Health & Fitness (206)
OAKLAND, Calif. (AP) -- Acting with a court order, the family of a 13-year-old California girl declared brain dead after a tonsillectomy has had her taken from a California hospital to be cared for elsewhere, the family's attorney says.
Jahi McMath was moved by a critical care team while attached to a ventilator but without a feeding tube, Christopher Dolan told The Associated Press.
She left from Children's Hospital of Oakland in a private ambulance shortly before 8 p.m. Sunday, Dolan said. Her destination was not immediately disclosed.
"It was a very tense situation," said Dolan. "Everybody played by the rules."
David Durand, the hospital's Chief of Pediatrics, said the girl was released to the coroner. The coroner then released her into the custody of her mother, Nailah Winkfield, as per court order, Durand said in an email.
On Friday Alameda County Superior Court Judge Evelio Grillo said Jahi could be transferred under an agreement with Children's Hospital and the girl's mother will be held accountable for developments that could include Jahi going into cardiac arrest.
The Alameda County coroner's office issued a death certificate for the girl Friday but said the document is incomplete because no cause of death has been determined pending an autopsy.
"They may have issued one but we don't have it. We don't think she's dead," Dolan said. "We got all the necessary legal paperwork in order to get Jahi out of there." He said the deal to move the girl came together Sunday.
A court injunction prohibiting Children's Hospital from removing the ventilator that has kept Jahi's heart pumping since her Dec. 9 surgery expires at 5 p.m. Tuesday.
Dolan wouldn't specify where the girl was taken but he said "they are going to care for her, respect her and love her. And they're going to call her Jahi, not `the body.'"
He told reporters at his office in San Francisco late Sunday that the girl will be getting a feeding tube before she is transferred to a permanent facility.
Dolan asked for privacy for the caregivers because the issue has raised such strong emotions.
"It's brought out the best in people and the worst in people," he said. "We've had people make threats from around the country. It's sad people act that way, so for Jahi's safety and for those around her, we will not be saying where she went or where she is."
The girl's uncle, Omari Seeley, told reporters that "we're very grateful. We're very proud. We want to thank everyone who supported us, everyone who stood in our corner, everyone who prayed for us, everyone who donated to make this possible. Without you guys, none of this would be possible."
After spending weeks in a very public and tense fight with the hospital, Jahi's family does not plan to disclose any more about their plans for her continued care until she is resettled, her uncle, Omari Sealey, told reporters on Friday.
The hospital has argued since before Christmas that Jahi's brain death means she is legally dead and she should be disconnected from the ventilator. It also has refused to fit her with a feeding tube or a breathing tube that would help stabilize her during a move, saying it was unethical to perform medical procedures on a dead person.
Hospital spokesman Sam Singer said officials were not informed where the girl was being taken.
"We hope that the family finds peace in this very, very tragic story," he said.
Winkfield, refusing to believe her daughter is dead as long as her heart is beating, has gone to court to stop the machine from being disconnected. She has wanted to transfer Jahi to another facility and hoped to force Children's Hospital either to insert the tubes or to allow an outside doctor to do the procedures.
Grillo on Friday rejected the family's move to have the hospital insert the tubes, noting the girl could be moved with the ventilator and intravenous fluid lines she has now. He also refused to compel the hospital to permit an outside doctor perform the procedures on its premises.
Dolan said Friday the family has located an unaffiliated physician to put in the tubes and that an outpatient clinic in New York that treats people with traumatic brain injures has expressed willingness to care for Jahi.
Jahi went into cardiac arrest while recovering from surgery to remove her tonsils, adenoids and uvula along with bony structures from her nose and throat and palate tissue. Three doctors have declared the girl brain dead based on exams and tests showing no blood flow or electrical activity in either her cerebrum or the brain stem that controls breathing.
Multiple outside doctors and bioethicists observing the case have confirmed that a patient in that condition meets the legal criteria for death and has no chance of recovering.
The judge earlier this week ordered Children's Hospital to keep Jahi on the ventilator until Jan. 7 at 5 p.m. He said Friday that he would dissolve the injunction as soon as Winkfield assumes custody of her daughter's body.
INDIANAPOLIS (AP) -- A man who allegedly stole human brain samples from a medical history museum was arrested after a California man who bought some of the tissue online alerted authorities.
