Doomed Baby Stillborn, Making Transplant Of Most Organs Impossible
Dec. 23, 1987
LOMA LINDA, Calif. (AP) _ A woman who wanted to donate her doomed baby's vital organs for use in transplants delivered a stillborn girl Tuesday afternoon, making most organs useless for transplant, officials said.
The case of the child delivered by Brenda Winner, 30, of Arcadia thus ended without resolving medical ethics issues that were hotly debated and that have been closely watched by right-to-life groups.
Mrs. Winner went into labor and was admitted to Loma Linda University Medical Center about 1 a.m., said Anita Rockwell, a spokeswoman for the hospital where Dr. Leonard Bailey has pioneered newborn heart transplants.
Shortly after 5:30 p.m., it was announced that the child was stillborn, despite efforts to resuscitate it. While most of the organs were unsuitable for transplant, the infant's heart valves and corneas could still be used, Dr. Joyce Peabody said. Doctors planned to remove the organs from the baby's body Tuesday evening, she said.
''We are all very sad to have to report to you some very sad news,'' Peabody said. ''This afternoon at 3:49 p.m., she delivered a little girl with no signs of life. ... Resuscitative efforts were stopped at six minutes of age.''
The physicians had persisted briefly, believing they might have detected a heartbeat after about three minutes, before giving up three minutes later, she said.
Mrs. Winner and her husband, Michael, a 29-year-old utility worker, learned in August their unborn child suffers anencephaly, a fatal, congenital defect in which most of the brain is missing or severely underdeveloped. They wanted their baby's organs donated for use in transplants.
''I hope that he will live on somehow,'' Mrs. Winner said earlier this month of the child she planned to name Jarren, regardless of its sex. ''And I hope the doors are open now for other parents.''
Dr. Elmar P. Sakala, the chief of obstetrics, described the delivery as ''probably one of the most difficult deliveries I've ever had.''
The doctors said they might have had better luck resuscitating the infant if the delivery had been easier. But they said they did not perform a Caesarean section because the surgery posed an unjustifiable risk to Mrs. Winner.
Asked how Mrs. Winner and her husband were doing, Sakala said they both were grieving not only for the loss of their daughter but because they had hoped their child's vital organs could be donated.
Peabody, who participated in the delivery, said about half of anencephalic children are stillborn.
''The issues about brain death and prolonging life obviously did not come into play because the baby was born dead,'' the physician continued. She said the hospital would continue its efforts to make use of anencephalic babies for organ transplants.
''I think I stand on that and our feelings on that have not changed,'' she said. ''If a family approaches us ... based on our experience today, we would still want to try it again.''
The physician said the mother felt ''sadness and relief that the pregnancy is over. Brenda was described as a reluctant pioneer and that's how I would see her.''
Bailey long has advocated saving the lives of babies with fatal heart defects by giving them hearts transplanted from anencephalic babies who are declared brain-dead. In 1984, Bailey transplanted a baboon's heart into Baby Fae, who died after 20 1/2 days, a procedure spurred by a critical shortage of newborn heart donors.
The anti-abortion Right to Life League of Southern California had been watching the Winner case, in an effort to make sure the child was brain-dead before its organs are transplanted.
''No live - and the key word is live - anencephalic child should be used for organ transplantation,'' said Susan Carpenter-McMillan, the group's president-elect.
Anencephalic infants die within days to weeks after birth as their breathing, controlled by the brain stem, slowly fails. However, because death comes slowly, the infant's organs are damaged and become unsuitable for transplantation.
Loma Linda had hoped to to keep the Winner child's organs healthy, had she not been stillborn, by keeping the baby on a respirator for up to seven days, periodically testing whether she could breathe on its own.
Under Loma Linda's new policy on the use of anencephalic babies as donors, if an infant cannot sustain breathing without a respirator and meets certain other criteria, it can be declared brain-dead so its organs could be used for transplants.
If the child isn't declared brain-dead within seven days, the respirator would be disconnected and the infant allowed to die naturally.
The California Pro-Life Medical Association had sent a letter to San Bernardino County Coroner Brian McCormick, asking that a medical examiner personally confirm brain death before an infant's organs are removed.
Mrs. Winner said that after learning of the unborn baby's condition through an ultrasound test on Aug. 29, she called 118 hospitals to find one willing to consider her child as an infant donor. Loma Linda accepted the Winners' unborn child as a potential donor earlier this month.