Sacramento judge to rule on continuing life support for brain-dead toddler

It’s been nearly a month since toddler Israel Stinson was declared brain dead at a Kaiser Permanente hospital in Roseville, but the 2-year-old’s life remains in limbo.

While the curly-haired boy lies hooked up to ventilators in a Kaiser pediatric unit, lawyers for his parents and the hospital were in federal court Wednesday, fighting over who has the right to determine whether he is legally dead.

His mother, Jonee Fonseca, has filed a lawsuit seeking a preliminary injunction that would bar Kaiser from disconnecting Israel’s ventilator. She and Israel’s father, Nathaniel Stinson, want him stabilized with breathing and feeding tubes installed so he can be transferred to another hospital or long-term care facility.

In his remarks, one of Fonseca’s attorneys, Kevin Snider, said time is of the essence, based on Kaiser’s description of the continual care required to keep Israel’s vital signs monitored and his organs functioning. “As things stand, he would not be able to continue on for much longer. We are trying very hard to keep him stable so he can be transferred to someplace else.”

The couple and their relatives said they have contacted numerous hospitals and long-term care facilities, as far away as Canada and New Jersey, but none has agreed to accept their son unless he is off a ventilator and has a feeding tube and a breathing tube installed.

“It’s one big roller coaster of emotions,” said his mother, a pharmacy technician in Vacaville. “These doctors are telling you there’s no hope, but then you go see your son and he moves to your voice and your touch. ... You realize there is hope.”

After questioning attorneys on both sides for about an hour, Judge Kimberly Mueller said she would issue a ruling by the end of this week.

Kaiser physicians and their attorneys have repeatedly expressed sympathy for the parents’ plight but said there is nothing that can be done to change the 2-year-old’s “irreversible” condition.

In a statement issued after the court hearing Wednesday, Dr. Chris Palkowski, chief of staff at Kaiser’s Roseville Medical Center, said “Our hearts go out to this family as they cope with the irreversible brain death of their son. We continue to offer our support and compassion to the family during this sad time. We will continue to follow the court’s directions.”

Fonseca, 23, said she held her son in her arms at Kaiser on April 22 and he took “a deep breath apart from the ventilator,” followed by by another deep breath 30 minutes later. She also said Israel moved his neck, shoulders and head, “as if trying to get comfortable.”

Kaiser officials maintain that those movements are not signs that he will ever recover. “While it is understandable that a parent in plaintiff’s situation would want to look for any sign of improvement or brain function, in Israel’s case, what the parent may be noticing has nothing to do with Israel’s brain function.”

In court documents, Dr. Michael Myette, the toddler’s primary care physician at Kaiser, stated that Israel’s movements are involuntary “spasms that emanate from the spine” and are not indications that his brain is responding to external stimulus.

Nearly a month has passed since Israel was declared brain dead – three times – by different physicians.

According to court documents filed by Kaiser Permanente attorneys, Israel has been treated by three hospitals since April 1, when he was taken to a Mercy Hospital emergency room. Given his severe condition, he was transferred to UC Davis’ pediatric intensive care unit where he suffered a respiratory attack that led to cardiac arrest. UC Davis physicians declared him brain dead, but his parents chose to have him transferred to Kaiser Hospital in Roseville for a second opinion.

Kaiser followed California’s Uniform Determination of Death Act, part of national standards that determine brain death, based on separate examinations by two physicians, at least 12 hours apart in the case of children. Kaiser’s determination of brain death was upheld by a California Superior Court ruling last month.

The parents’ attorneys have gathered support from doctors and a religious professor in their case against Kaiser.

An expert witness for the family, pediatrician Dr. Paul Byrne, who flew in from Ohio for Wednesday’s hearing, said he has visited Israel several times in the hospital, including Tuesday night, and has seen him seemingly respond to his mother’s touch and voice.

“He’s a beautiful little boy. He has movements, not reflexive movements, but what I would call purposeful movements,” Byrne said. “There’s a good chance he can get some recovery, but you can’t tell how much.”

Byrne represents the Life Guardian Foundation, a religious-based organization that believes life does not end when a person is still breathing. “Brain death is fake death,” he said Wednesday. “Israel is a living boy. He’s not dead.”

Byrne, who is not medically licensed in California, also consulted with the parents of Jahi McMath, the Oakland teenager who was declared brain dead in 2014 after cardiac arrest and complications from sleep apnea surgery. Her parents fought to keep their then-13-year-old daughter alive on a ventilator and eventually won permission to transfer her to New Jersey, which allows brain-dead patients to remain on life support if there are religious objections to ending that support. McMath has remained in New Jersey ever since, hooked up to breathing apparatus.

John A. Nash, a minister and a professor at Beulah University, a Christian college in Atlanta, said he has known Israel’s parents for years and is familiar with their “deeply held beliefs regarding the end of life.” As Christians, he said in a court filing, they do not believe that human life ends until the heart stops beating.

In the last 28 days, an online fundraising effort, “Save Israel’s Life” on GoFundMe.com, has raised about $12,600 for his medical expenses.

The couple, who also have a 1-year-old daughter, are on paid disability from work to tend to Israel and make court appearances.

This story was originally published May 11, 2016 at 7:19 PM with the headline "Sacramento judge to rule on continuing life support for brain-dead toddler."