Jesica Santillan

Jesica Santillan was a 17-year-old girl who secretly traveled to the United States from Mexico with her family in hopes of finding medical help for her congenitally enlarged heart and lung failure (Kher & Cuadros 2003). After settling into Louisburg, North Carolina, the family was met with an issue—Jesica’s condition had worsened, but they could not afford the $500,000 operation. Mack Mahoney, a local building contractor, heard about the family’s struggle and set up a foundation to raise money for the operation. The fundraiser was ultimately successful in raising sufficient money, and Jesica received a heart-lung organ transplant on February 7, 2003 at Duke University Hospital; however, she mistakenly received a pair of organs that did not match her O-positive blood type (Stein 2003).

Prior to the operation, Santillan was expected to have approximately six months left to live. Correct information regarding her blood type was given to the surgical team who flew out to Boston to collect the transplant organs, but for unexplained reasons, the doctors had collected type-A organs rather than type-O-positive (Associated Press, “Hospital” 2003). Santillan was admitted to the hospital and anesthetized while the organs were still in transit. A few hours following the implementation of the wrong organs, Dr. Jaggers received a call from the laboratory from which the organs came, stating that the organs were incompatible with Santillan’s blood type. Santillan immediately underwent aggressive therapy in an attempt to minimize the effects of organ rejection as doctors searched for a second set of organs.

Twelve days after the initial organ transplant, a CT scan suggested that irreversible brain damage had not yet occurred. A heart and set of lungs matching the blood type of Santillan were received later that same evening. Dr. Jaggers discussed the prospect of a second heart-lung transplant with the family and hospital and a second surgery was performed the next morning. Immediately following the second surgery, Santillan’s organs were functioning in an acceptable manner and there was no indication that her neurological state had changed. By the next morning, however, her neurological state had rapidly declined and proceeding CT scans showed swelling and bleeding in the brain. A series of tests were performed, and Santillan was shown to have no brain function. By 1:00 P.M. on February 22, she had met the official criteria for brain death and was pronounced dead (Associated Press, “Chronology” 2003).

Duke, which is renowned for its quality care, attributed the mistake to human error, a lack of caution, and to an inattention in assuring that the transplant organs matched the blood type of the recipient. The doctor who made the error, Dr. James Jaggers, made a public apology in which he took full responsibility and promised that he had done everything in his power to keep the patient alive (Archibold 2003).

Ultimately, Jesica Santillan’s case underscores a controversial debate over the ethics of second-transplant operations, especially when human organs aren’t freely available. Santillan received new organs within a matter of days, while most people have to wait a couple of years. People have questioned the ethics behind the second transplant, not only because Santillan was an illegal immigrant, but also because the second transplant may have been improper and could have potentially saved the life of another individual who has been waiting longer. Many questioned why an illegal immigrant was prioritized over legal citizens who have waited for years. Hospital officials have spoken out of the matter and stated that they have the right to put whomever they feel is deserving on the national waiting list. Organs are accepted from donors, regardless of their legal status, so the thought is that it would be hypocritical to not accept these same individuals as recipients of organ transplants (Grace 2003).

The medical error that occurred in Jesica Santillan’s case is extremely relevant to the politics of health for two reasons. First, it highlights the contradictory attitudes and policies of the American health system in relation to immigrants. This is seen in the ways in which Santillan was portrayed in the media—sometimes as an innocent young girl in dire need of help; other times as an undeserving immigrant who stripped another vulnerable individual of potentially life-saving organs (Hoffman 2006). Secondly, it questions the safety and quality of medical care and raises the issue of potential reform. Research has shown that most medical errors occur by well-intentioned people in flawed systems (Kohn, Corrigan, & Donaldson 2000). The American healthcare system is advanced and well-respected in many ways, but it isn’t perfect. Not only do medical errors put the patient’s life at risk, but they also cost a lot of money that could have been allocated elsewhere. New strategies and standardized protocol need to be considered and implemented to improve patient safety and to reduce the likelihood of Santillan’s case happening to someone else.

Moreover, cases such as Santillan’s have contributed to the debate on malpractice insurance. Doctors claim this increase is a result of the large sums of money that are awarded in malpractice trials. As a result, former President Bush urged for a limit on the amount of noneconomic compensation awarded in such trials. Noneconomic meaning the amount of compensation given to someone whose loss would not cause the family economic harm. On March 13, 2003, the House of Representatives passed a bill that declared that compensation for pain and suffering would be limited to $250,000 in trials resulting from medical error (Tanne 2003). Santillian’s case, in particular, was discussed during this point in history because Jesica serves as an example of the kind of patient who would suffer as a result of such a legislation because her death did not result in her family losing income because she did not work (Stolberg 2003). This relationship between health and the ability to work also relates back to the concept of politics of health because of Americans’ cultural ties between health and productivity. The passing of this legislation in particular is indicative of the way in which individuals are valued in the healthcare process and directly illustrates a positive relationship between salary and an individual’s worth.

References

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Associated Press. “Chronology Of Events Regarding Jesica Santillan Transplant 12345Attempts.” WRAL.com. February 22, 2003. Accessed February 04, 2017. 12345http://www.wral.com/news/local/story/104296/.

Associated Press. “Hospital Had Data Before Transplant Error.” The Washington Post. 23145February 20, 2003. Accessed February 04, 2017. 12345https://www.washingtonpost.com/archive/politics/2003/02/20/hospital-had-12345data-before-transplant-error/bff6cfc7-f6ad-47bd-9a80-12345471147370af9/?utm_term=.a42e891b4e69.

Grace, Francie. “Final Goodbye To Jesica Santillan.” CBS News. February 18, 2003. 12345Accessed February 04, 2017. http://www.cbsnews.com/news/final-goodbye-to-12345jesica-santillan/.

Hoffman, Beatrix. “Sympathy and Exclusion Access to Health Care for Undocumented 12345Immigrants in the United States.” In A Death Retold, 238-54. University of North 12345Carolina Press, 2006.

Kher, Unmesh, and Paul Cuadros. “A Miracle Denied.” Time. February 23, 2003. 12345Accessed February 04, 123452017. http://content.time.com/time/magazine/article/0,9171,425866,00.html.

Kohn, Linda T., Janet M. Corrigan, and Molla S. Donaldson, eds. “Errors in Health Care: 12345A Leading Cause of Death and Injury.” In To Err is Human. Washington, D.C.: 12345National Academies Press, 2000.

Stein, Rob. “Girl Has Second Transplant After Error.” The Washington Post. February 1234521, 2003. Accessed February 04, 2017. 12345https://www.washingtonpost.com/archive/politics/2003/02/21/girl-has-second-12345transplant-after-error/f147f4ae-3cbf-44d4-9578-123457c3b64c6cb3c/?utm_term=.e8fd61fee435.

Stolberg, Sheryl Gay. “Transplant Mix-Up Enters Debate on Malpractice Bills.” The New 12345York Times. February 25, 2003. Accessed April 03, 2017. 12345http://www.nytimes.com/2003/02/26/us/transplant-mix-up-enters-debate-on-12345malpractice-bills.html.

Tanne, Janice Hopkins. “When Jesica Died.” BMJ : British Medical Journal. March 29, 123452003. Accessed April 03, 2017. 12345https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1125622/.