then compared notes from a year ago, they would see that death actually occurred then and Mamma Nails would be exposed for the fraud that she is. It is infuriating that she is scamming money in this morbid way.

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  7. Thank you for an excellent sum of Dr Byrnes. He is an old coot in my book and anyone that follows him and actually believes what he says must not be able to follow the English language well. He doesn't 'say' anything factual, nor does he actually seem to follow the Catholic faith. The Catholic faith believes Jahi McMath died when her brain did. We don't even know what religion this family follows.

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    1. The family apparently is Baptist, and Baptists aren't rigidly organized. Some (or many, for all I know) would disagree with Jahi's family's views. However, they'd give leeway to conscience.

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    2. it seems anyone who wants to engage in religious tomfoolery claims to be baptist.

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  8. I have asked this question in several sites but I never got a clarified answer. So here goes. If Jahi body us regulating body temp what dr examined her and made that statement? And if that is true than if she is brain dead how can the body regulate her temperature? Doesn't that require brain function?

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    1. Every photo shows her under heavy piles of blankets. Her body is not regulating temperature at all.

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  9. I can't imagine the hospital spending money on lawyers to defend this case when it would be cheaper to pay out the $250,000 "chump change". This hospital does not need to defend its reputation. I think the doctor's insurance will also tell him to settle. Doctors really don't have that much to say about entering into a law suit or not. Insurance companies usually make the decision.

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    1. I've worked in insurance for over 30 years. While ultimately the insurer may determine to offer a settlement, it's not as easy as all that. The $250,000 cap is for noneconomic damages, and with a child Jahi's age you wouldn't see economic damages such as past and future lost wages. But the family is keeping Jahi's "alive" and they're seeking future medical costs to pay for her "care". The insurer cannot settle unless the plaintiff is willing to take the settlement, and I just don't see that happening.

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    2. @Songbird - I read the lawsuit. The family is suing for possible future earnings of Jahi, but just in case the court rules Jahi is dead, they're also suing for wrongful death and the pain and suffering of her family.

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    3. But, she's dead, dead, dead. The family can keep her "alive" for as long as they want, she still has a death certificate in CA. CA's $250K cap covers pain and suffering of her family, doesn't it? You're right, though, songbird. I can't see the family settling for the chump change either. Should be an interesting ride!

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    4. Alleycat is right. Under CA law, the family's wrongful-death award for their own pain and suffering would be capped at $250k -- just like Jahi's own noneconomic med-mal damages if she were alive. They could claim uncapped econ damages only if they proved financial dependence on Jahi, which is 'way unlikely with a minor child ... unless the child was some sort of precocious high-earning celebrity.

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    5. The family suctioned her without permission most likely dislodging the clots that were forming (and perhaps sutures), and they also fed her hamburger and had her laughing and talking after specifically being told she needed to remain quiet. They disrupted the healing process and are directly responsible for the hemorrhage that killed her. In my opinion, they shouldn't pay a single dime!! If anything they should be the ones suing this horrendous poor excuse for a mother.

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    6. They acknowledged the talking and suctioning but the hamburger story qualifies as internet myth. It's based on a one-off anonymous, untraceable, unconfirmable, later deleted internet post.

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    7. Ignoring everything that happened post brain death...

      I don't think you can put blame on a family for not knowing how to use medical equipment. I wouldn't let an unlicensed driver drive my car, for obvious reasons. So why was this family even given a suctioning device to begin with? Something is missing here. A girl is bleeding profusely (in the ICU no less) and instead of having a doctor do a quick check, they're given a device to just suck the blood out?

      IF that is the true version of events, then yes, the hospital was negligent in the same way I'd be held liable if an unlicensed driver wrecked my car.

      However, purely on anecdotal evidence of watching someone slowly die in the ICU and visiting different family that recovered from there. I'm willing to bet that the hospital did what they were suppose to, and that the bleeding has been exaggerated by the family. I find it hard to believe that the solution to large amounts of bleeding is to just get bigger containers for the blood and then a suction tube that could be fatal if used incorrectly. I've watched oxygen levels go from normal to fatal in a few seconds for no outside reason beyond the body just shutting down. There's just no way to predict something like that.

      Surgeries come with risks.

      Even if the family HAD done everything the way you think they were suppose to, the result would have likely been the same.

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    8. What I meant by that is I doubt they would have given the family a suction tube to use if it was going to be potentially fatal. It was probably a piece of routine equipment that wouldn't cause any harm either way. So it was either harmless and can't be attributed to her death, or it had the potential to cause problems and nurses shouldn't have handed it out.

      I just know that any time I've been to the hospital the nurses meticulously monitor all the care down to how many Ibuprofen pills you can have. So I'll guess it was a harmless straw, and something else caused her to go into cardiac arrest.

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    9. they didn't give the family the suction device. they gave them a graduated basin so they could catch the blood without disturbing the incisions any more than necessary - and to measure the blood loss. G-suc took it upon herself to use the suction device - which she said in the first interview and then backtracked later on.

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    10. Ken, we actually don't know WHAT the **** happened. We can't rely on the family's claims about anything -- even the ones that might admit liability -- and the hospital has been enforcedly mum.

      Delete
    11. Even if she DID suction without permission, what was that device doing there in the first place? Hospitals aren't exactly known for keeping unnecessary equipment lying around patient's rooms. If the grandmother had brazenly brought her own stuff or even deliberately used equipment she wasn't suppose to touch, it wouldn't fall under HIPPA laws and the hospital would likely have grounds to press criminal charges, for the same reason hospitals can press charges when parents commit medical abuse against their children by deliberately getting invasive unnecessary tests and procedures.

      The girl was in ICU which means the hospital knew they had to monitor her for complications. There were already known risks. I think you're giving the family too much credit in their ability to alter her fate either way.

      Delete
    12. I have never seen a hospital staff bustle all the equipment they didn't intend to use out of a patient care area. I don't recall what exact equipment was standing ready in the ICU's I've had the "pleasure" of visiting, but I do know if a patient aspirates something they don't have to run down the hall to the storage closet to get what they need to deal with it.

      and yes, the hospital has been enforcedly mum - which is one reason I want the lawsuit to actually happen, so we can get some official records about what happened.