David Charles, 21, was arrested Dec. 16 after investigators were tipped off by a San Diego man who became suspicious about six jars of brain tissue he'd bought on eBay for $600.
Charles faces theft and other charges. It was not immediately clear whether he has an attorney.
Marion County court documents allege Charles broke into the Indiana Medical History Museum several times over the past year and stole jars of preserved human tissues, including brain samples, from long-dead psychiatric patients.
The museum is on the grounds of a former state psychiatric hospital, Central State Hospital, which closed in 1994. The museum's director said the tissues are from autopsies spanning from roughly the 1890s to the 1940s.
"A museum's mission is to hold these materials as cultural and scientific objects in the public interest. To have that disturbed - to have that broken - is extraordinarily disturbing to those of us in the museum field," the museum's executive director, Mary Ellen Hennessey Nottage, told The Indianapolis Star (HTTP://INDY.ST/1BBGS2U ).
Indianapolis police had investigated several break-ins at the museum's storage facility before the San Diego man helped lead police to Charles. That man called the Indianapolis museum after noticing labels on the containers that he bought on eBay, court documents state.
Indianapolis police detectives traced the transactions and eventually spoke to the seller. Police said that seller had obtained the brain matter from Charles.
Charles was arrested during a police sting after the eBay middleman arranged a meeting in a parking lot. Court documents state that the day before his arrest, Charles had stolen 60 jars of human tissue from the museum.
Nottage, who said she's grateful much of the stolen material has been returned. She also said she spoke to the San Diego man who bought the six jars.
"He just said he liked to collect odd things," she told The Star.
Information from: The Indianapolis Star, HTTP://WWW.INDYSTAR.COM
MIAMI (AP) -- The so-called "young invincibles" are so important to the success of the Affordable Care Act that supporters and detractors are spending millions to reach them with racy ads, social media campaigns and celebrity endorsements. The president is even (gasp) asking their mothers to help convince them to sign up for insurance.
The federal government and states running their own exchanges have launched marketing efforts for this crucial demographic of healthy young adults, but it's unclear if the messages are getting through.
Eric Fisher, a 28-year-old from Salt Lake City, said he still hasn't seen any of the social media campaigns - one of which targets Utah residents with images of people snowboarding and rock climbing.
He tried to sign up online when the federal marketplace first launched but couldn't because of the long wait times and other website glitches. He said he'll try again at some point. He added that the historic health care overhaul isn't a topic he and his friends spend much time talking about.
"It's not like a coffee table conversation," Fisher said.
According to a recent Harvard survey, many of Fisher's peers are undecided.
A poll by Harvard's Institute of Politics shows about 40 percent of people between the ages of 18 and 29 are on the fence about whether to sign up, with the rest split fairly evenly between those likely to enroll and those who probably won't.
The survey of 2,000 young adults was conducted from Oct. 30 to Nov. 11, after the first month of enrollment on the health care exchanges and when sign-up problems were at their peak.
Consisting of healthy college students and twenty-somethings, the so-called "young invincible" demographic is the holy grail of the Affordable Care Act. Insurers need their participation to offset the costs of covering older, sicker Americans. If enough young people decide not to buy insurance through state or federal marketplaces, it could throw off the market's equilibrium and cause insurance rates to rise dramatically the following year.
Federal officials haven't released detailed demographic information on who's enrolled so far, so it's not clear how many young people have signed up.
Ad campaigns in many states are courting undecided young adults. In Colorado, a nonprofit group created a series of provocative "got insurance?" ads. One features a blonde standing next to a life-sized cut-out of celebrity heartthrob Ryan Gosling with the caption, "Hey girl, you're excited about easy access to birth control and I'm excited about getting to know you. She got insurance." Another touting "Brosurance" encourages men doing a keg stand not to tap into their beer money to cover medical bills. When the exchange launched, models wearing nothing but underwear and "Get Covered" signs passed out fliers in downtown Denver.
Arizona and Utah ads targeting weekend warriors and other athletes note the risks of getting hurt without health insurance.
Shmuel Johnson, who works in Los Angeles at a small sound studio, hasn't seen any ads or perused the state's health exchange.
"There's this elitist attitude that (politicians) think they know what's better for us than ourselves and that's part of why I take issue with this. I'm being forced to do something that's not necessarily in my best interest," said Johnson, a 31-year-old who's never had insurance. "I don't need insurance, man. I'm healthy."
