In Re Guardianship Of Hailu

361 P.3d 524 (2015)

Purchase the Printed Copy at bsmsphd.com

Nature of the Case

To access this section all you need to do is click here and register.

Facts

Aden Hailu a 20-year-old university student went to St. Mary's Regional Medical Center (D) after experiencing abdominal pain. The doctors decided to perform an exploratory laparotomy and remove her appendix. During the laparotomy, Hailu's blood pressure was low and she suffered 'severe, catastrophic anoxic, or lack of brain oxygen damage,' and she never woke up. Hailu was transferred to the St. Mary's Intensive Care Unit (ICU), under the care of Dr. Anthony Floreani. Within the first two weeks of April, three different EEG tests were conducted all of which showed brain functioning. Dr. Heide concluded that Hailu was not brain dead but was 'rapidly declining.' Dr. Heide examined Hailu's neurological functions; her left eye was minimally responsive, she was chewing on the ventilator tube, and she moved her arms with stimulation. The next day, Hailu did not exhibit these same indicia of neurological functioning. Hailu failed the apnea test which was to see if she could breathe on her own. D concluded that 'this test result confirms Brain Death unequivocally.' D notified P, Hailu's father and guardian, that it intended to discontinue Hailu's ventilator and other life support. P opposed taking Hailu off life support and sought judicial relief. P filed an emergency motion for a temporary restraining order. The order was granted to give P enough time to verify the diagnosis. P failed to get an independent expert but presented Dr. Byrne-a known opponent of brain-death declarations. Dr. Byrne complained that Hailu was never treated for thyroid problems and testified that this treatment will help her improve. Third, Dr. Heide testified that D applied the American Association of Neurology (AAN) guidelines to Hailu to determine if she was brain dead. He testified that the AAN guidelines are the accepted medical standard in Nevada. The AAN guidelines call for three determinations: (1) whether there is a coma and unresponsiveness; (2) whether there is brainstem activity (determined by conducting a clinical examination of reflexes, eyes, ears, etc.); and (3) whether the patient can breathe on her own (determined by conducting an apnea test). Dr. Heide believed that Hailu 'had zero percent chance of any form of functional neurological outcome.' Further, Dr. Heide also administered a Transcranial Doppler test, which is a test that measures blood flow to the brain. While there was still some blood flow to Hailu's brain, the lack of blood flow was consistent with brain death. On a subsequent hearing, P presented a plan to move Hailu to Las Vegas. Dr. Callister testified: 'I believe that her status is quite grim. I think that her chance of survival, her chance of awakening from her current state is a long shot. However, I do not think that the chance is zero.' Dr. Callister questioned the reliability of the AAN guidelines stating that the AAN guidelines will always yield results consistent with brain death for a patient with a nonfunctioning cortex, even if the mid or hind parts of the brain are still functioning. Dr. Callister conceded that under 'a strict definition' of the AAN guidelines, Hailu 'would meet their category [of brain death].' The trial court ruled in favor of D. The district court granted an injunction pending P's appeal.