      Delete
    13. It's very unlikely that this will go to trial.

      Delete
    14. yeah, unfortunately, cheaper often wins over justice.

      Delete
    15. You also have to remember, that doctors, nurses, anyone working with children, have a mandatory reporting law. If they suspect abuse, they MUST report it. If the grandmother had interfered with medical treatment a report should have been filed against her, or the hospital is definitely in the wrong in that regard as well. If there was foul play I think the hospital would have already been investigating that and filing a report.

      I don't know what equipment is standing by either, but I don't think a spit sucker is really an emergency piece of equipment that would be there just in case.

      I'd bet money that the family did nothing to cause her death, and neither did the hospital. If they haven't pushed for a trial, chances are it's because the hospital can't be found negligent. If the hospital hasn't filed a child abuse report, chances are the family didn't interfere or do anything they weren't suppose to.

      Shit happens, and finding someone else to blame is easier than coming to terms with the fact that you're not in control of your universe and there is nothing you can do to prevent death or harm from coming to you, or your loved ones. Jahi's family above all else needs come to terms with the fact that they did what they thought was right to the best of their knowledge at the time, and that putting her to rest won't change that nor will it change what happened.

      Delete
    16. all of my sources say there is one accessible in every patient care area in any hospital they have contact with. and, remember, any reports the hospital has filed have been sealed under patient privacy regulations. only if there is a lawsuit will those be made public.

      and it is debatable whether Granny should have known better than to use the suction on a fresh surgical site or not. we don't know exactly what her certification is.

      a young girl is dead. we don't have enough data to know how avoidable that death was. but the family is claiming she is still alive, and freeloading off well intentioned people that is a travesty of justice for Jahi.

      Delete
    17. hospital worker here, a suction set-up is standard equipment in any hospital room and doubly so in the ICU. If you have worked in the hospital or received training as a nurse as grandma did then it is very easy to turn on and use. In fact, even without training it would be very simple to figure out. There is nothing negligent about the equipment being present. In fact, in my experience it is bolted to the wall because it is often needed during emergency situations. What is negligent is using it after being instructed not to, as grandma did.

      Delete
  10. that picture's either been heavily photoshopped or it's very old. not a hint of the skin breakdown on her fingers that was visible in pictures from over a year ago.

    sam

    ReplyDelete
  11. The left hand was the one showing the pits and dark sports.

    ReplyDelete
  12. To anonymous at 05:58. You wrote "that picture's either been heavily photoshopped or it's very old."
    Both of the "either" options applies- very old and heavily altered. One thing the photo "editing" perp cannot do, and that is to make Jahi's hand fingers straighten out.

    Anonaware

    ReplyDelete
    Replies
    1. Personally, I'd guess it's makeup and crappy photo filters, like they're doing with her face.

      Delete
  13. I like the part about those who agree that the poor girl is dead "misleading" and "lacking integrity"!

    Obviously, proof by groundless assertion backed up with a picture of a hand has no capacity to mislead at all!

    Ugi

    ReplyDelete
  14. When I first read this ridiculous "update" I was hoping that someone, preferably a real doctor, would deconstruct Byrne's preposterous assertions. I'm no medical professional but when I read his BS about beating hearts and deflating lungs I nearly popped an artery, let's not even get into yet another picture of a disembodied hand as "proof of life". I'm happy to see that DocBastard answered my silent internet plea and debunked Byrne. Now, if only we could somehow hack this blog post onto the Renew America site...

    I don't know if the good Doc realizes it but someone posted a recent comment at the end of his last McMath update that claimed to have knowledge of this poor girl's current condition, at least as of last December. If what that person said is true, I can't imagine anyone--even a doddering, delusional dolt like Byrne, walking into Jahi's room and declaring her alive.

    ReplyDelete
    Replies
    1. I forgot to mention that it would be great if Doc Bastard would weigh in on the Duggar scandal, especially in light of the family's relentless campaigning against LGBT rights. With his history, Josh Duggar and Co. pontificating about what a grave threat LGBT people are to children is hypocrisy of the first degree, no?

      Delete
    2. Sorta hope Doc Bastard doesn't get into any reality show crap or political issues. There's enough of that crap all over the Internet.

      Delete
    3. Same here, Alleycat. I enjoy Doc Bastard's medical insights and don't see any reason on earth that he should take on nonmedical trash-TV or political crap.

      Delete
    4. I will demur commenting on the LGBT issue except to say one thing:

      Well done, Ireland.

      Delete
    5. Anonymous 26 May concerning that comment about her current condition -

      I'd ignore it. It's just more uncheckable dismissable sourceless internet blah.

      Delete
  15. Should have specified a tweet would suffice. It's not like he hasn't tweeted about non-medical issues before. I agree this blog is not the forum. Since I don't tweet I mentioned it here. Sorry.


    · May 23

    Thanks @aigkenham for elucidating so clearly why you & other bible thumpers are anti-#MarriageEquality. https://answersingenesis.org/family/homosexuality/ireland-and-gay-marriage/ … #MarRef2015

    ReplyDelete
    Replies
    1. If Doc finds my comment off topic I hope he deletes it since I can't. Have a nice day.

      Delete
  16. Praying for Jahi,her family and caregivers always.

    Carol

    ReplyDelete
    Replies
    1. try praying for them to see the truth and have a case of honesty, and bury the poor girl instead of making her a circus sideshow.

      Delete
    2. I pray for her to rest in peace and for social services to take the other children and place them somewhere where they can recover what they have been forced to deal with emotionally. They are kids, they shouldn't be spending time with a corpse. They are the real victims here!

      Delete
    3. Foster homes have little to no regulation. I know people who are fostering and they shouldn't be allowed anywhere near vulnerable children. A lot of kids end up being abused in foster homes from the other children. Most homes just set the bar to "not being abused" and not a step above it.

      I'm not going to go on a rant about this. But don't be naive in thinking that CPS isn't a broken and damaged system.

      Delete
    4. and is it worse than implicitly telling your children that they are less important than a corpse?

      Delete
    5. Shark is right about fostering. It's not some panacea and it could just multiply the damage.

      Delete
    6. wow, that's bad. my state must be a shining star then.

