Radionuclide Evaluation of Brain Death in the Post-McMath Era: Epilogue and Enigmata

Abstract

O n occasion, a patient ’ s medical odyssey emerges from obscu-rity into the public domain. Jahi McMath was an unfortunate 13-y-old girl who suffered a cardiac arrest after surgery and was subsequently declared dead by neurologic criteria (hereafter referred to as brain death [BD]). Her family successfully petitioned the courts to prevent interruption of supportive care. She was maintained on a ventilator for 4.5 y until experiencing cardiopulmonary arrest in June 2018. Because the profound and protracted legal arguments surrounding Jahi ’ s medical course resulted in extensive media coverage, many clinical details were disclosed in the public domain, which served as a nidus for editorials and reviews in the medical literature. An article on radionuclide evaluation of BD appeared in this journal in 2016, reviewing the initial course of Jahi McMath ’ s illness and discussing the role of scintigraphy in the determination of BD ( 1 ). Jahi ’ s entire medical records were released, including images from a radionuclide BD examination ( 2 ). This editorial updates the prior report by providing additional clinical history, radionuclide images and their analysis, and a discussion of controversy and questions engendered by this tragic case. Clinical information presented here is in the public domain, either in previously published literature or with per-mission granted by Jahi ’ s mother.