Aden Hailu, a 20-year-old college student, fell ill in April and experienced low blood pressure during surgery, causing catastrophic lack of oxygen to her brain.
Carson City, NV—The Nevada Supreme Court ordered a Las Vegas woman declared brain dead at a Reno hospital to be kept on life support, ruling that standards used by the hospital to make the determination might not satisfy state law.
The unanimous opinion issued Thursday and authored by Justice Kristine Pickering means Saint Mary’s Regional Medical Center must continue life support for Aden Hailu, a 20-year-old college student who fell ill in April. She experienced low blood pressure during surgery, causing catastrophic lack of oxygen to her brain.
Within the first two weeks, three different electroencephalogram tests, or EEGs, were conducted. All showed brain function. A doctor concluded she was not brain dead at the time but was “rapidly declining.”
In late May, doctors performed an apnea test, taking her off ventilation to determine if she could breathe on her own. She could not, leading a doctor to conclude “this test result confirms brain death unequivocally.”
Doctors notified Hailu’s father and guardian, Fanuel Gebreyes, on June 2 that they intended to remove her from a ventilator and life support.
Gebreyes filed for an emergency temporary restraining order, leading to court hearings in the summer.
At a July 2 hearing, Dr. Aaron Heide, testifying on behalf of Saint Mary’s, said AAN guidelines are the acceptable standard in Nevada and require three determinations before finding someone brain dead — unresponsiveness; lack of brainstem activity as determined by reflexes and eye movement; and whether the patient can breathe on their own.
Heide concluded Hailu “had zero percent chance of any form of functional neurological outcome.”
At a subsequent hearing, Gebreyes brought in Dr. Brian Callister, who practices internal medicine, to examine Hailu. Callister described the woman’s status as “quite grim” and the chance of survival “a long shot.”
But he noted all three previous brain tests showed brainwave activity and that other organs of her body were functioning.
Callister also questioned the reliability of AAN guidelines, saying they will always support a finding of brain death for a patient with a nonfunctioning cortex, even if other parts of the brain are functioning.
The district court ruled in Saint Mary’s favor, but granted an injunction so Gebreyes could appeal.
Justices reversed the lower court ruling and ordered a hearing to determine whether the AAN guidelines used by doctors at the hospital to declare Hailu brain dead are acceptable under the Uniform Determination of Death Act, adopted by Nevada in 1985. The law requires a determination of “irreversible cessation” of “all functions of the person’s entire brain,” including the brain stem.
The opinion said the district court “focused exclusively on whether Saint Mary’s physicians satisfied AAN guidelines, without discussing whether the AAN guidelines satisfy (state law)” or whether AAN guidelines are “accepted medical standard in Nevada.”
“Though courts defer to the medical community to determine the applicable criteria to measure brain functioning, it is the duty of the law to establish the applicable standard that said criteria must meet,” the court said.
“We recognize the important implications this case has for physicians, hospitals, families, patients, and, most importantly, Aden Hailu and her family,” Pickering wrote.
Source: Las Vegas Review-Journal
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