Archie Battersbee - Thread 3

[BongoJim]

Follow on from previous full thread

www.mumsnet.com/talk/in_the_news/4596573-archie-battersebee-case-thread-2?page=1

What happens if his body starts to fail? Will the hospital have to try CPR?!

'I think this is where most people look at the evidence and can see he isn't dying. He died months ago. This was more just not wanting to let go I think.'

I know but, you know, the stages of grief...denial, bargaining, anger. She's been through them all.

And I agree with PP that grief isn't an excuse for saying the things she has but I do think there's so many factors influencing her and she's surrounded by people who are making it worse and winding her up and taking advantage of her. I look at her in those interviews and she looks so pale and tired and defeated and I just think they both need to rest now, in different ways, Archie and his mum. She needs to start her recovery from all of this.

Part of me wonders, with the army group being closed down, are the family going through the withdrawal voluntarily this evening but I know realistically they'll go to the EHRC and delay a bit more.

She is portraying herself as the victim, while claiming Archie is soon to be the victim of a murder.

She is a victim as a DM facing the loss of her DC in such tragic circumstances.

She clearly isn’t well.

In her mind he needs time for things to improve, we know time won't change the outcome.

yes, necrotic equals rotting and there are parts that have turned to liquid.

The posterior pituitary gland makes a hormone I know as anti diuretic hormone, also called vasopressin in the UK. It concentrates urine. After severe brain injuries this stops being made, it is associated with a very very poor prognosis.

This means that Archie can’t concentrate his urine and, without exogenous vasopressin, would pass unlimited amounts of clear urine. This has been the tricky part for staff, because even with the hormone he’s been unstable, still needs iv fluids to keep his BP up and body salt corrections from what is lost in the urine.

His body is on a knife-edge.

@Miffee here in the judgment on the 13th june The Consultant Neuroradiologist reported that there had been global shrinkage of Archie’s brain since the last MRI scan of 15th April 2022. There had been development of fluid overlying the brain inside the skull. The abnormal appearance of great and white matter continued and had become worse since the earlier MRI.
88. There was severe damage to the deep centre of the brain including to the thalamus. The severe coning seen on 15th April 2022 had not changed. The cerebellar tonsils which had been squashed together with the lower part of the brain stem and had herniated through the bottom of the skull remained but there were signs now of necrosis (death or decay). There were signs of necrosis of the medulla and it was now shrunken. Dr P explained that this is the lower part of the brain stem which controls breathing and heartbeat.
89. There was still the absence of blood circulation through the larger arteries that supplied blood to the front and back of the brain.
Page 21

90. In terms of the spine there was no evidence of primary injury to the spine, something Archie’s parents had been very concerned about but the clinician observed that there was evidence of necrosis of the front part of the thoracic spinal cord. He thought that looked related to a loss of blood supply. He observed further necrosis lower down the spine in the lumbar region and also found “necrotic debris” caused when necrotic tissue has shed higher up in the spinal cord.
91. In summary Dr P’s evidence to the Court on 6th June 2022 was that Archie’s loss of brain volume was caused by an atrophy of the brain and this was consistent with it not getting oxygen. The development of fluid in the skull was as a consequence of the deprivation of blood supply and oxygen. He said that the brain tissue was beginning to issue fluid and it was gathering in a compartment where it would not normally be expected to be present. There had been a number of changes since 15th April 2022 and certainly no improvements in the appearance of the brain structures.
92. Dr P was asked particularly about the thalamus as that was a hugely important area involved in vision, speech and in consciousness. It is also involved in movement of limbs and sensation. He said the areas of damage were much more marked and there had been a progression of damage.
93. He was asked about the brain stem. He said it remained in an abnormal position at the top of the spinal canal. The structures had changed between the two scans. There was necrosis of the brain stem. He said somewhere between 10 and 20% of the brain stem had undergone necrosis but that damage to the brain stem was Page 22

over 50%. The necrosis was caused by the squashing of the brain stem and the coning into the top of the spinal cord.
94. Dr P was asked if the necrosis would continue and he said that there was probably not much more that could occur. In his experience, from the scans, Archie had reached the point of no return. The sort of images he was seeing were ones he usually saw at perimortem or postmortem.
95. Dr P’s evidence was followed by the evidence of the specialists Dr Z and Dr F. Their evidence made bleak hearing for the family and the Court. There were no signs of recovery, and the evidence was that there was a deterioration. I have set out above Dr F’s evidence about Archie’s diarrhoea. She also spoke about the problems he has with his urine output which fluctuates to such an extent that he needs hourly calculations as to how much vasopressin he requires.

www.judiciary.uk/wp-content/uploads/2022/06/Archie-Batteresbee-judgment-2-1.pdf

Also what is the issue with his urine? I have heard a lot about it but understand the divine significance beyond things not working as they should. Would the issues with urine and his digestion (which I understand) occur in any other conditions?

Your blood is filtered through your kidneys. The kidneys extract water and waste products from the blood to make urine. They also concentrate the urine, putting water back in the blood.

How much water they put back is controlled by a hormone called Anti-Diuretic Hormone (ADH). If you've just knocked back 18 pints of water they don't put much back, and you pee for England. If you've been stuck on a delayed train for 4 hours in a heat wave (looking at you, East Coast Rail...) they put back as much as they can, and you pee out something that looks a bit like guiness. (Incidentally, alcohol stops this hormone from working properly, so if you've had those 18 pints were guiness you pee too much and end up dehydrated.)

