Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if
you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another question from our readers and the question was
After Coming Off the Ventilator, Is There a Chance to Go Again Ventilated?
You can check out last week’s question by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer questions from one of my clients Bea, as part of my 1:1 consulting and advocacy service! Bea’s mother is
ill in ICU after a cardiac arrest but is recovering and Bea is asking why the ICU doctors declare her brain dead and want to withdraw treatment right away?
Bea: Hello?
Patrik: Hi Bea. It’s Patrik here from Intensive Care Hotline.
Bea: Hey. Hi, hi, hi.
Patrik: Hi. How are you?
Bea: Well, I’m doing better.
Patrik: Right.
Bea: Yes.
Patrik: Right.
Bea: We actually moved a little bit more forward on this. Let me give you some updates.
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Patrik: Yes. And I do remember, I believe it all happened very quickly. They were telling you they have to withdraw treatment and then it all happened very quickly, and then only later did you find out that a service like ours existed. Do I recall that correctly?
Bea: I think so. When I talked to you, I didn’t know many facts. I think I talked to you in December.
Patrik: Might have been just before Christmas or around Christmas.
Bea: Correct, right. The thing is, things have happened. In January of this year, I got a phone call from a nurse. I think that changed everything, all the perspective.
She actually had been trying to contact me for many months, since my mother had issues. And she actually described a lot of different things before I see you. I think that was funny. So, I like to talk to you. Perhaps you can give me your opinion, which is helpful.
Patrik: Yeah, yeah.
Bea: So what she did, she is on the regular medical area, the regular floor. That’s where my mother was hospitalized. So she believed and she observed… Because her job is to monitor the floor. She had a monitor in front of her, you know that role, right? In the hospital there’s a monitor nurse, she is an assistant nurse. She’s sitting there to monitor all the room to see activities, anything odd and she needs to report to the people on the
floor to look for it, and to help.
Bea: So she believes on that morning, the last day, she said she had called in many help. She was left to die in her room. Suffocated, she was not getting oxygen. No heart monitor and she was laid flat while she was oxygen-dependent.
So she had a severe case against all these people. She filed the complaints to the nursing board. She’s filed a police report. She did all of that, we didn’t know.
Patrik: Wow, wow, wow.
Bea: She did all of that including homicide detective. Everybody in the hospital. That we didn’t know while we were talking. But I think spiritually, we felt something was wrong. You can tell, and I know that something is wrong, but we just didn’t know.
Patrik: Yeah, sure.
Bea: So that was the first episode of putting her in ICU. So I think the thing is, we were talking about ICU because I feel if she gained heart rate and the blood pressure was normal, and then they just don’t want to keep her there. They keep saying that she was brain dead,
which was because she was left to die.
Patrik: Yes, yes, that’s right. And now I do remember, I mentioned to you at the time that in order to determine brain dead, there would have to be two independent parties doing some testing and confirming that. You remember that?
Bea: Well let me tell you what I found. The hospital doctor went in between shifts.
My mother was in the ICU on the 19th in the evening and had gained heart rate and blood pressure. And then the next day she’s recovering. Although she’s not responding, because that’s normal, normal. She has been brain dead for a long time. But she was there trying to recover.
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Patrik: Can I just interject here because the reason I want to interject here, there is a clear definition for the brain… Nope, if somebody is brain dead, they’re not recovering, they’re dead. Okay?
Bea: Really?
Patrik: Yes, yes. So nobody can be brain dead and be revived.
Bea: Really?
Patrik: Yes, yes. I really think people-
Bea: I didn’t know that.
Patrik: Yeah. People mix up the terminology and are not aware of what it actually means. I think you’d really need to be clear that if somebody is brain dead and you stop life support, their body is passing away, their heart stops. And I remember, you mentioned to me at the time that your mother was deemed brain dead. However, what I said to you at the time, I do remember that, before somebody can be deemed brain dead there needs to be some
testing.
Patrik: There are some clear guidelines around testing for brain dead. So please nobody should use the word brain dead loosely without knowing what it actually means.
Bea: Yeah.
Patrik: So what do I mean by that? You would have heard the term brain damage, right? There are a big difference and no correlation between brain death and brain damage. They are two separate issues.
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Bea: Wow, that’s very important.
Patrik: That is very important. That is incredibly important.
Bea: Okay. Now she was gaining blood pressure, everything. I already told you that. So the second episode is that it seemed like I did everything I was supposed to do, although I didn’t know I was supposed to do that. And then when they tried to save my mother on the ICU floor, they either opened up a big vein in her major vein to put medicine in.
Bea: I was talking to the lead nurse, which is also there. I contacted her, left messages regarding my concern that something was wrong upstairs. But after that, they would not allow me to go upstairs anymore.
Patrik: Really?
Bea: But the upstairs had a lot of things happen. I didn’t know that. Only in January I understand. So, basically, I was talking to the head nurse complain about how they treated my mother. I felt that they hadn’t done anything, that my mother actually was abused and neglected for. But I didn’t know that was what the concern upstairs, that was claimed already by another nurse who works there.