He'll wait until March to enroll and says he'll select the cheapest, lowest-level of coverage available simply to avoid the fine. Experts expect many young adults, like Johnson, to wait until March.
In 2012, 18 million 19 to 34-year-olds lacked insurance - or 27 percent of all people in that age group, according to U.S. census data.
The Obama administration is making the rounds on college campuses to encourage people to sign up and has enlisted celebrities including Lady Gaga and Kerry Washington in its Get Covered social media campaign. Jennifer Hudson and Olivia Wilde were featured in skits pushing the Affordable Care Act on the humor website FunnyorDie.com. In the latest push, an Obama impersonator encourages young adults to tell their friends to get covered in an online rap.
The president himself recently told a group of mothers visiting the Oval Office that: "Moms can tell young people who think they're invincible that they're not and prod them to at least get information."
California state exchange officials even tried to persuade women to pay the first month's premium as a Christmas gift to their adult children and grandchildren.
Experts say engaging young invincibles requires a nuanced touch. They prefer to talk with their peers about pragmatic things they can do to impact the world, but aren't interested in ideological debates, said Morley Winograd, author of 3 books on millenials, including "Millenial Momentum."
But the cost of coverage will play the biggest role, experts say.
More than 3 million young adults have health insurance thanks to the Affordable Care Act because they remained on their parents' health insurance, according to the feds. The law extended the age that children can stay on their parents' plan to 26.
Joshua Benson stayed on his parents' insurance until he turned 26 last year. After that, Benson, who had his pancreas removed and needs daily insulin for his Type 1 diabetes, struggled to find coverage. He was either denied or quoted $2,000 monthly premiums, said the South Florida resident, who works part-time as a grocery store cashier.
He recently enrolled in a platinum plan with no deductible that costs him $170 a month and even covers his endocrinologist. The federal government kicks in another $200 a month.
Benson says he was amused by the Funnyordie.com skits, but said many other ads "are focusing more on getting our attention than actually giving us any valid information."
On the other side of the aisle, groups that oppose the health overhaul such as Generation Opportunity are spreading their message at college tailgate parties. The organization gained a following after disturbing-by-design social media videos featuring a creepy Uncle Sam popping up at gynecological and proctology exams went viral. The tagline urged young adults to keep big government out of their personal health decisions.
The group's recent tailgate party at the University of Miami had all the markings of the South Beach club scene: hired glossy-haired models handing out swag, free alcohol and a sea of sweaty twenty-somethings bumping and grinding to a live DJ.
Mette Jensen, a 22-year-old student, says she supports "Obamacare" even though she signed a petition against it.
"Well, why not. I love free stuff."
Follow Kelli Kennedy on Twitter at WWW.TWITTER.COM/KKENNEDYAP
Associated Press writers Brady McCombs in Salt Lake City, Utah and Gillian Flaccus from Los Angeles contributed to this report.
WASHINGTON (AP) -- Whether you love it or hate it or are just plain confused by it, you've got to give the health care law this much: There's plenty of drama.
The nail biting goes on. As the clock ticks toward the Jan. 1 start of insurance coverage under President Barack Obama's big, bold and bedraggled creation, there are inklings it might get a second wind.
But that could turn out to be just hot air.
Time will tell, soon, as policies take effect in new health insurance markets that have been enrolling customers - or trying - for nearly three months.
A look at the law's broad strokes, its brush with disaster and the roots of a possible rebound:
No more denying people coverage when they've been sick. No more stratospheric premiums for the previously or currently ill, either. No more cutting off insurance payments because someone has used up a year's worth of benefits. For all the headaches signing up, questionnaires are also notable for questions they do not ask: Have you been treated for cancer? What is your medical history? It won't matter anymore.
Few in the polarized debate over the health care overhaul defend the history of an insurance system that can drive people into poverty when they get sick or steer them away from treatment they need. The critics quarrel with the means more than these particular ends. And families like the fact that adult children can stay on their parents' plans until they are 26, an early consequence of the law and one of its few visible effects until now.
More than 4 million people lost coverage because their policies fell short of new federal standards. Far fewer gained insurance in the new markets in that time. This happened despite Obama's repeated and now discredited pledge that people happy with their insurance could simply keep it. He partnered that assurance with a promise that people happy with their doctors could keep them, too. Not so, in many cases. Another rude awakening.