      Delete
    7. Carol, are you off your meds, she's brain dead honey

      Delete
    8. You could live in utopia but it wouldn't change the fact that ripping a child away from their family, with no way of knowing when or if they'll be reunited is incredibly traumatic and shouldn't be used unless there is real abuse going on, not parenting disagreements.

      Most kids that have been taken from CPS develop anxiety issues that they could be snatched or taken away at any moment, it takes them a while to feel secure with their environment again. Even abused kids are traumatized from being yanked from their homes for the sheer fact that they're blind sided by it. They internalize it and blame themselves for it.

      Imagine being suspended from your job one day for no reason you could understand or foresee and no idea if you'd get it back or even work in your field again, you'd be stressed about it. The only explanation was that your boss was treating you poorly. If you were given your job back, you'd probably go back to work a bit paranoid about if it would happen again. Unless you actually WERE being treated shitty, then you'd be relieved to be out of the situation.

      There's that stress coupled with the fact that most people are not qualified to be foster families, but there's not enough resources to really hire and train good families for this job so the system has to make do.

      Delete
    9. so you missed the part about the youngest child acting out in kindergarten because her mother was on the other side of the country playing dress up with her dead sister? maybe you should re-read the kesselrun site to see what their family life was really like.

      Delete
    10. So.. your solution to her acting out from not being around her mother... is to take her away from her mother and whatever stable environment she does have. Sounds legit.

      Delete
    11. While we're at it, why not take away military kids and put them in foster homes too. They can be real shits when their parents die or ship off for extended periods of time. If we're going to use kindergarten kid's behavior as the litmus test here you might have to take away children who don't get chocolate cupcakes for dessert too.

      Honestly go look up what real abuse is, and then we may continue this conversation. ;)

      Delete
    12. no, the solution to her acting out from not being around her mother is to give her a mother who WILL make an effort to be around. the kid is already not around either of her parents. how do you take someone away from what she doesn't have?

      you're just throwing strawmen out all over the place right now. you're so busy itching for a fight that you are overlooking the 500 pound gorilla in the room. Mama Nails has been playing barbies with Jahi for over a year in New Jersey, and her children are still living in California. if they WERE living in Jersey with her, they'd be sharing a bedroom with a corpse on a ventilator - assuming Jahi is still on a ventilator and they are not lying about that, too. because those of us who actually learn about things know they are living in a two bedroom apartment that they shanghaied lawyer Dolan into paying the rent on.

      MY solution is for mama to stop living a lie, and bury Jahi with whatever shreds of dignity remain and then go back home to California and her LIVING children, and get a job and live within her means and be a mother to her children.

      and learn the difference between abuse and abandonment. abuse is having a personalized whoopin' stick, and abandonment is throwing away a child who gets in your way.

      Delete
    13. The comments here have entered high-dudgeon pontification mode. No thanks.

      Delete
    14. I've thrown no strawmen. I've simply pointed out that a parent absent for an extended period of time isn't grounds for abuse or removal. Luckily, social services agrees with me so continuing to try and make you see reason on this is pointless as nothing will come of your sanctimonious rant.

      You're just talking in circles. You claim her parents aren't there. Therefore she is already in the care of a caretaker. So what would be the point of uprooting her and putting her in the care of a stranger?

      Just own your shit and say you want to punish "Mama Nails", you clearly don't care about the best interests of her children if you need to bring Dolan, conspiracy theories about Jahi's corpse, and sanctimonious ramblings about how she should "be a mother".

      If you truly felt her children were in a terrible situation, you'd be filing a report. But we both know you won't.

      Delete
    15. "What Constitutes Child Abandonment?

      The term "child abandonment" is broadly categorized and used to describe a variety of behaviors. Specific examples of child abandonment vary, but common actions that may lead to child abandonment charges may include:

      Leaving a child with another person without provision for the child's support and without meaningful communication with the child for a period of three months;
      Making only minimal efforts to support and communicate with a child
      Failing for a period of at least six months to maintain regular visitation with a child;
      Failed to participate in a suitable plan or program designed to reunite the parent or guardian with a child;
      Leaving an infant on a doorstep, in trash cans and dumpsters, and on the side of the road
      Being absent from the home for a period of time that created a substantial risk of serious harm to a child left in the home
      Failing to respond to notice of child protective proceedings; or
      Being unwilling to provide care, support, or supervision for the child

      http://criminal.findlaw.com/criminal-charges/child-abandonment.html

      Delete
    16. http://kesselrunin12parsecs.tumblr.com/

      Delete
    17. http://www.ndaa.org/pdf/ncpca_statute_child_neglect_abandonment_3_07.pdf

      Here are the actual laws. This should clear up any misunderstanding you may have with it, and provide you with reasonable information on why a parent traveling overseas on active duty or visiting another state for an extended period of time would not apply to a child abandonment charge.

      Delete
    18. Nails left 3 children behind. The oldest got pregnant and had a child of her own after Nails left her in California. The youngest daughter got in trouble in kindergarten and was later (if the accounts I read are true) brought to NJ to live in the apartment with the corpse. I have also read that the only son has gone to live with his father, so at least he is removed from the circus for now.

      That little girl though is only 6 (I think), and she is forced to live in a small apartment with a corpse. I read that it is a two bedroom apartment, so either she shares a room with Jahi or is sleeping on a couch. In either case, she comes home from school every day to a corpse. The smell, the way she looks, etc is not a healthy thing for a 6 year old to be exposed to and for a year an a half!? That kid has got to be messed up!! Foster care would seem prefereable to that. I honestly think mama nails should be brought up on child abuse charges for what this has done to that child.

      Delete
    19. I'm not going to comment on either of the issues in the above thread, I just want to add on to the last post above me:
      There is a third option for the youngest kid's sleeping arrangements, and it is by far the sanest and healthiest option: she might be sharing a bedroom with her mother.

      That said, even sharing an appartement with a corpse must be traumatising enough and I hope the situation is resolved before she gets old enough to question her mother's desicions and understands the whole extend of the mess she is part of.

      Delete
    20. Do you mean her mother and stepfather, since I assume he and Mama sleep together? I'm not quite sure healthy is the right word to describe a situation where a 6 or 7 year old gets to witness or hear Mama and stepdad doing the nasty.