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Bea: So interesting enough, I want to talk about ICU first and then we can go back to others. I think she’s recovered well on the second day and the third day. But unfortunately, on the second day in the evening, that’s less than 24 hours. There was a hospital doctor, the neurologist came to the room. I was there, she talked to other staff with her. I think that the staff was supposed to do a test called apnea.
Patrik: Apnea? That would have probably been part of the brain dead testing most likely, most likely.
Bea: Let me tell you what I experienced. I was there, the doctor arrived, wanted to do an apnea test. And interesting also in the evening, during the transaction of two shifts, I guess they want to take some time there so no-one can see it, or nobody can have responsibility. So I was there. The doctor said, “According to Texas law, that if somebody brain dead that we need a test it, to pull the life support without the test is done and showing no
sign of life and then we have to let her go.” I told her, “My mother only recovered less than 24 hours. I believe she’s doing very well.” And accordingly, the heart rate, blood pressure seemed to be very normal to her condition. That was significant. That’s bizarre already, that’s a miracle.
Bea: And I asked, I said, “How can you pull the life support? Without that she may not be able to breathe on her own at this moment.” And the doctor said, “Don’t worry, it only takes a few minutes.” But, the two technicians were there, correct her.
They said, “No, it takes more like 15 minutes.” That’s ridiculous. You take somebody who recover only from dead less than 24 hours ago. You want to pull the life support to do 15 minutes plus test without life support? You are putting her to death, to die.
Patrik: Yep. Very much so, yeah.
Bea: That’s what I’ve told the doctor, I’d said and the doctor was mad at me, probably written some notes to it to make me look like I interfere with her plan. I need this. My job is save my mother.
Patrik: Absolutely. Can I just… Sorry, just so that I’m following everything correctly here. So when they were planning to take your mother off the ventilator, they were planning to do that to end her life, is that correct or was there another reason? I didn’t quite get
that.
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Bea: I think they really want to terminate her because there are two parts of it.
One, to cover up the problem upstairs, which I didn’t know at the time. Remember?
Patrik: Yeah, yeah. I do remember.
Bea: I didn’t talk to anybody, I was not up there. But the second part is that the doctor thinking well the hospital probably has a duty not letting bring that person in there so that they will not be able to collect large amounts fee from the Medicare or whatever, the insurance.
Patrik: No. Not probably, not necessarily. And I’ll tell you why, and I don’t want to jump around here, but your mother was in her nineties wasn’t she? Do I remember that correctly?
Bea: My mother was in there 19th of November?
Patrik: No, no. Your mother’s age. She was in her nineties?
Bea: Oh no, she was 82.
Patrik: 82 okay. The reason I’m asking is, you mentioned that potentially people would not go back into ICU. But the reality is, when patients are declared quote-unquote brain dead, there could potentially be an argument around organ donation. And I don’t want to jump around here, but has there been any discussions at the time around withdrawal of treatment because of brain death and then potential harvesting some organs for your
mother?
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Bea: They did.
Patrik: Right.
Bea: They did the donation of organs, but I think I told them not because my mother was not dead.
Patrik: Yep, okay. Now I’m following. Now carry on to where you were before that. I just needed to get clear in my head that I’m following everything correctly. Yeah.
Bea: Okay. For the record, my mother doesn’t have any heart disease, that’s very fortunate. She only had a kidney failure, which is taken care of by the dialysis machine. She has no heart issues, not diabetic. No problem with any other health.
The only health issue she had, it’s all related to kidney issues, which is very fortunate. She could have lived because dialysis doesn’t kill people.
Patrik: No, of course not.
Bea: It doesn’t matter if she 82, she might even live up to 92 or more.
Patrik: Correct, correct.
Bea: She didn’t go to the hospital for heart failure, that would be a different story.
She went in for a simple arm infection was her graft, that the doctor wants to put her in there to monitor if she is reactive to the antibiotics they are giving to her. The doctor tricks her into the hospital, which is I think why I need to go after that doctor, because my mother should not have been hospitalized for that, or we talk about that later, okay. I just want to tell you what I know. Then the doctor want to do the test. The technician, I think, did not
agree with her. I think the doctor wanted to pull my mother’s plug.
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Patrik: Can you please remind me why did your mother go into hospital in the first place? She had a cardiac arrest, is that correct?
Bea: No my mother had no cardiac… I just told you she had a minor arm infection because she had a graft on the arm that was infected from outside. The doctor was giving her antibiotics. So the doctor wants her to go to the hospital, this is her dialysis doctor, not the hospital staff. The doctor used to work there and then at that time he’s not up to it.
Bea: I told him without him taking care of my mother, I would not want to go there.
I told him very clearly, I don’t trust the hospital because I had one bad experience a couple of years before, similar because they keep my mother there for almost a month while there’s nothing there to do. They were trying to kill her then, I think. And I want to take her out then, it’s several years ago. I did. They have a record in the case there that I took my mother out without a doctor’s consent. I said, “Fine.”
