Archie Battersbee case

[whynotwhatknot]

I was just wondering why we're not allowed to post about this case-the deletion message mentioned it was ongoing so wouldnt be fair to the family

Charlie gards case was on going and there was numerous threads about it

Anyway if this stands maybe we can discuss

i don’t think the court can go back to the declaration of death

But he was declared dead by the High Court judge.

So does that stand, there’s no further discussion about whether he’s brain dead and it’s accepted he is (as per the high court) and the appeal for “best interests” is the end of the road?

If that’s the case the whole argument is whether a (legally) dead person’s best interests need to be considered.

Surely the Court are acknowledging that Archie is not dead?

A dead person does not have any “best interests”.

By allowing the “best interests” case to go ahead they are basically saying that they class Archie as being alive?

By allowing the “best interests” case to go ahead they are basically saying that they class Archie as being alive?

I think it’s drier than that, more that the High Court judgement wasn’t considered robust enough on this point, with insufficient paragraphs.

I think I’ve leaned that common sense here isn’t applicable (a dead person doesn’t have “best interests”) but it’s more about legal box ticking in what will eventually have a sad outcome for Archie’s family.

If they were disagreeing with all of the High Court judgment, and stating the Archie were “alive” there’d need to be a whole new case and reasons as to why the court disagreed with the medical evidence.

I don’t think it’s right, to allow an appeal on a specific legal point when it means that Archie’s body, with his decaying brain, remains on a ventilator.

hollie is probably in denial but everything she says abujt the doctors and hopsital is so wrong and damaging

all the army are pumped up now saying he'll wake up soon dont worry etc

On a article about it on Facebook there's the same sort of comments that basically this now means he'll wake up and go home..

Exactly theyre giving her false hope which i think shes bought into unfrotunately

if you say anyting to the contrary youre told youre evil and a mother knows if theyre child is ok

well clearly not re charlie gard and alfie evans who also thought they shold be kept on machines because they would be ok one day

I haven’t managed to finish watching the whole hearing yet and not seen the order, but I think the Court of Appeal has in effect quashed the declaration of death so that legally there is no such declaration, and technically he is still alive for the purposes of the best interest test.

I do feel for her, but my DH (who is a paediatrician) made the point that although not exactly common, there are quite a number of children who are on ventilation with no hope of recovery whose parents do not behave like this and which do not end up in court. We all react differently I suppose.

It's heartbreaking. It really is

But would they allow the parents to fund Archie's care until a change of mind occurs? Someone mentioned someone they knew took home a child in a coma and fully funded treatment themselves

I know that may not be in the child's best interests but may be the final push to make the parents realise the hopelessness of the situation

He’s not a well person who is ‘just’ in a coma though is he? He’s brain dead and requiring ventilation, huge amounts of medical input and needing one to one nursing care. He’s a very critically ill child needing lots of complex medications every day and his life basically hangs in the balance. He’s already been on the brink of a cardiac arrest on two occasions. And he absolutely can’t be moved - it’s physically impossible. He can’t just be popped into the back of an ambulance with his ventilator next to him.

I imagine his care costs thousands most days.

If you read the court judgment it clearly shows there's no prospect of this even being an option I'm afraid.

thats the problem people sayin oh but my friend/relative wa sin a coma and they took them home

hes not in a coma he needs round the clock care with highly intricate medicines prcedures being done it cant just go on and on indefinitely

I put this out there on the other thread but thought I’d put it here as well.

I do not believe that the Court of Appeal wanted to rule on the brain death issue. This is because diagnosis via MRI is not the standard method - and the primary method could not be attempted on Archie.

By passing it back to the High Court on “best interests” they avoid this hot potato. The issue with a court making “new” law is that it would be appealable at the Supreme Court. It would take a long time to hear and prepare for such an appeal as well. Sending it back on “best interests” grounds is the quickest way to resolution.

It will be interesting to see what, if anything, the judges state about brain stem death in the judgment. It is also telling who they have assigned to the 11 July heating. Justice Hayden - who heard the Evans case - and is therefore highly experienced and competent in these matters.

It is also telling who they have assigned to the 11 July heating. Justice Hayden - who heard the Evans case - and is therefore highly experienced and competent in these matters

I'm sure once thats realised by the group it'll throw up more accusations. They already go about how the hospital and staff are out to get him...

Hopefully if the decison is made to stop treatment the family can find peace with it. If that's what could happen at the next case?

Yes I know he's not 'just' in a coma, the needs are immense etc

But his family seem to think it's a possibility. The only way to get through to them may be to let them explore that option and come to the obvious conclusion themselves

The army are saying he will wake up soon and sadly, the mother is believing this

Reality of the situation will soon become apparent

Can someone who has kept up with this please explain to me the tests they have/haven't done on his brain?

