Transplant Teen Dies

Jesica Santillan, the teenager who survived a botched heart-lung transplant long enough to get an odds-shattering second set of donated organs, died Saturday afternoon.

She was declared brain dead at 1:25 p.m., and taken off life-support machines at about 5 p.m., said Duke University Medical Center spokesman Richard Puff.

He said he did not know if the hospital had the family's consent to turn off the machines.

An attorney for the family, Kurt Dixon, had said hours earlier that the Santillan's had wanted to keep Jesica alive and get another, outside opinion on her chances of recovery, but that permission to do so had been denied by hospital officials.

CBS News correspondent Mark Strassman reports that, under North Carolina law, the hospital didn't need the family's permission to take Jessica off life support, but the stage may be set for a potential legal tussle.

Hospital spokesman Puff had said earlier Saturday that tests showed Jesica had lost all brain activity, and blood was no longer flowing to her brain.

"Based on the results of these tests, Jesica's doctors have pronounced that Jesica has died," Dixon said.

Strassman reports that, before Jesica died, the hospital asked the family if they would like to redonate her heart and lungs. The family refused.

Though the newest organs, transplanted Thursday, were performing well, her brain began swelling and bleeding shortly after surgery, causing severe and irreversible brain damage, doctors said.

Jesica had been unconscious since the first transplant, when her body rejected the donor organs that didn't match her O-positive blood. Her health continued to deteriorate, and by the time a matching donor was found and the new organs transplanted, her condition was critical.

Dr. Karen Frush, the hospital's medical director of children's services said Friday there was no sure way to tell when the brain damage occurred. But Mack Mahoney, a family friend and Jesica's chief benefactor, said doctors told the family it was due to the time Jesica was connected to life support.

"Life support ruins kidneys, it ruins brains, it ruins all the organs of the body," he said.

Jesica's mother, Magdalena Santillan, said at a news conference Friday night that she believed hospital officials were not telling her the full story. She had said then that she wasn't ready to remove her daughter from life support.

Jesica had a heart deformity that kept her lungs from getting oxygen into her blood. Relatives have said her family paid a smuggler to bring them from their small town near Guadalajara, Mexico, to the United States so she could get medical care.

In the first operation, Dr. James Jaggers implanted organs from a donor with type A blood that were incompatible with Jesica's O-positive blood.

Hospital chief executive Dr. William Fulkerson said Jaggers wrongly assumed compatibility had been confirmed when he was offered the organs, and later failed to double-check that assumption, a violation of the hospital's procedures.

Duke officials explained the error in a letter sent Friday to the United Network for Organ Sharing, which matches patients with donated organs.

The letter was signed by Fulkerson and Dr. Duane Davis, surgical director of Duke's lung transplant program. They said Jaggers declined the organs for one patient who was not ready for transplant and asked Carolina Donor Services, an organ procurement organization, whether they were available for Jesica.

CDS officials checked the data and called back, offering the organs to Davis, who declined because they were the wrong size for his patient. The organs were then offered to Jaggers for Jesica, the letter said.

Mahoney, a building contractor who started a charity in Jesica's name, complained that image-conscious doctors hesitated to take the blame for the bungled operation and lost precious time in the hunt for new organs.

"If she dies, they murdered her," he said Friday.

Fulkerson pointed out that the second set of organs was found "in days" - under two weeks, compared to the three years Jesica had spent on a waiting list before the first operation.

"I think we have been honest and forthcoming with Jesica's family about her medical care every step of the way and we have accepted the responsibility publicly," he said.

Eighty percent of patients awaiting transplants die before organs can be found.

Jesica's place on the list was determined by several factors, including the severity of her illness and her age.

Her immigration status played no role because hospitals may place non-U.S. citizens on their waiting lists and must give them the same priority as citizens, said Anne Paschke, spokeswoman for the organ network. But they cannot perform more than 5 percent of their transplants on non-citizens.

Heart and lung transplants are rare for teenagers: In the first 11 months of 2002, there were four nationwide for children between the ages of 11 and 17, UNOS' records show. The previous year, there were four.