      Delete
    21. Shark you have too much time on your hands to be constantly spouting unintelligable information

      Delete
  17. Lipgloss? does he think she put it on herself? How long until she really starts to smell? Not being mean, just curious.

    ReplyDelete
  18. depends on what smell you mean. since she has a feeding tube, and biological processes are continuing, and she is not getting up to go to the bathroom, they will have to have her in diapers and change them periodically. if she has bedsores, I understand those add a certain aroma, and assuming the signs of necrosis we saw half a year ago are true, that would have a smell of its own.

    safe to say mama didn't spend a very comfortable winter having to have the windows closed.

    ReplyDelete
  19. Marlise Munoz was being kept on full support and still, according to her mother, there was a foul odor in the room. I read a post on the Allnurses forum a while back that invited everyone to add their choices for the top ten bad smells encountered on the job. Just about everyone rated "neuro breath"as #1 or close to it. From what I gathered the worse the TBI the fouler the breath. I would say you couldn't get worse than brain dead on that scale.

    ReplyDelete
  20. Death has a very distinct odor, and it 'hangs' around. While trying to do right by a decedent's family, and give them time to say "good bye" before having the corpse transported to the morgue, the corpse resided in the clinic for over 6 hrs, for the next few days, I could still smell it. At this point I'd hazard a guess that all anyone has to do is get near the building Jahi is 'residing' in to smell the death.
    ~AnonRN

    ReplyDelete
    Replies
    1. Good point, except with the machines keeping her heart beating there is tissue perfusion so not real sure if the smell of decay is prominent in this case

      Delete
    2. The body was already well on it's way to decay when they took her out of the hospital. I remember reading the opposition to placing a feeding tube...parts of Jahi's body were already starting to deteriorate. According to the doctor who wrote the opposition, even with drastic measures certain functions would continue to decay. I can't imagine that decay not having an odor associated with it.

      Delete
    3. I believe you're right. Marlise Munoz was on full somatic support for a far shorter period of time and her mother described there being a distinct odor of decay which was one of the things she found so upsetting about seeing her daughter that way.

      Delete
  21. J Laryngol Otol. 2010 Jan;124(1):59-66. doi: 10.1017/S0022215109990922. Epub 2009 Sep 18.
    Post-tonsillectomy pseudoaneurysm: an underestimated entity?
    Windfuhr JP1, Sesterhenn AM, Schloendorff G, Kremer B.
    Author information
    Erratum in
    J Laryngol Otol. 2010 Jan;124(1):66.
    Abstract
    OBJECTIVE:
    To identify patients undergoing arteriography to verify vascular complications of tonsillectomy, with an emphasis on pseudoaneurysm.
    PATIENTS AND METHODS:
    We undertook a retrospective analysis of the case records of 8837 patients who had undergone tonsillectomy between 1988 and 2004 at our institution, together with a review of expert reports written for professional boards and civil courts as well as personal experiences or communication. We also conducted a literature review using the PubMed database.
    RESULTS:
    We identified seven cases with vascular abnormalities. In addition, we identified three cases of pseudoaneurysm formation, involving two children and one adult patient, with bleeding 21, 36 and 58 days after tonsillectomy. Successful management included embolisation (two patients) and revision surgery (one patient).
    CONCLUSION:
    Post-tonsillectomy pseudoaneurysm formation is extremely rare and unrestricted by age. Correct diagnosis depends largely on a high index of clinical suspicion. Delayed and repeated episodes of gushing haemorrhage with spontaneous cessation appear to be a significant clinical marker. Immediate arteriography, with simultaneous embolisation, is highly recommended. The lingual artery is the most commonly involved vessel.
    PMID: 19765325 [PubMed - indexed for MEDLINE]

    Timeline:

    1900 - Massive hemorrhage

    0130 - Cardiac arrest

    ReplyDelete
    Replies
    1. This article shows that pseudoaneurysm formation is a fleetingly rare condition after tonsillectomy surgery, around 0.03%. It is possible this happened to Jahi, but highly unlikely. More than likely she simply bled postoperatively. Why she bled will hopefully be discovered as the future trial goes on.

      Delete
    2. Yup, it's definitely John Benson, Dr. Copy/paste.

      Delete
    3. Three identified cases out of 8,837 patients "with bleeding 21, 36 and 58 days after tonsillectomy." Sure sounds like Jahi McMath's case...rolls eyes.

      Delete
    4. doc:

      What I've posted is a citation on an actual study, it's not an article. It was done in Europe and if you notice, it did say that pseudoaneurysm formation is rare. But keep in mind, those patients who developed pseudoaneurysm after tonsillectomy in the study, developed them days after being discharged from the hospital. Secondary bleeding.

      Let me ask you this, is heavy bleeding normal after tonsillectomy? Would you agree that this type of hemorrhage could be related to surgical technique, vessel injury, or difficulties encountered in achieving complete hemostasis?

      In Rosen's operative report, he noted that he found a "suspicion of medialized carotid artery on right." You add heavy bleeding on top of that + anatomical anomaly + temporary cessation of bleeding based on the timeline of event from1900 to 0030, and you have a recipe for pseudoaneurysm which cannot be ruled out.

      Evidence? They need to perform angiography and evaluate all arteries. A Radiologist can then confirm based on the status of the arteries.

      Delete
    5. gee, who do we know who googles things and cuts and pastes with no comprehension...

      Delete
    6. Yes, that's John Benton (aka goldenshellback), all right. His irrelevant PubMed cite is only one of many dead giveaways.

      Delete
    7. John ~ is it really you? Where have you been?

      Delete
    8. He's not really "John," either.

      Delete
  22. You must remember this
    A nick is just a nick, a sigh is just a sigh
    The fundamental things apply
    As time goes by

    ReplyDelete
  23. Emerg Med J. 2007 May; 24(5): 367–368.

    Dissection of the carotid artery and pseudoaneurysm as a cause of fatal airway obstruction.


    Carotid artery dissection is a rare entity, and most cases are attributable to causative factors, which include trauma and local malignancy. Those few that present with local mass effect and respiratory compromise may deteriorate rapidly, requiring urgent resuscitation and consideration of endotracheal intubation, which is often dangerous and/or impossible.

