After two heart-lung transplants and nearly two weeks of life support, perhaps the frail body of 17-year-old Jesica Santillan just had enough.
Jesica was declared dead at 1:25 p.m. Saturday, following confirmation from several brain scans and neurologic examinations that she had lost all brain activity.
Life support was continued throughout the afternoon so the family could say goodbye, and Jesica's brand new heart stopped beating at 5:07 p.m.
On Feb. 7, a heart and lungs of incompatible blood type were initially transplanted into the girl, whose body rejected the organs, necessitating a second transplant. Following nearly two weeks of life support and declining health, a compatible set of organs was located and transplanted into Jesica early Thursday morning.
A CT scan conducted 3 a.m. Friday revealed life-threatening swelling and bleeding within the brain, forcing placement of a catheter to drain fluid and measure pressure.
Evaluation by a neurologist that morning established irreversible brain damage and a lack of brain function. Further tests and scans followed Saturday, and by 1 p.m., a neurologist confirmed that Jesica met the criteria for brain death.
A day before the second transplant, a CT scan did not reveal any irreversible brain damage, maintaining Jesica's eligibility for organ transplantation.
Kurt Dixon, an attorney
"Jesica's family and the family of Mack Mahoney are devastated by these turns of events," he said.
Dixon indicated the family is considering a lawsuit but declined to say anything specific.
An autopsy is planned for Monday, said Dixon. "We just want to make sure we know what the cause of death was," Dixon told the Associated Press Sunday. "If there's going to be legal action down the road, you want to have a definite cause of death. You don't want to speculate about that."
Controversy has arisen over whether the family had given the Hospital permission to remove Jesica from life support.
The family had initially requested a second opinion on the girl's condition from outside the Hospital, but Dr. Karen Frush, assistant clinical professor of medicine and chief director of children's emergency services at the Medical Center, informed them that was not an option by state law.
"All requests by the family, such as second opinion or continuation of ventilator and medication support, were not options in the setting of death," Frush said in a statement released late Sunday.
Despite their reported hopes that Jesica's case would publicize the need for organ donations, the family refused to allow Jesica's own organs to be donated, Frush explained in the statement.
Jesica had suffered from health problems almost since birth.
While living in Mexico, her birthplace and home for 14 years, she had been diagnosed with restrictive cardiomyopathy, characterized by an enlarged heart that impressed on her lungs. With little chance for a needed heart-lung transplant in Mexico, the Santillan family illegally immigrated to the U.S. three years ago, specifically seeking out Durham and Duke Hospital.
Jesica was officially placed on the transplant list for a heart and lungs in May 2002, when her condition had deteriorated to the point when only new organs would save her. Feb. 6 of this year, her family was notified that organs had become available, and they were transplanted into her the next day.
It was revealed later that the type-A organs were mistakenly transplanted into the girl, who had type-O-positive blood--an eventually fatal mismatch.
In a candle-light vigil Sunday night, a somber crowd of about 60 mourners gathered across from Duke Hospital to share grief with the Santillan family. Children passed out flowers, candles and white balloons as the crowd prayed in Spanish and held signs high for the gathering press. "Jesica is an example of courage and valor," said one sign in Spanish.
The vigil was principally organized by the Association of Mexicans in North Carolina, to demonstrate their support. "The reason we're here is to show solidarity with the family and the community," said organizer Gloria Sanchez. "This is such a terrible mistake. We don't want this to happen to anyone ever again--not just Mexican, but anyone."
Get The Chronicle straight to your inbox
Signup for our weekly newsletter. Cancel at any time.