After a wave of cancellations, the government revised its rules on substandard policies to let insurance companies offer them for one more year. It's not clear how many plans will be retrieved from the dustbin as a result. Some will be allowed to buy bare-bones catastrophic plans. And people who lost their insurance can shop for new plans that in many cases will offer better terms. But better coverage will often come at a higher cost.
Ugly goes to HealthCare.gov, the federal government's buggy online insurance portal, impenetrable for weeks for many if not most who tried to see what plans they could choose from and perhaps sign up for one. It's on the mend. But until coverage begins for those who took that route, its prognosis remains uncertain.
Washington can put a positive spin on almost anything, and federal officials did just that at the very start. Yes, HealthCare.gov is buckling under the user load. That's because folks love it!
The smiley face soon melted into a swamp of recriminations. Led by Republicans, of course, who feigned indignation that the law many of them despise wasn't working out so well. A more authentic response came from Democrats: the heebie-jeebies. They'd gone to bat for the law in the mighty struggle to pass it in 2010 and faced down all efforts that followed from the GOP to repeal it. With elections coming next year, Democrats are not happy.
"The president needs to man up, find out who was responsible and fire them," Rep. Rick Nolan of Minnesota steamed.
"No one is held to account," agreed Democratic Sen. Bill Nelson of Florida.
On opening day, Oct. 1, some 3 million people had tried to access the site. Merely six people signed up for coverage, according to a congressional committee's documents. The online Spanish-language portal wasn't ready as promised. But really, for weeks, the English one wasn't, either.
"No excuse for it," Obama said, repeatedly vowing to fix it.
No one has been fired. When GOP Rep. Marsha Blackburn of Tennessee asked who's to blame for the "debacle," Health and Human Services Secretary Kathleen Sebelius replied, "Hold me responsible for the debacle."
So everyone, rather unusually, was on the same page in sizing up the launch, or at least they were on the same word. It was a debacle.
Seat-of-the-pants patches, pivots and delays began before the debut of the woebegone 1.0 website and spread well beyond it.
In July, the government postponed one of the law's central features for a year - the mandate that all businesses employing 50 or more people provide health coverage or risk a penalty.
In late November, it announced a one-year delay in the online marketplace for small businesses to find coverage for their employees. They could still get insurance from the exchanges through traditional avenues like brokers, but direct access had to wait as the government gave priority to making the portal work for individuals.
Meantime, insurance companies were sending out cancellation notices for more than 4 million individual policies that didn't meet new federal requirements, prompting an about-face by the government. Federal officials decided these substandard policies could exist for one more year. It remains to be seen how many canceled policies will be revived as a result.
Then there was the paper-phone-Web conundrum.
With the online system ailing, Obama urged people to apply by mail and phone and used the megaphone of the presidency to give out the toll-free number, 800-318-2596.
But snail mail, if helping in a pinch, wasn't proving to be an efficient substitute for the streamlined process envisioned by the law. Kelly Fristoe, an insurance agent in Wichita Falls, Texas, told AP he'd submitted 25 paper applications in two months and hadn't received any responses by early December, despite assurances from Washington that all paper applications received in October had been processed.
The same week that federal health officials told reporters there were no problems with paper applications, they were quietly discouraging further use of paper in contacts with enrollment counselors, insurance brokers and others. It was time to get back to the website as time grew ever shorter to apply by Dec. 23 for coverage starting Jan. 1.
As December progressed, another batch of improvisation emerged.
The government announced a one-month extension of a special insurance program for nearly 86,000 people who cannot get any other coverage because of pre-existing illness. The program should not be needed in the new year because coverage can no longer be denied to the previously sick. But the risk of insurance gaps from the troubled rollout prompted officials to keep the program around a while longer to be safe.
Similarly, Washington ordered insurers to provide coverage on Jan. 1 for any customer who pays by New Year's Eve. The industry went the government one better, extending the deadline until Jan. 10. The administration also allowed some of those with canceled policies to sign up for catastrophic insurance.
On Dec. 1, the government reported progress fixing the website. Now people had a 19-in-20 chance of finding it in operation. You could click more than 99 times out of 100 and not see pages crash. Some 50,000 people could use it at once. But did that mean smooth signups? Not necessarily.
The user experience was clearly much better, but that's only half of it. The back end, where insurance companies take in the information for processing, was problematic. Insurers complained of errors, garble and duplication, a data tangle that the government blamed mostly on a bug affecting Social Security numbers - soon overcome, officials said.
