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

The peripheral nerve testing, by muddying the water, shows the consequence of doing a test you wouldn’t normally do, for reasons that aren’t clinically necessary, for purely medico legal reasons.

Near death by hanging wouldn’t cause a peripheral motor neuropathy and Archie was an athlete. There was no prior history of muscle weakness, muscular atrophy.

They may have done tests to try to show the neuromuscular junction was intact, as Hollie was claiming the drugs were taking longer than predicted to leave his system, but again, this isn’t routine and isn’t necessary weeks after they were given.

I think we're going to have to wait for the written Court of Appeal judgments for the answer on that one. I assume they're going to produce them before the next hearing, though they don't absolutely have to if they've made orders.

I thought peripheral nerve testing was a pre qualifying test for brain stem death?

only if there’s doubt about whether sedating/paralysing drugs are still on board (usually should have worn off after more than 5 half lives have passed).

If the CA has set aside the declaration that Archie had died, then the best interests judgment can still be fully determinative because it will be a decision that it is in his best interests to turn off life support, at which point he will stop breathing and his heartbeat will stop so there will be no argument that he is still alive. There will be no need for anyone to determine whether he is currently alive or not.

However, it is virtually inevitable if that is the decision made that it will be appealed in its turn, so unfortunately the hearing on the 11th won't be the last of this - unless Archie has another cardiac arrest which he doesn't survive.

Ah that makes sense thank you!

Thank you @AmaryIlis

In some respects it is a shame then that best interests were not the focus of the first hearing.

His brain is decomposing. No idea why this appeal was granted. Feel terrible for her obviously but it doesn’t alter facts

It's a Facebook page that was originally set up to examine alternative views on the Alfie Evans case I believe. It's an interesting page and gives a lot of context into Archie's background and why maybe the family are making the decisions they are making. But some of the group members are taking it a bit far and posting on Hollie and Ella's personal pages and demanding to know where the go fund me money is going to and so on. I saw a person there respond to one of the smiley get well soon Purple Heart messages with a very blunt definition of what brain death is. Someone called her on it on the DFA page and she said 'they needed educating.' although I agree with DFAs take on pretty much all of the case, it actually is verging on malicious at times.

However, it is virtually inevitable if that is the decision made that it will be appealed in its turn, so unfortunately the hearing on the 11th won't be the last of this

This is one of the two reasons I don’t think the rule needs to be changed for brain stem death criteria.

The first, as I said earlier, is that after my literature search last night it seems any hospital that can, does perform ancillary studies like imaging, EEGs to support decision making pretty much does so. But coding them in law means some patients would have to be escorted to hospitals - ventilated - to prove death. As it stands, the brain stem death assessment is a clinical, bedside assessment that can be done anywhere. In reality, those additional tests, done pretty routinely, will be used to guide decision making and family’s understanding. Most families accept the results.

The second point is that Hollie won’t accept any medical consensus. She’ll keep this going on point she can, for as long as she can. She was shown Archie’s scans and denied they were his. She posts recordings of his fixed, dilated dead eyes and says he’s looking at things. She insists his hand has grasped her hand, even though this hasn’t happened for anyone else, for the last nearly 3 months. She has he has a change in his heart rate when she is there, even though a provoked EEG where, among other things, Archie was played a recording of her voice, continued to show absent brain wave activity,

I don’t think laws need to be changed to protect against these scenarios. Before this ends, everything will have been challenged, and not on the basis of Archie’s clinical status.

@nolongersurprised could there be a "plan b" test? I know clinically for other pathologies (ICU I know very very little of) there are alternative routes to diagnosing conditions. Would brain death be diagnosed in a hospital without an ICU MRI, CT facilities?

I think the reason I have said I think there needs to be another way if the established test cannot occur, is how unpalatable the current scenario is. I cannot imagine that it benefits anyone at all, in fact.

Yes I think they are ,you don't have to understand all the medical stuff to understand that Archie is never going to recover
But people on these "Armies" are often very.low in intelligence and unable to grasp even the basics and they egg each other on .