    Carotid artery dissections (and pseudoaneurysms) are rare entities. Fifty‐eight per cent of extracranial dissections are carotid in origin and 88% present with infarct. Other presentations include cervical pain and/or headache, and incomplete Horner's syndrome. Rarely, dissection can cause severe dysphagia, neck swelling, dysphonia, and extremely rarely, rapidly life‐threatening airway obstruction.This is due to the symptomatic mass effect from retropharyngeal haematoma. Causes include penetrating or blunt carotid trauma, head and neck malignancy/irradiation, TONSILLECTOMY or peritonsillar abscess, or cervical spine injury/manipulation, the others being attributed to spontaneous dissection.

    ReplyDelete
    Replies
    1. Give it up, John.

      Delete
    2. This report is about airway obstruction from a dissection or pseudoaneurysm. This is not what happened to Jahi. She bled to death.

      I don't know what your motivation is here, but you're really reaching. And poorly.

      Delete
    3. doc;

      I've presented circumstantial evidence per res ipsa loquitur. If you don't agree with them, you'd have to prove that she bled to death. Under res ipsa doctrine the burden of proof is shifted to the defendant.

      Take note, I did mention for them to evaluate the arteries involved, via angiography. You don't think this is important?

      Delete
    4. No you haven't. Res ipsa loquitur would be saying "She bled to death". You haven't presented any circumstantial evidence, because you haven't presented any evidence at all. What you're doing is hypothesising.

      The burden of proof is on the one making the claim (ie the party claiming wrongdoing). Innocent until proven guilty - heard of that?

      You seem to be as good a lawyer as you are a doctor. But those issues aside, again I ask you what your motivation is here.

      Delete
    5. his motivation is to get attention. nothing else.

      Delete
    6. actually, Res ipsa loquitur would be closer to saying "they posted on social media that she was talking and laughing despite the fact they were specifically told she was to remain silent and communicate only by writing on a whiteboard."- it refers to evidence that any reasonable person would interpret as proof of negligence.

      Delete
    7. doc;

      Res ipsa loquitur allows plaintiffs to use circumstantial evidence to infer negligence in California.

      What circumstantial evidence?

      1. Severe post-tonsillectomy hemorrhage.

      2. Anatomical anomaly per Rosen's post-operative report.

      3. Temporary cessation of bleeding based on the timeline of events.


      4. Oxygen desaturation.

      These are all signs and symptoms of dissection of the carotid artery
      and pseudoaneurysm, doc.

      Let's have one of the lawyers from Northern Cal. explain "res ipsa" to you.

      By Elinor Leary, The Veen Firm, PC, © 2014 by the author.

      The res ipsa loquitur doctrine is an evidentiary rule that shifts the burden of proof to the defendant. (See CACI 417; Howe v. Seven Forty Two Co., Inc. (2010) 189 Cal.App.4th 1155, 1161-1163) Under the doctrine, the defendant is presumed liable and must disprove negligence if the plaintiff meets three elements: (1) the harm ordinarily would not have happened unless someone was negligent; (2) the harm was caused by something that only the defendant controlled; and (3) the plaintiff’s voluntary actions did not contribute to the harm. (Id.; see, Fiske v. Wilkie (1945) 67 Cal.App.2d 440, 447)

      Of course negligence and connecting defendant with it, like other facts, can be proved by circumstantial evidence. There does not have to be an eyewitness, nor need there be direct evidence of defendant’s conduct. There is no absolute requirement that the plaintiff explain how the accident happened. Res ipsa may apply where the cause of the injury is a mystery, if there is a reasonable and logical inference that defendant was negligent, and that such negligence caused the injury.

      Delete
    8. You obviously don't understand the difference between an aneurysm, a pseudoaneurysm, a dissection, haemorrhage, and a medialised carotid. An "anatomic anomaly" doesn't mean what you think it means. Plus, we don't know the timeline of events because the family hasn't allowed the hospital to release any such information, so the cessation of bleeding an desaturation are rumours at this point, nothing more. Not to mention the fact that haemorrhage doesn't imply anything other than bleeding. You're making a supposition based on a 0.03% statistical chance from one article.

      So what you're doing is hypothesising based on hearsay. I'd hardly call that even circumstantial evidence.

      Now I'll ask you one last time - what is your motivation behind these rather silly assumptions? I'll also ask politely that you stop cut-and-pasting. And by that I mean cut it the fuck out.

      Delete
    9. doc:

      Your tears are delicious. I'll agree that CHO has some explaining to do because we all know that they will invoke "res ipsa." Hell,they might even explain the difference between aneurysm,pseudoaneurysm,and dissection. One thing is for sure. The burden of proof is shifted to the defendant.

      Good day.

      Delete
    10. If there are tears, it's only because I'm laughing at your preposterous presumtuousness.

      Your first problem is establishing res ipsa. According to the law, evidence regarding the actual negligent act and cause of injury must be unobtainable. It is not unobtainable here. Also, the patient must not be responsible for the injury. There are rumours (as I'm sure you well know) that Jahi's grandmother suctioned her and possibly fed her. This alone is enough to eliminate res ipsa.

      That said, the more I learn about medical malpractice in the US (and in California in particular), the more disgusted I am.

      Now are you all finished, or do you have more to add?

      Delete
    11. doc;

      If the actual negligent act and cause of injury is not unobtainable in this case then CHO would have to present their evidence explaining what happened and why Jahi went into cardiac arrest at 0030 due to bleeding.

      The family will then present their own circumstantial/direct evidence challenging CHO and the judge decides whether res ipsa can be applied in this case.

      That's how it works.

      Delete
    12. John: You recently posted on FB that CHO had settled with the plaintiffs for $3.1 million. If that's true (it isn't), why do you continue to post about what evidence the family will present at trial? You are as full of it as ever and have no clue about medicine OR law.

      Delete
    13. I don't talk to anonymous people.

      Delete
    14. And you're not John Benton either. Is this Christopher Dolan? You must be bored today.

