20-year-old woman in Reno end-of-life case dies

RENO — A private autopsy is planned to determine how a 20-year-old college freshman died while on life-support in the midst of an end-of-life court battle, the family’s lawyer said Tuesday.

Aden Hailu, of Las Vegas, died about 4:30 p.m. Monday at Saint Mary’s Regional Medical Center in Reno, said David O’Mara, the attorney representing Hailu’s father and family.

Hailu never woke from anesthesia after surgery in April, and doctors first pronounced her dead May 28, but her father, Fanuel Gebreyes, went to court to delay removing her from life-support.

Correcting an earlier Associated Press report, O’Mara said hospital officials told Gebreyes on Monday that Hailu’s heart stopped and resuscitation efforts failed — not that the cause of death was respiratory failure.

The family is making arrangements for a private autopsy, O’Mara said.

The Washoe County coroner was notified but didn’t plan a medical examination because the death was at the hospital and a public autopsy isn’t required, said Lynn Sack, aide to Coroner Ellen Clark.

“The hospital asked the family to have an autopsy done,” O’Mara said. “In this situation, we think an autopsy will be helpful to find out the true cause of death, and it may provide guidance about how these cases are handled in the future.”

Gebreyes was at the hospital when his daughter died, the attorney said, and he noticed Hailu was having trouble breathing — even with a ventilator. But Gebreyes wasn’t in the room when hospital staff later told him that monitors signaled Hailu’s heart had stopped.

Saint Mary’s officials declined to immediately comment about the case. Spokeswoman Jamii Uboldi cited patient privacy provisions of the 1996 Health Insurance Portability and Accountability Act, or HIPAA.

Uboldi said administrators need Hailu’s father, Fanuel Gebreyes, or a legal representative to allow them to talk about Hailu’s death. O’Mara said Gebreyes was considering the request.

Two medical ethics and law experts reached by AP said the hospital’s interpretation is proper. HIPAA regulations about the release of medical records apply for 50 years after a person’s death, said Timothy Jost, law professor emeritus at Washington and Lee University, and Arthur Caplan, at New York University’s Langone Medical Center.

Hailu was a freshman at the University of Nevada, Reno. Saint Mary’s said in court filings that she suffered severe low blood pressure and a lack of oxygen to the brain April 1 during surgery to remove her appendix and explore the cause of abdominal pain.

The Nevada Supreme Court ruled in November that Washoe County Family Court Judge Frances Doherty was too quick to reject the family’s bid to keep Hailu on a ventilator and intravenous fluids.

The Supreme Court sent the case back to Doherty for more hearings about what justices acknowledged was an “extraordinarily broad standard”: Whether Saint Mary’s met state law requiring a finding that irreversible cessation of brain stem functions met “accepted medical standards” that are “uniformly applied among the states” that enact the Uniform Determination of Death Act.

Nevada is among 37 states and the District of Columbia with laws based on the act, according to the National Conference of Commissioners on Uniform State Laws.

Last week, the judge gave Saint Mary’s the go-ahead to conduct brain wave tests that the hospital said would confirm doctors’ determinations that Hailu was brain dead and wouldn’t recover. But the judge indicated she wouldn’t rule until on the question of life or death until at least Jan. 22

O’Mara said Tuesday it didn’t appear new EEG tests had been performed but he had no more immediate information.

O’Mara earlier accused the hospital of wanting to end life-support to cut costs. He said Gebreyes felt that as long as there was a chance Hailu was alive, the hospital should treat her or find a place that would.

Attorneys representing the hospital argued it was unfair to force the hospital to treat Hailu indefinitely.

The hospital maintained that money wasn’t the issue, but that administrators needed to respect doctors’ medical judgment.

Saint Mary’s doctors said three EEG tests conducted during the first two weeks of April showed declining brain function, and no EEG tests were performed after that.

Gebreyes then refused to consent to new brain wave tests. He insisted that Hailu needed treatment, not tests, including thyroid medication and a tracheostomy so she could receive nutrition through her throat, not just intravenous fluids.

The judge told the father he could move Hailu to another facility if he wanted, but O’Mara has told AP the family couldn’t immediately find a place to take her.