Would brain death be diagnosed in a hospital without an ICU MRI, CT facilities?

well, the brain death criteria, as they stand don’t need any imaging. So yes. And people are declared dead in small hospitals all over the world without up to date imaging, all the time.

Pragmatically, any young person who presents like Archie did would be transported to a tertiary hospital for “everything to be done”.

how unpalatable the current scenario is

This situation isn’t occurring because of brain stem death testing limitations though. There’s no compulsion to keep someone on the ventilator because the motor nerve test was invalidated by peripheral nerve unresponsive. Especially when the sedation/paralysing drugs had long worn off.

A clinical picture is very clear without it - you could say to the family that the paralysing drugs had been out of his system for 3 weeks, the other brain stem tests were consistent with death, the imaging looked like a dead person’s and the EEG tests showed he had no brain wave activity. You don’t need to keep him going because of the motor test.

This situation is occurring because of the family’s stance. 99.999% of families, once the sedating meds had worn off, would realise their relative had gone, wasn’t moving or responsive and would let them go. If it wasn’t the motor responsiveness test it’d be something else, and in fact, currently is.

This. Their medical knowledge is based on TV shows where someone is unconscious in bed for a while then miraculously wakes up, sits up and is back to normal in 5 minutes.

I completely agree with you, I suppose it just seems to be a recurrent issue with cases such as these ending up in a protracted court process. I suppose nothing can be done to stop it happening. It just seems that this situation should.not keep happening as a way to support people through their grieving process

I suppose nothing can be done to stop it happening

I don’t think there’s a single medical test in the world, or any protocol, that Hollie would accept. There was a similar case in the US with Jahi McGrath (I think that’s the name) who was on a ventilator for years. Her mother posted pictures where her fingers and toes were rotting but there was an attempt to make it less obvious by nail polish.

I suspect cases will continue to turn up periodically, especially as social media is able to recruit support now in a way that wasn’t possible before.

the problem is hollie has publicly stated the doctors are disgusting for wanting to sotp treatment that this appeal proves their wrong
she might be being hyped up by the army but i belive she thinks shes right and hes not dead-

I suspect cases will continue to turn up periodically, especially as social media is able to recruit support now in a way that wasn’t possible before.

Yes, sadly, I believe you are right.

although I agree with DFAs take on pretty much all of the case, it actually is verging on malicious at times.

Agreed. I've been reading the Dignity For All page a lot recently. It started out as a sensible discussion but has descended into a witch hunt over the past few days. They're getting as bad as the Army now. I think the issues surrounding the Captain Tom Foundation have convinced them that there's something suspicious going on with the Gofundme.
The info that they've dug up on Pavel Stroilov is interesting though. If I remember correctly, he had dealings with the Alfie Evans case too.

Thank you @nolongersurprised for all of your medical explanations on this thread, they’re really useful.

I agree the eye video is really harrowing. It’s interesting that this is still happening because in the High Court judgement, the judge records the family’s position was they accepted Archie wouldn’t recover but wanted him to be able to pass away in the hospital when even with treatment his body cannot continue. Clearly this isn’t accurate and they still believe he can recover.

I think now Hollie can't or won't back down.
Not only does she feel she can't let Archie down, she is also responsible for the army!

I'm afraid i just can't share in the good feeling towards Hollie that a lot of people still has. Keeping that boy alive and stoking the Army's wrath is nothing short of despicable.

The trouble is that by starting all the Army stuff she's painted herself into a corner. It's near-impossible now for her to say "I've thought about it, realistically he died weeks ago, I've discontinued the legal action and we turned the machines off this morning". Though I'd love to see the Army's reaction if she did.

Probably think she'd been forced to say it.

Thank you @nolongersurprised for all of your medical explanations on this thread, they’re really useful

Thanks! I’ll admit to being over invested because I can’t believe how wrong it feels.

The trouble is that by starting all the Army stuff she's painted herself into a corner

after that recording of his eye I think she’s mentally unwell, delusional. This is not a criticism, the grief and trauma of finding my son like that could well result in an acute mental health event.

With stress compounded by how there’ll be an inquest when this is over, or there would be in this part of the word. Not sure about the UK