      Delete
    15. doc:

      Here's your eyewitness who saw Jahi's O2 Sat dropping down to 79%.

      https://www.youtube.com/watch?v=2ZhhTWhlW9c

      Delete
    16. An eyewitness with a vested interest and who changed her story from "I suctioned her" to "I didn't suction her". Right, that's credible.

      I'll wait until the actual hospital flow sheets come out which documented her vitals. That's called objective evidence. Eyewitnesses are notoriously inaccurate, especially biased ones.

      Delete
    17. You know who I am. We've sparred over this case for a long time. This clip is not proof of anything. Also, what happened to the $3.1 mil settlement?

      Delete
    18. he never has anything to add, he just throws stuff that he never actually read at the wall hoping something will stick, or he can at least evoke a response. as long as he gets a response he is happy. ignore his ravings and watch how fast he has a meltdown.

      Delete
    19. DocB, this is JB's previous claim. Google university is not helping him...

      Here's what happened to Jahi: Her bleed was precipitated by perioperative dexamethasone. Instead of protecting her airway, her d u m b nurse kept on giving the family more cups to collect all the blood. Eventually, Jahi succumbed and went into cardiac arrest due to blood clots forming that obstructed her airway. There are other factors: 1.POPE. 2. Laryngospasm. 3. Epiglotitis. 4. Laryngeal edema. 5. Abscess. 6. Tongue swelling. 7. Swelling due to electrocautery. Jahi could have been saved if the nurse only knew what she was doing.

      Delete
    20. doc: I would love to see those flow sheets too, along with electronic Md progress notes, H&H, estimated blood loss in OR + amount of blood in suction canister,code blue intubation note (multiple attempt,more than 3X?), post-intubation CXR (foreign bodies, POPE?), anesthesia record, nursing notes,MAR + discovery.doctors order sheets.

      I've also read the lawsuit complaint and there was no indication that the surgeon came to the hospital when informed by nurse about Jahi's deteriorating condition before she went into cardiac arrest at 0030. If surgeon didn't come to attend to her during an emergency, it would be a standard of care violation, that's all they need.

      Delete
    21. There we agree. The surgeon should have come. Full stop.

      All your other hypotheses and assumptions and guesses are worthless. We need the facts.

      Now that we agree, I'd like to know your motivation here.

      Delete
    22. First off, the claim that the surgeon didn't come is only coming from the family, who wants money. That is proof of nothing. Someone who's claimed a legal background(as JB has claimed many times) would know this. Second, they passed a state investigation that found they followed the standards of care. In answer to your question DocB, he's here to troll and just hopes to provoke a reaction.

      Delete
    23. and yes, he is the same golden shellback you booted from your last post about the Jahi McMath circus.

      Delete
    24. If the surgeon didn't return, could it be because he was in the operating room working on another patient? Doctors typically schedule surgeries on a particular day and do a few of them in succession. I believe she woke up and appeared to be fine. There wouldn't be a reason for him to start his next surgery.

      Delete
    25. Correcting the last sentence. There wouldn't be a reason for him to not start his next surgery.

      Delete
    26. anonymous 2158: The state investigation has nothing to do with discovery, request for production, and deposition, in medical malpractice.

      Delete
    27. doc: I have no motivation. I think differently.

      Delete
    28. Lasacgal; The timeline of events disagrees with ya.

      Delete
    29. Which has nothing to with what i said. Point missed(not surprising).

      Delete
    30. I'll agree that they passed the state's "clerical" medical standard investgation but that doesn't mean they're off the hook.

      Delete
    31. Again only timeline presented by family, so there is no confirmation of any timeline or any of the events.

      Delete
    32. Lasacgal:

      Look on page 6 line 14 of the complaint. It says "RN was informed there would be no immediate intervention from ENT or Surgery" - documented after RN reported Jahi's deteriorating condition and blood loss to surgeon.

      Sorry, but the surgeon was a no show between the hours of 1900 to 0030. That's 5 hours my dear.

      Delete
    33. look on the post made June 8, at 0842.
      "Again only timeline presented by family, so there is no confirmation of any timeline or any of the events. "

      sorry, but that is only Liar Dolan's claim, not an official report.

      Delete
    34. Kenny: No. There is no need for the family to present timeline of events regarding this case. You get those from the medical records i.e., nursing notes, post-operative report, anesthesia record, nursing flowsheets, Md records, code blue sheet.

      It was also Jahi's RN who documented that "there would be no immediate intervention from ENT or Surgery" in nursing notes.

      Delete
    35. That note, most likely taken out of context, is meaningless. Much like your posts. The full notes could easily say more but we, and you, don't know that. Why don't you google another medical reason so we can laugh some more?

      Delete
    36. John, that phrase likely means that the nurse spoke with the surgeon who informed the nurse that there would be no intervention. That doesn't mean he wasn't there (though the family claims he wasn't, which I actually believe).

      If the timeline and events are as described by the family are accurate (which I actually do believe), the surgeon wasn't there until several hours had elapsed and she continued to bleed. If that is the case, he was negligent, plain and simple. No one should ever bleed to death from a tonsillectomy, and any anatomic anomaly would make it more likely to have a haemorrhage or other complication, and LESS likely the surgeon's actions (or inaction) would be found to be negligent.

      You're barking up the wrong tree, John. Looking for an anomaly is counter-productive if you're trying to prove the surgeon negligent.

      Delete
    37. doc:

      Thank you very much. I wanted to get your expert opinion so I came with dissection and pseudoaneurysm to get your reaction, and also to find out if you agree with the rest of your followers who believes that defendant hasn't done anything wrong while they put the entire blame on Jahi's family.

      I agree. If the surgeon wasn't there. He was negligent, plain and simple.;)

      Delete
    38. I thought YOU were the expert John. What happened to being a PA, criminalist and med mal investigator?

      Delete
    39. guilty! docbastard may get a message regarding expert opinion,

      Delete
    40. and, again, we have only the family's word that that notation was in the notes. because the family is requiring that all of the hospitals records be sealed under HIPPA.

      and since the family has already been caught changing their story, we have no reason to believe them.

      Delete
    41. kenny: No. The lawsuit has been filed and I'm sure the legal request for documents or request for production happened already. The notation came from the nurse's charting and NOT the family. What is it that you did not understand? HIPPA does not apply since last time I heard Brusavich is representing the family. Please fire your neurons.

