OAKLAND -- Even as tests showed that 13-year-old Jahi McMath has no brain activity -- a week after what should have been routine tonsil surgery went horribly awry and left the girl legally dead -- her family vowed Tuesday to keep her on life support and called for prayers in the hope that the girl could somehow still recover.
With the assistance of a ventilator at Children's Hospital Oakland, Jahi continues to draw breath, and her heart continues to beat. Angered by what they said were hospital officials' attempts to pressure them into taking the girl off life support, her family presented the hospital Tuesday with a cease-and-desist letter and vowed to take further legal action to keep the girl alive.
While a brain dead diagnosis, according to medical professionals who spoke to this newspaper, is an irreversible state of complete failure of the brain, making someone legally deceased, the girl's family said it believes that if the heart is still beating, there's still a chance.
Hospital officials have repeatedly declined to speak about Jahi's case, saying that the family had not given them permission to do so publicly. State and federal laws in place to protect a patient's privacy prohibit the discussion of medical conditions or treatments without that permission.
The family called on people from around the world to pray for Jahi, saying her fate should be should be in the hands of God, not in the hands of doctors.
"We are not on doctor's time now, we are on God's time," the girl's uncle, Omari Sealey, said Tuesday afternoon outside the hospital.
The family was joined Tuesday by their lawyer, Christopher Dolan, who earlier in the day emailed the letter to the hospital's CEO, chief of pediatrics and others, demanding they "refrain from any actions or activities which would remove Jahi from life support."
A copy of Dolan's letter, provided to the Bay Area News Group by Dolan, maintains the family's position that hospital officials planned to disconnect Jahi from a breathing machine on Tuesday despite the family's wishes to keep her alive. The letter cites the Patients Bill of Rights in California, which maintain that the family has the right to make the decision.
Dolan said the hospital has indicated that there is no timetable to remove life support, and Jahi's family is willing to file an injunction in court to stop the hospital if they do.
"The medicine they provided didn't work," Dolan said. "It's time to let God work. At this point we are banking on prayer."
On Tuesday, Chief of Pediatrics David Durand issued a statement, saying that due to medical privacy regulations, "we are not able to correct misperceptions created about this sad situation. Nonetheless, we want to assure the community that we are doing everything in our capacity to provide support to the grieving family."
Jahi entered the hospital Dec. 9 for routine tonsil surgery to relieve the symptoms of sleep apnea, a procedure that would normally keep her in the hospital for only one night. After surgery, her family said she appeared healthy and alert until later that night, when she began bleeding, later went into cardiac arrest and was pronounced brain dead Thursday after swelling in the brain.
S. Andrew Josephson, a neurologist and medical director of inpatient neurology at UC San Francisco, said brain death is a specific diagnosis, given by two doctors, that is "legally, morally and ethically equivalent to death."
"Brain death can be a very difficult concept for even very sophisticated people," Josephson said. "It's not something we encounter on a daily basis."
It is uncommon for families to leave a loved one who is declared brain dead¿ on life support, said Jessica Zitter, an intensive care unit and palliative care doctor at Oakland's Highland Hospital. Typically, hospitals and the families will arrange a reasonable amount of time for all family members to arrive and say goodbye, she said. But in the rare instances it occurs, the reasons usually are because of a distrust of medical staff or strong religious beliefs that cardiac death is death and that a patient should be cared for until the heart stops, regardless of what the brain is doing.
"She's alive to me," Jahi's mother, Nailah Winkfield, said Tuesday. "She's not dead. She still has a heartbeat."
The family has called for an international prayer vigil from 6 to 7 p.m. Pacific Standard Time on Wednesday. A local vigil will be held at the same time at Paradise Baptist Church, 9704 Empire Road in East Oakland.
Staff writers Rick Hurd and Erin Ivie contributed to this story.