Brain death is defined as the irreversible loss of all functions of the brain. It is different from a persistent vegetative state, in which a person is alive with retention of some autonomic functions. A brain death person can be legally declared dead even if life support equipment maintains the body’s metabolic processes functioning.
Brain injury that is the result of lack of oxygen (and progresses to brain death) can occur during a surgical procedure under general anesthesia as well as some diagnostic procedures now performed under heavy sedation. Lack of oxygen at the time of surgical procedure leads to ischemic hypoxic encephalopathy which progresses to brain death if prolonged for several minutes.
The diagnosis of brain death is a clinical diagnosis. A full clinical examination must include two (2) assessments of brain stem reflexes and an apnea test to be conclusive. In the absence of these confirmatory tests, brain death cannot be diagnosed and certified. An EEG (electroencephalogram) test is not required to certify death, but it is considered to have confirmatory value.
Brain death certification requires a process to be followed that includes:
• Identification of a clear etiology of brain dysfunction • Irreversibility of coma • Exclusion of any condition that might confound the examination of cortical or brain stem function • A complete neurological examination
o Absence of spontaneous movement o Absent pupillary reflex o Absent corneal, cough and gag reflexes o Absent oculovestibular reflex o Failure of heart rate to increase by more than 5 beats per minute after 1- 2 mg of Atropine intravenously o Absent respiratory efforts in the presence of hypercarbia (elevated CO2) • Assessment of brain stem reflexes • Interval observation period • Confirmatory testing
When brain death is the result of prolonged lack of oxygen supply to the brain, it is important to ascertain the cause of oxygen deprivation to the brain. In some instances, the decrease in oxygen supply to the brain is the result of a preventable cause or negligence, and the underlying circumstances should be reviewed and evaluated by experienced medical malpractice counsel.
Brain death may give rise to a medical malpractice cause of action. If as a result of a physician's or nurse's error the condition of a patient worsened or a patient has been unexpectedly injured, the family deserves legal representation. If a patient has suffered from lack of oxygen and subsequent brain death due to a physician's or nurse's error, let Dr. Borten and the Boston area medical malpractice attorneys at Gorovitz & Borten review the specifics of your case. We can help you assert your rights and get the compensation you deserve.
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