      Delete
    42. funny. our agent in the court system has been unable to find any record of the filing. there has been notihng since the suit was "leaked" showing that they were claiming Jahi is both alive and dead - apparently her last diagnosis was by Dr. Schrodinger.

      Delete
    43. Put the crack pipe down kenny.

      Delete
    44. you know I prefer strĂ¼del.

      Delete
    45. Did Benton actually say that Docbastard might be called to provide an expert opinion in the Jahi McMath lawsuit? I can't even...

      Delete
    46. Poor, poor john. Yes, you are an expert, but only at googling stupid ideas you don't understand. Go ahead and tell DocB about all the professions you've had in the last year. Tell him how you've claimed to be in contact with CHO, Dolan and the family. Tell him how you claimed to have performed a PET scan on Jahi. Don't forget to mention how you claimed a couple of weeks ago that the case was settled for 3.1 million dollars.

      Delete
    47. If Brusavich really needs to solicit an expert opinion from an anonymous doctor on the web, his lawsuit is in some deep doodoo. I can just see him presenting that evidence to the court. This is in no way meant to disrespect the Doc but isn't this somewhat akin to Dolan's proof of life from doctors who never physically examined Jahi? Jeez Benton, get a grip. You can't cite from an anonymous source in court, much less offer it as expert testimony.

      Delete
    48. imho, ENOUGH already with/from JB.

      Sheesh.

      Delete
    49. FYI:
      The lawsuit was filed in California Superior Court, County of Alameda:
      Case Number: RG15760730
      Title: Spears VS Rosen, Initial filing on 3/3/15.
      Judge: Robert B. Freedman
      An Initial Case Management Conference is scheduled for 07/24/2015 10:00 AM

      Delete
    50. I just have to comment.

      First, hey Doc! Are you aware that John Benton (that moron troll) took this whole conversation, condensed it and posted all over Facebook on every page that is about Jahi "Doc Bastard says the surgeon was negligent" I thought you would want to know!

      Second, Benton you ass! No way that Doc is gonna be supeonaed to testify in a case where he never examined the patient.

      Third, according to the Alameda county court website, the suit was filed, but the defendants have not been served AS OF TODAY.

      Fourth, Whether the Dr was negligent by not showing up or merely in another surgery and depended on the intensivists to show up and handle the situation isn't even the point. had the family not fed her a hamburger, had her laughing and talking and suctioned her without training or permission, the stiches wouldn't have blown and she wouldn't have bled to death.

      Fifth and finally-if the suit is to proceed, the family will be forced to release cho and the sugeon from hipaa privacy and in that case (and only that case) we will find out the truth.

      Delete
    51. I would love to see the faces if Doc was subpoenaed and his first comment was "I'm going to have to examine the patient"

      Delete
    52. So the notorious John Benton has reared his ugly head once again.

      Doc, please be advised that it would be highly unwise to share any personal information with Benton. He's unlikely to be anyone or anything he represents himself to be. For instance, he's variously claimed to belong to 3 different branches of the military and once claimed to have spent over a decade with a military battalion that had been decommissioned for the majority of the time range he cited. He claimed to work as a criminalist for LAPD, though they had nobody by that name in their employ and nobody who fit the background description he was claiming for himself. He's claimed to be a currently practicing PA in California, though the only PA with that name was licensed in a different state, the 'PA' certificate he offered as evidence was a fake from the Web, and he personally does not exhibit the clinical knowledge or reasoning skills one would expect of a PA. He's claimed upwards of 20 other significantly different occupations over the last two years as well.

      More significantly, he's claimed to have hacked into Ms. McMath's medical records and viewed protected health information from her case without the appropriate signed releases from her family.

      His MO is to copy and paste portions of (often irrelevant) journal articles he doesn't comprehend very well and then claim those articles somehow "prove" Jahi had some particular diagnosis and/or that Children's Hospital was negligent in the care of Ms. McMath, often chortling about how many "dollah" the family will eventually win in civil litigation. His spamming of journal articles and gradual take-over of discussion boards can become extreme. Finally, he's deliberately shut down entire boards when the participants on those boards stopped responding to him...or upped the ante to regain attention with actions like posting dead baby pictures. He's been banned from more places across the Web than I can count, including once from here when he posted under the moniker Goldenshellback.

      That is the John Benton you are dealing with. Just thought you should know the background.

      Delete
    53. Legal Aid/Wannabe Trial Attorney,
      and Mkey:

      Character assasination is not going to change docbastard's expert professional opinion. After all, he is a board certified trauma surgeon, and he voluntarily expressed those opinion without compulsion.

      The most important thing is he believes the family and the family's claim that the surgeon did not show up, did not return, and did not attend to Jahi when she was bleeding profusely after tonsillectomy. That act alone is a serious deviation from standard of care.

      Delete
    54. John, what I believe is irrelevant. Only the facts matter. I don't have any evidence that the surgeon either was not at the hospital or did not return. If he was not there, I don't know why. That is the information that will come out at trial (if it occurs, which I doubt). Based on what I've read, it seems like he was not there. And if he was not or did not return for a good reason, that would be a breach of the standard of care.

      The big qualifier there is IF. We need facts.

      As for any expert legal opinion, I can almost guarantee I will not be asked. As a trauma surgeon (and not an otolaryngologist), I likely would not qualify. But more importantly, they'd need to find me first.

      Delete
    55. John, it's not character assassination, it is truth and everyone here knows it. You think DocB and anyone else here can't see that you ignore the posts that point out some of your most blatant lies over the past year and a half? Do you think DocB has already forgotten about how you posted that his tears are delicious? It's hilarious that you think anyone takes you seriously. Oh, btw, I know you fail at Google but you might want to look up the word "IF" and what that means.

      Delete
    56. Quote from the grandmother taken from CNN(Jane Velez-Mitchell) - notice how she mentions talking to doctors before the emergency.