By the middle of the month, things were looking up, though not rosy.
On Dec. 20, Obama said more than a million people had been able to sign up for coverage, a big improvement over the 365,000 who'd had coverage three weeks earlier. But even as he announced the new number at a news conference, some applicants were having problems with the website.
Officials are braced for a late surge of insurance hunters. And for the 2014 installments of a drama seemingly without end.
NEW YORK (AP) -- With smokers exiled 12 years ago to New York City's sidewalks, some took up electronic cigarettes as a way to come in from the cold. They could puff away once again in restaurants, offices or even libraries without running afoul of the city's ban on smoking in indoor public places.
Now they're down to their last few puffs with the City Council's 43-8 vote Thursday to expand the smoking ban to include e-cigarettes. Outgoing Mayor Michael Bloomberg is expected to sign the measure, which he has pushed throughout his 12 years in office. The ban would then take effect in four months.
Also Thursday, the council paved the way for an eventual ban on plastic foam containers and approved the creation of a website that will help the public track federal dollars budgeted for Superstorm Sandy-related damages. The flurry of activity - more than two dozen introductions and resolutions were passed - came on the council's last legislative session of the year.
Speaker Christine Quinn said before the vote on e-cigarettes that the evidence on whether nicotine inhalers are truly safe is insufficient. She said allowing the devices in places where cigarettes are now banned also could "renormalize" smoking and undermine the public perception that the habit is now acceptable only in the privacy of one's own home.
"We don't want a step backward with that," she said.
The vote came amid sharp disagreement within public health circles over how to treat e-cigarettes. The tobacco-free smokes heat up a chemical solution and emit vapors while giving smokers their nicotine fix.
Manufacturers say the mist is harmless, and most scientists agree that regular smokers who switch to e-cigarettes are lowering their health risk substantially.
The devices, though, aren't heavily regulated. And experts say consumers can't yet be sure whether they are safe either for users or people exposed to second-hand vapor puffs.
Like regular cigarettes, the nicotine in e-cigarettes is also highly addictive. People who use them may be unable to quit, even if they want to. That has raised concerns that a new generation of young people could gravitate toward e-cigarettes and wind up hooked for life or even switch to tobacco cigarettes.
The Food and Drug Administration has said it intends to regulate e-cigarettes as tobacco products but has yet to issue any rules, leaving manufacturers free to advertise while regular cigarette ads are banned.
Several states, including New Jersey, Arkansas, Utah and North Dakota, have already expanded their indoor smoking bans to include e-cigarettes. Other bans have been proposed in several big cities. About half of the states restrict sales to minors.
At a City Council hearing earlier this month, city Health Commissioner Thomas Farley urged the council to approve a ban, saying the city couldn't risk rolling back the progress it has made driving down smoking rates.
The American Lung Association and the Campaign for Tobacco-Free Kids agreed. Other public health advocates did not. They said that in a nation where roughly 1 in 5 adults are hooked on indisputably deadly cigarettes, safer alternatives should be embraced, not discouraged, even if science hasn't rendered a final verdict.
E-cigarette manufacturers say they don't believe their products will be used as a gateway drug to cigarettes, and they have criticized New York's proposed ban as a rush to judgment.
"Companies like us want to be responsible, but when you have municipalities prematurely judge what should be and what shouldn't be, based not on the science, I think it does the public a disservice," said Miguel Martin, president of e-cigarette brand Logic.
While the measure's advocates say e-cigarettes resemble tobacco smokes enough to confuse restaurateurs trying to enforce smoking laws and send a message of social acceptability, manufacturers say that reasoning is muddled.
"That's like saying we shouldn't be able to sell water because it looks like vodka," Martin said.
The foam bill allows lawmakers to ban the product - technically called expanded polystyrene foam - if after a yearlong study the commissioner of the Sanitation Department finds the material can't be recycled effectively. It takes a long time to break down in landfills, and there's debate over how readily it can be recycled once it's soiled by food.
An online database to track the use of Sandy funds already exists and is operated by the Bloomberg administration. Thursday's bill will update the website, creating a searchable, interactive online tool that allows users to look-up by zip code information about how federal Sandy dollars are being spent.
Associated Press writers David B. Caruso and Jennifer Peltz contributed to this report.