My mother lived for two more years. Otherwise probably dead then.
Bea: So anyway, those are extras I remembered. Now, let’s go back to that day, that doctor who wanted to pull the plug. I think the two technicians were upset because they see my mother was recovering, the blood pressure with a monitor and heart rate was normal. That’s a miracle for somebody who only recovers from dead less than 24 hours ago. So I told the doctor basically, “Get out of here. I don’t want to do that.” She seemed to be
very unhappy. I think she want to pull the plug on my mother. Her reason is that it’s a brain dead. The Texas law have not allowed us to keep her. That’s what it is. I requested the hospital, “Please provide me with a copy.” I need to know, I’ve never seen that before. And they never did supply it to me. I asked the hospital
administration as well, all of it. Nobody gave me that. I told you that before as well, I think.
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Bea: Okay, let’s go through that day. She had only been there from 19th in the evening until 22nd, they pull the plug on the 22nd. She was doing very well on the 21st in the evening even. Her blood pressures came back, the medicine was reduced to almost none on the 21st in the evening, which I knew because we don’t have experience with the hospital but I was even informed by the head nurse of the hospital. She was telling me that her father
actually went to the hospital some time ago because she said she had to hire a sitter. After all, she doesn’t trust. I thought that was ironic. Later on when I refreshed, that she is working for the hospital.
She’s a head nurse of the entire hospital, one of them. She was telling me she doesn’t trust anybody if her own father goes to the hospital and she had to hire a sitter, 24 hours watching.
Bea: I thought that’s ironic, but I didn’t know. I wish I was there on the 21st in the evening. I talked to the nurse on night shift. She was informed me they had an EEG done during the day. I asked her to give me a copy. She said that she doesn’t have it. She wanted me to
contact the nurse next morning to get a copy.
And I asked her, “Can you tell me the result?” She briefly told me, “It looked like your mother still have a wave.” I was very happy because my mother’s blood pressure. Heart rate was normal, and then I said, “Well, that’s significant after she is only 48 hours recovering.” And she hardly needs medicine because they reduce this medicine as you progress.
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Patrik: Can I just-
Bea: Yeah. You are familiar with everything I said.
Patrik: Right. I just want to make one comment. Even if your mother was brain dead, there are brain dead people who have good blood pressure and a good heart rate, let’s put it that way. There are people who might be confirmed as brain dead and who might have stable and normal blood pressure and a normal heart rate. I just wanted to say that too.
Bea: See, that’s different. But I told them, several nurses, on shifts, I told them that my mother responded to me several times. Very minor, but I talked to her in her ear. She responded to me. Because we have a routine with my mom, I always talk to her in that way, it’s a funny way to call her. She always responds. She responded to me at least three, four times during that time of recovering, several days. I call her many times. I touch
her, I wash her and rub her to make sure that she had some touch. And I told them about that. No one pays attention. So on the 21st in the evening or 22nd in the morning, around 3:00 AM because I always leave there 2:00 AM to 3:00 AM just make sure that my mother’s gone to sleep on the hospital floor.
Bea: So I have found that my mother may be still alive. I have this regret and I think that I should sleep there. I said, “I would like to go home to sleep.” I’ve been sleeping there for two days and she said, “Oh go home. No problem. I’ll watch your mother. No problem. Just come back tomorrow morning.” Okay, I was going to come tomorrow morning. But according to the record later, somebody came in around seven, that’s also a shift changing,
and they did an apnea test, according to them.
Patrik: Notes?
Bea: There’s no record found. Because later on, I went to the record, even talked to the imaging department. The guy has to make all the other copies for me, on all the other tests. He said, “I did not find EEG, although it says somewhere it has EEG, I don’t find the picture. But I don’t see any apnea test.” So my suspicion is they did it just by pulling the thing out of her. She was murdered in the ICU, second murder. So there is no apnea test.
So this moment I didn’t think hospital had that record.
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Patrik: Have you asked for it? Have you asked for the records?
Bea: Yes. In particularly because apnea tests, it’s like an EEG. It’s the imaging test.
Patrik: Yes. But you know, I can’t believe there is no records of that. I can’t believe it.
Bea: It says no apnea test can found, although on the record… It confuses the issue, I only have the records of that day of general. I don’t have all the notes from every nurse. Those are different records.
Patrik: Yeah, yeah. Let me ask you something else. Have you got a death certificate?
Bea: Yes I did.
Patrik: So what’s the cause of death on the death certificate?
Bea: Of course it’s made up.
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Patrik: What does it say? What does it say?
Bea: Let me read it to you, okay.
Patrik: Thanks.
Bea: Just a second. Cardiopulmonary arrest.
Patrik: Cardiopulmonary, okay. And that’s it? Anything else?
Bea: Oh yeah. Second it says sepsis, S-E-P-S-I-S.
The 1:1 consulting session will continue in next week’s episode.
Kind Regards
