OAKLAND -- Adding a dramatic chapter to the struggle of a family praying for a medical miracle, a judge ruled Friday afternoon that officials at Children's Hospital Oakland must keep a 13-year-old girl -- who has been ruled brain-dead -- on a ventilator until a court-approved doctor can assess whether the teen has any chance of recovering.
The decision came at the end of a hearing in which the hospital asked to remove Jahi McMath from the ventilator, publicly stating its position in the case for the first time. The facility "has no duty ... to continue medical intervention," the hospital's lawyer wrote, because "tragically, Ms. McMath is dead and cannot be brought back to life."
Alameda County Superior Court Judge Evelio Grillo, however, sided with the family of the girl, who suffered cardiac arrest after her Dec. 9 tonsil surgery and was declared brain-dead Dec. 12. Grillo granted a temporary restraining order directing the hospital to keep the girl on the ventilator and continue giving her intravenous fluids through Monday, when a court-approved doctor will examine the girl for any signs of brain activity.
"(The ventilator and IV fluids) are to continue until the court makes its decision on the independent physician," Grillo said. "That is not to be removed."
The doctor will be selected from a list of neurologists on staff at UC San Francisco who have been preapproved by both Jahi's family and attorneys for Children's Hospital. The doctor will present findings in court on Tuesday, and Grillo will decide what steps to take next.
The case has drawn national attention and brought focus to two difficult issues: the use of tonsillectomies as a treatment for sleep apnea, as in Jahi's case, and the debate over the meaning of the term "brain-dead."
The family left the courthouse Friday afternoon without comment, and the family's lawyer, Christopher Dolan, was not immediately available for comment Friday evening.
Though the ruling provided a clear path forward in the case, it likely did little to ease the anger the family has expressed toward hospital administrators. In a Thursday evening news conference, minutes after a meeting with the hospital's chief of pediatrics, the family lashed out, saying that administrators told them Jahi had to be removed from the ventilator "quickly" because she was "dead, dead, dead, dead."
Jahi's mother, Nailah Winkfield, said she asked hospital officials: "Can't we have her for Christmas? ... I told them, 'You better not take my child off that machine. You do not have my permission.'"
Hospital officials have repeatedly said that federal and state medical privacy laws prevent them from discussing details of Jahi's treatment without the family's permission. Friday's court filing was the hospital's first major release of information about the case.
Jahi had complex tonsil surgery to help her with sleep apnea, weight gain and other health problems. She began bleeding from her nose and mouth and experienced cardiac arrest later that night, hospital officials and family have said.
In a legal filing, the hospital's attorney says that "two separate Children's physicians determined that Ms. McMath was brain-dead. In addition, at the request of the family, three additional independent physicians -- unaffiliated with Children's and either selected by or approved by Ms. McMath's family/next of kin -- examined Ms. McMath.
"Each confirmed the diagnosis of brain death. ... Accordingly, Children's has declared Ms. McMath to be dead."
The hospital listed numerous steps officials took to support the family once the diagnosis of brain death was made, including repeated meetings with medical staff, support from social workers and the hospital's chaplain, special accommodations for visits, a room for the family to meet away from Jahi, and space in the facility's Family House.
The strongly religious family has said from the start of the struggle that they are hoping for divine intervention and a medical miracle. Hundreds attended a prayer vigil at an East Oakland church Wednesday night.
Family members have also been pressuring hospital officials to release the girl's full medical record. Hospital spokeswoman Melinda Krigel said Friday that Winkfield would have a portion of the medical records Friday and all of them by Monday.
The case has drawn national attention and brought the medical procedure into the spotlight.
Dr. Peter Koltai, a pediatric ear, nose and throat surgeon at Lucile Packard Children's Hospital at Stanford, said he did six tonsillectomies on Monday, "and every parent was asking about that story," he said.
Koltai said the hospital has done 5,000 to 7,000 of the procedures in his 35-year career, and while there has been postoperative bleeding, never has there been "catastrophic results like this," he said.
"Bleeding is not unheard of," Koltai said, adding the carotid artery feeds the tonsils. "There's always a risk of bleeding after a tonsillectomy."
He called a death from tonsillectomy "very unusual."
Hospital officials have refused to directly address most aspects of Jahi's care and treatment, citing state and federal medical privacy laws. The hospital released a statement late Thursday asking the family to allow them to openly discuss Jahi's case.
"We implore the family to allow the hospital to openly discuss what has occurred and to give us the necessary legal permission -- which it has been withholding -- that would bring clarity, and we believe, some measure of closure and deeper understanding of this medical case," said David Durant, chief of pediatrics, in the statement.
On Friday, Dolan said that since he has been retained, the hospital has not asked his clients for permission to speak to the media about Jahi's case.
He said if the family did ban the hospital from publicly addressing Jahi's case, it's because his clients want hospital officials to "tell them what happened before they tell the media."
"We are willing to have an open and public dialogue and will give them (hospital officials) permission to talk about why they're doing what they are doing as long as we -- the family, the hospital and anybody from the press -- are all in the same room," Dolan said.
Staff writers Katie Nelson and Mattias Gafni contributed to this report. Contact Kristin J. Bender at firstname.lastname@example.org. Follow her at Twitter.com/kjbender. Contact Natalie Neysa Alund at 510-293-2469. Follow her at Twitter.com/nataliealund.