My dad sadly had a cardiac arrest 8 weeks ago caused by dialated cardiomyopathy (he was only 62). He was brought back with a defibrillator but was expected to have cell death showing on his CT scan due to how long he was down for. His CT scan results were OK and didn't show brain damage but he was still semi vegetative. After this they did an eeg which only showed a historical mini stroke so an Mri was done. The consultants said the Mri was OK and the patient in the bed just didn't match the scans which looked okay. Eventually they got a neurologist in to look at the mri who said he did see some brain damage and my dad's life support was withdrawn in his best interests.

Did they not do a CT scan on archie initially as surely that would have shown cell death and been all the proof they would need? Is the nerve stimulation test they are looking at the SSEP test? (short latency somosensatory evoked potentials).

I just dont get how if he is already dead they haven't been able to get the solid proof they need to prove this and be able to withdraw life support.

Hes had multiple scans. eegs and partial brain stem testing.
he will have had CT scans on admission with follow up MRI's once stable enough to transport to scan. Often early scans don't tell the full picture as the brain will continue to swell after a hypoxic injury and brain death where the brain stem is pushed down into the spinal canal often takes a few days to develop

He's been in so long now though that CT scans and mri's would now give an accurate picture. Are his parents preventing tests to be repeated?

He had an MRI that showed no blood flow to his brain.There is no coming back from that. He was declared dead after that scan by judge Arbuthnott.

He's requiring medications to be calculated on an hour by hour basis and administered to him.

There's no communication between his brain and organs like the heart, lungs, kidneys etc, this means that everything has to be manually measured and regulated by interventions.

Even just getting him into an MRI scanner on a different floor would have been incredibly intensive and risking cardiac death.

He would have a violent and distressing death (for HCPs and loved ones) if they even attempted to bring him home. I honestly think anyone commenting on the case needs to read the court documents first!

I believe they are resisting these tests now they understand them to be risky.

I believe they are resisting these tests now they understand them to be risky

He has had extensive imaging, including MR angiograms showing blood flow (or lack of). Read the high court judgement.

His brain is rotting and bits of it have broken off and are in his lumbar spine. There was some (but reduced) blood flow to his brain just after the initial injury but with cellular swelling and death that has ceased. There’s been no blood flow to his brain for over 2 months.

His posterior pituitary glad in his brain stem has ceased to function and he has diabetes insipidus. This has nothing to do with blood sugar but he can’t concentrate his urine at all due to lack of anti-diuretic hormone. This hormone is involved in concentrating the urine so without treatment he would die quickly from fluid losses. The medical team say his replacement hormone and body salt losses need to be calculated hourly.

Based on a list Hollie posted of his meds he’s also lost anterior pituitary hormone function as well and needs replacement hydrocortisone (for cortisol) and thyroxine. He is not in a coma, he is unresponsive.

His body is high needs, very unstable. He couldn’t be moved to a lower acuity setting and if they were paying for his care they’d be bankrupt by now.

eh?

Not sure what in my post contradicts previous court documents.

I was just pointing out the family have refused further neuroimaging, now they understand it is risky. Previously, they had refused brain stem testing and been keen for neuroimaging (e.g., MRI, CT) because they misunderstood the relative risk of both.

You've also basically reiterated what I just said in my PP @nolongersurprised - that the level of manual monitoring & intervention in order to prevent cardiac death could never be achieved at home...

I just dont get how if he is already dead they haven't been able to get the solid proof they need to prove this and be able to withdraw life support

It’s all in the High Court judgment.

He has also had EEG studies showing no brain waves, including a provoked EEG where he was exposed to music, his friends/family voices and there was no response.

Hollie is the only one who has felt a hand grasp, no one else including medical or nursing staff have felt any movement at all or response to response to stimulus. His pupils are fixed, dilated and don’t respond to light.

The brain stem test has a number of components. He couldn’t be reliably tested on the last one because his peripheral nerves don’t respond (because he’s dead). However because this could theoretically give a false positive on the brain stem test he couldn’t technically complete the whole array of tests. In reality, he failed it because he was too dead.

So the High Court judge ruled that he was brain dead on the basis of his brain rotting, dropping off, lack of blood flow for 2 months.

Imaging/blood flow studies are not the old-school, accepted way of declaring brain-stem death and this issue was to be addressed on appeal Wednesday.

However - this was swerved (forever, to be picked up later?. A few posters and I have been debating this for the thread) in favour of “best interests” for Archie, which was apparently not addressed in enough detail by the High Court judge.