That hormone is made in the hypothalamus, deep in the brain. Archie isn't making it any more, because that bit of the brain has gone. If left untreated, he'd literally pee out all the water in his blood until his heart stopped working because there was nothing left to pump.

The doctors are giving him a drug called Vasopressin, which is synthetic ADH, to mimic what the hormone should be doing.

Has the army group been shut down then?

I think the army are closing ranks because they know it's the end game. Probably arranging a demo they don't want people seeing.

@OpinionsUnseen it looks like it's been archived but there are other public groups named after him calling for storming the hospital

His mother however doesn't believe a word of it.

Very very few people could be shown those scans and think, “Let’s keep going”. One of the experts cited in the High Court case said he had only seen scans like that in people who had died.

Hollie refused to believe they were Archie’s

@Motorina
I wish I was as clever as you!
Thank you for explaining that.

There needs to be a law put in place to stop these case being taken to court, whilst I really feel for the parents in these cases all this is just putting off the inevitable, also taking doctors away from their patients, costing the NHS tonnes of money which could be used to save countless lives.

I very much doubt it. He has a court ruling in place that states his current treatment isn’t in his best interests. I don’t know if a DNR is specifically mentioned, but I’d be astounded if it would be considered ethical to even try.

I can’t remember who said it, but there’s no way Archie could go to a hospice, or have other staff care for him. Without massively skilled intervention from a regional ITU team he’d die in moments. Even turning him will be dangerous at this point. It’s astonishing that his heart is still going at all.

Lots of people over the thread mentioning the tests being changed and preventing this happening again. The brain stem tests are irrelevant. The courts quite rightly set aside the issue of whether or not he was dead, and rightly concentrated on whether continuing treatment was in Archie’s best interests or not. If the tests had been performed, and resulted in any outcome whatsoever, it wouldn’t have made any difference, to anyone except the despicable CLC. They are just trying to muddy the waters and use Archie to further their anti-choice agenda.

When faced with a parent accusing you publicly which will go global of executing Theo child you have to make sure you tell them every option they have to fight you if they disagree

This is fair enough up to a point, but disregards the issue that Hollie and her supporters seem likely to go on hurling accusations no matter what - today's treat on the FB thread was that "paedophile satanists" are running things

If that's the case, and some will forever deem the hospital to be in the wrong anyway, might it not be time to focus a little more on what's best for Archie and less on those who - for whatever reason - appear to be thinking of anything but?

And if not, what was the point of all the legal and professional effort, especially if there's a realistic chance Archie will pass "naturally" because of delays within the ECHR?

Thanks for taking the time to add such detailed and clear explanations @Motorina .

There's a post on AA from an admin confirming they are applying to the ECHR tomorrow by 9

There's a DNAR order in place. Justice Hayden ordered it a few weeks ago.

I utterly disagree.

These cases are rare because very few parents take this route in the face of the medical evidence presented to them.

However, whether you agree with the decisions of these families or not, it's important in a democratic society for people to have access to legal challenge when there is disagreement about such a fundamental matter.

Furthermore, it's important that such court orders are available for public scrutiny, to give the public confidence that decisions/recommendations made by the medical profession and the judiciary have been made in the best interests of the patients.

Without this process, the rhetoric of the "Army's" goes unchallenged in a clear, methodical and transparent way.

That has a huge implication for public trust for any family facing such decisions in the future.

As stands, these cases are fortunately rare and they demonstrate repeatedly that the medical professionals made the right call, which is vital in maintaining public confidence in such situations.

I've never seen a situation that's so fast moving but where nothing actually happens.

Yes I guess your right it is just a shame that we have saw the cases increase over the last few years.

I keep coming back to the staff who have caring for Archie over the past 3 months. That job much be so so challenging anyway, stressful, emotional and exhausting, I couldn’t imagine how they keep work place emotions boxed up and seperate so they don’t impact on home life. And then to have to hear/read Hollie Dance’s words this week. To have to go back into do your shift knowing that she’d used such offensive language and told the world’s media. Soul destroying.

The ECHR must be the ultimate last stop surely. The decision today I think cited the human rights and says they were not being breached. I can't remember the exact wording.
Hollie's words have been disgusting but I feel for her and how lost and frightened she must feel. And angry. Angry at the world that has taken her son from her and she is doing whatever she can to communicate that anger, fear and sense of loss. I don't agree with her words but I understand why she would want to try anything and everything possible to help Archie and ultimately herself to ease those emotions. It's not in Archie's best interests but it's understandable.

During one of the appeals, it was mentioned that the staff were finding that caring for Archie was distressing. It must be really hard to care for a patient that you know has no hope.
Hollie's barristers tried to dismiss it, saying that their feelings did not matter. The judge said that the feelings of the staff did matter.

I don't think they're inviting anything. They've almost certainly been asked for more time to allow those applications to be lodged. They weren't going to turn anything off until 11 a.m. anyway, and they can't stop the application being lodged; so essentially they've made it clear to the family that this won't stop them turning the machines off unless an application has been lodged two hours in advance of the planned extubation time.