      CHAPMAN: A lot wrong. A lot wrong. Any time you have bleeding, you do not take it lightly.
      The surgeon should have been called. He operated on Jahi. He should have been called. And there should have been -- it should have been taken seriously how much she was bleeding, and it wasn`t.
      And I asked them, I said, "Do you find this to be normal with this type of operation?"
      And the nurses said, "I don`t really know."
      And I said, "Well, then, go get a doctor."
      And then I even asked the doctor, "What are you doing to do about this?" They started some drip that even the nurses hadn`t, you know, knew about and sprayed some sort of aspirin in her nose. And she was profusely bleeding from the nose.
      And Jahi and I were both kind of suctioned -- you know, Jahi was spitting the blood out. And I kept monitoring all of the monitors and especially her O2 saturation.
      And the O2 saturation should be, from my experience as being a nurse, 96 to 100 percent. It was dropping down 90, 88, and it dropped down to 79. And I said, "Everybody get in here now." And then the doctors came, and I really trusted that they were going to do all they could for her.

      Delete
    57. They've also lied in the complaint when it says that Jahi's mom had to call Sandra Chapman to come to the hospital. Again, quote from same source.

      CHAPMAN: Yes. She came out of recovery, and then they moved her to intensive care. And they told us to wait, that they were getting her together. And we waited a long time. And I told my daughter, "Go in there and see what`s going on."

      Delete
    58. To all Anonymous,

      Let me make it simple for all of you. Under the doctrine of res ipsa the burden of proof is shifted to the surgeon.

      The surgeon must prove that he was not negligent and that he did not abandon jahi after nurse informed him of deterorating condtion and blood loss.

      It's that simple.

      Delete
    59. You mean you're that simple? Res ipsa has to be proven to apply before the burden is shifted. A med mal investigator would know this. Your stupidity is funny.

      Delete
    60. Why, of course. They will have a hearing in front of a California liberal judge and he will decide whether res ipsa can be applied. Ha ha!

      Delete
    61. But you said a few weeks ago they already settled. Did you lie?

      Delete
    62. Nice non answer. That makes you a liar, and a bad one at that.

      Delete
    63. docbastard agrees with me. And if they can convince the judge that Jahi is not dead according to udda's definition, they'll get millions. There goes your micra. Flushed down the toilet.

      Delete
    64. not about res ipsa and he said "if". look it up

      Delete
    65. John, I never said I agree with you. I said "If". You seem to be assuming that res ipsa will be invoked and confirmed. That's a big assumption. And she will not be declared not-dead. That's an impossibility and a ridiculous thing to even consider.

      So get that one thing straight.

      Delete
    66. doc:

      DocBastard7 June 2015 at 14:45
      There we agree. The surgeon should have come. Full stop.

      The comments above were made by you.

      With regards to res ipsa, they won't have any problem establishing the three essential factors in order to invoke the doctrine in front of a liberal judge. This means that there are no ifs or ands or buts about something; it's less expensive and any med mal lawyer could tell you that it's best to go that route in this particular case.

      If they have evidence that jahi's brain is not entirely dead, that evidence will be presented in front of the judge along with their experts.

      Delete

  24. Someone finally got around to posting a link to Byrne's article on the Keep page. This is the predictable response:

    Kiki Black Pretty Cuff
    Yesterday at 10:16pm.
    Yayyyy jahi you did it you woke up i have been waiting on this news I'm so so so so proud of you god is good all the time love u baby girl keep on fighting god still BLESSING you

    ReplyDelete
    Replies
    1. without even considering if she really woke up there would be reports form real doctors in real publications.

      Delete
  25. John Benton is a known troll and not worth the time of day. He also hates to be ignored....just saying đŸ˜‰

    ReplyDelete
  26. The problem with the time line that Dolan provided....and looking at You Tube videos of what the family actually said on the news is.....they are different versions of the story of whether the surgeon or any physician was at the bedside. According to the grandmother, they were not happy with the answer the physician provided and wanted him to come 'back'. To me that means he was there, just not long enough for the family to feel comfortable.

    ReplyDelete
    Replies
    1. I have a feeling it's something like the family that cried "wolf!". Doctor got tired of stupid people overreacting to normal post op bleeding.

      Delete
    2. and since their social media posts as shown on the kesselrun site demonstrate that they took pride in making themselves obnoxious, there is reason to believe that might be the case - as well as the fact that it is entirely possible the bleeding didn't actually get bad enough to be a concern until after G-suc did her thing.

      Delete
  27. I dont see any reason to believe that. We plain do not know what happened.

    ReplyDelete
    Replies
    1. right, we only know what the family claims happened - and we have enough conflicting versions of their story to know that they change the story to suit their wishes. for example, above we have grandma's story that she was talking to the doctor during a time when the timeline benton keeps throwing at the wall says neither doctor nor grandmother was there.

      Delete
    2. Ken, if or since their posts are so suspect then we shouldn't use them as bases for speculations. I think the speculation has gone wild enough in this case with ifs becoming "facts" in short order.

      Delete
  28. This comment has been removed by a blog administrator.

    ReplyDelete
    Replies
    1. Pure trolling. I hope DocB boots you again.

      Delete
    2. For being a blight.

      Delete
  29. John Benton 12 June 2015 at 02:56

    docbastard agrees with me. And if they can convince the judge that Jahi is not dead according to udda's definition, they'll get millions. There goes your micra. Flushed down the toilet.

    ~~~~~~

    Why would they have to convince a judge Jahi's not dead? That's a medical determination. Seems the people they'd have to convince are the doctors and the medical examiner, and they've been remarkably unable to do so, even though they've had the ability to do the necessary repeat testing for at least a year. Instead, they've consistently made unsubstantiated claims of life to the non-medical public in lieu of required tests by medical doctors presented to the coroner and the courts. This is the modus operandi of someone who knows their case for 'life' would be unconvincing to anyone with solid medical knowledge, and indeed Dr. Fisher spanked them down very hard on the quality of their "evidence" of life.

    But let's say they were able to get the death certificate overturned. That fact, by itself, would not mean they would prevail in any civil litigation they brought before the court. So, no, getting her declared alive would not mean they'll collect millions. It would only open up the possibility for them to TRY to collect more money than they can try for now.

    IMO, what you suggest isn't going to happen. This is going to settle quietly out of court, and the deceased will remain legally deceased. If they had a strong case, it would have been brought well before now.

    ReplyDelete

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