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Was this 'irreversible coma' really irreversible?

HOW OFTEN HAVE WE HEARD THE TERMS: IRREVERSIBLE COMA, PERSISTENT VEGETATIVE STATE (PVS), AND MEDICAL EXPERTS TESTIFY THAT THERE IS NO CHANCE A PATIENT CAN COME OUT OF AN IRREVERSIBLE COMA OR PVS? On Tuesday, January 17, 2006, the Supreme Court of Massachusetts acting in reliance on such expert medical testimony rendered a judgment authorizing the removal of an eleven-year-old girl from artificial life support and tube feeding. The girl (a victim of approximately two dozen reported incidents of child abuse over many years) had been savagely beaten by her adoptive mother and adoptive stepfather. One day later, on Wednesday, January 18, 2006, the hospital in which the little girl was expected to die reported that she had come out of her coma. The child's birth mother first noticed that the child moved her hands. She brought this to the attention of those caring for the child, only to be told that it was an "involuntary" action and was no cause for hope of any possibility the child would emerge from her coma. When the childs birth mother returned the next morning she was positive that there was "voluntary" movement. Only after repeated efforts and requests that the child hold and let go of objects did hospital officials see the light. However, they were reluctant to have the birth mother make any public disclosure. Only after hospital officials were convinced that the coma was neither irreversible nor was the child in a PVS was it reported to the media.

WAS THIS A CASE OF MISDIAGNOSIS OR WAS IT A MIRACLE? Last fall, physicians diagnosed Haleigh Poutre as being in a PVS and virtually brain dead. Court testimony given by expert medical witnesses described her brain stem as "severely injured, leaving her unable to think or feel, and in an "irreversible coma." Alison Avrett, Haleigh's birth mother reported improvements in the child's condition and emphasized that the child's hand movements appeared deliberate. However, physicians convinced her that such movements were involuntary and not significant. How wrong they were! Ms. Avrett was so convinced by what she perceived to be voluntary movements by Haleigh the following morning that she reconsidered her previous opinion that Haleigh was in an irreversible coma and in a PVS. Curiously, physicians did not inform the Department of Social Services (DSS) which had custody of the child until a significant period of time had passed.

THE STATE DEPARTMENT OF SOCIAL SERVICES (DSS) FILED A PETITION WITH THE MASSACHUSETTS SUPREME COURT SEEKING AN ORDER AUTHORIZING REMOVAL OF ALL ARTIFICIAL LIFE SUPPORT AND FEEDING FROM THE CHILD (IDENTIFIED BY THE COURT AS "SHARLENE"). Little did the court know that the judgment ordering the removal of all life support systems would, in fact, draw national attention to the little girl who defied the medical experts who had opined that she was in an irreversible coma and in a PVS. What was so unusual about this misdiagnosis? This same little girl had been the subject of approximately two dozen complaints of child abuse inflicted on her by her adoptive mother and her live in boyfriend as well as her adoptive stepfather.. And what did the DSS do? Absolutely nothing! This same DSS was awarded temporary custody of the child. DSS and the child's adoptive mother and stepfather filed a joint emergency motion requesting a DNR order. Ironically the child's adoptive mother and stepfather (the petitioner in the case before the Supreme Judicial Court) were both arraigned in the Westfield Division of the District Court on charges relating to the injuries that the child allegedly sustained at their hands. The child's adoptive mother was released on bail on September 22, 2005, and died later that day, apparently the victim of a murder-suicide or double suicide. On September 26, the child's adoptive stepfather filed a petition to be declared the "de facto parent." It was denied!

HALEIGH POUTRE WAS THE VICTIM OF MANY INCIDENTS OF CHILD ABUSE BY HER ADOPTIVE MOTHER, HER BOYFRIEND AND HER ADOPTIVE STEPFATHER. However, Haleigh was also the victim of a flawed system. DSS let Haleigh down just as much as those who subjected her to child abuse. DSS was charged with the responsibility of protecting Haleigh and thousands of other victims like her. How can DSS possibly justify its failure to act after two dozen reports of child abuse? The last of which nearly killed her. But she did not die!. Initially, she was slated for death by the removal of her artificial life support and feeding tubes predicated on the testimony of medical experts. Again, Haleigh did not die! Haleigh lives today despite all who let her down. In re Care and Protection of Sharlene, No. SJC-09269 (Mass. 01/17/ 2006) N.E.2d--MA

Meet the Editor & Publisher: A. David Tammelleo, JD, is a nationally recognized authority on health care law. Practicing law for over 40 years, he concentrates in health care law with the Rhode Island firm of A. David Tammelleo & Associates. He has presented seminars on medical, nursing and hospital law throughout the United States. In addition to his writings as Editor of Medical Law's, Nursing Laws & Hospital Law's Regan Reports, his legal articles have been published in the most prestigious health law journals. A prolific writer, his thousands of articles, as well as his achievements as an attorney and lecturer, have won him recognition in Martindale-Hubbell's Bar Register of Preeminent Lawyers, Marquis Who's Who in American Law, Who's Who in America and Who's Who in the World.
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Title Annotation:persistent vegetative state petition
Author:Tammelleo, A. David
Publication:Nursing Law's Regan Report
Geographic Code:1U1MA
Date:Jan 1, 2006
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