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Saturday, October 08, 2005

Ind. Decisions - Judge takes infant off life support

As reported by Tim Evans today in an above-the-fold, front-page story in the Indianapolis Star, Marion County Superior Court Judge Marilyn Moores yesterday "ordered life support removed Friday from a 5-month-old Indianapolis boy with a severe head injury that investigators say was caused by abuse." More:

The Marion County Department of Child Services requested the removal of the ventilator that is keeping Hamad Elijah Sanda alive. The agency took custody of the baby Sept. 26, four days after he was brought to the Methodist Hospital emergency room with a skull fracture and brain injury.

Citing the boy's grave condition and testimony from medical experts who said there was nothing more they could do, [Judge Moores] issued the order over the objections of Hamad's mother, Tiwanna Sanda. The judge also issued a "do not resuscitate" order. * * *

Moores said it was up to hospital officials to determine when to remove Hamad from the ventilator. Medical personnel will continue to provide water or nutritional support to the baby through a feeding tube.

Dr. David Westenkirchner, director of the pediatric critical care unit at Methodist, testified Friday that it was not known how long the boy would survive after the ventilator was removed.

Moores recessed the hearing so that members of the hospital's medical ethics committee could review the case and issue a recommendation. When the hearing resumed late Friday afternoon, Westenkirchner said he and three members of the committee agreed it was medically ethical to remove the child from the ventilator even though he does not meet the legal definition of "brain dead" because there is some brain stem function.

In her ruling, Moores wrote that she had been assured by the medical experts that "he will never be able to eat by mouth. . . . He would likely be blind and deaf. He will never sit, stand, roll over, crawl, talk, smile, laugh or in any way interact meaningfully with his environment." "There is no medical treatment that can be provided to reverse the severe and extensive damage that has been done to his brain."

While no one has been criminally charged in the case, Moores said the evidence was clear that the boy's injuries -- including several fractures that predate the brain injury -- were the result of abuse. Indianapolis police are continuing an investigation into how the boy was injured. * * *

The hearing offered a rare glimpse into the workings of the juvenile justice and child protection systems. Those proceedings typically are closed to the public and media, but Moores opened Friday's hearing at the request of The Indianapolis Star.

Requests from child protection officials to discontinue life support for children who are wards of the state are "unusual but not unprecedented," said Jennifer Hubartt, chief legal counsel for the Marion County Department of Child Services.

James W. Payne, director of the state Department of Child Services, called the request "one of those once-every-five-years kind of things" and said this was the first such case since he began overseeing the state's child protection agency in January. Payne, a former juvenile court judge, said he had made similar decisions in cases involving children who were wards of the state during his tenure on the bench. [Judge Moores succeeded Judge Payne on the bench.]

"Nothing could be more emotional, difficult -- just awful," he said. Payne said the situation underscores the important role of parents, who must take responsibility for their children's welfare. "We can't build a system big enough (to save all Indiana children) if parents do not do their jobs," he explained.

The Star story includes a link to IC 16-36-1-5, Indiana's medical consent law.

Posted by Marcia Oddi on October 8, 2005 08:20 AM
Posted to Ind. Trial Ct. Decisions