Case Summary: A-1026

From Alcor News, May 19, 2008

by Tanya Jones

Member A-1026 was admitted to the hospital in southern California in mid-April, 2008; and once there, he became infected with MRSA bacteria. He became septic and suffered renal failure, as the infection failed to respond to treatment. His condition worsened when the doctor ceased all treatment except that needed for the patient’s comfort, and he suffered cardiac arrest on 30 April at 06:30.

Our transport vehicle and personnel were nearby. Hospital personnel administered the first few stabilization medications and performed chest compressions until team members arrived. Alcor personnel had driven out with the transport vehicle the night before, so it was available for the case. Two members of the regional team assisted with the stabilization. They transported the patient to a local facility for washout after completing surface cooling, medication administration and cardiopulmonary support. Subsequent — and extensive — femoral surgery did not reveal femoral veins that were adequate to perfuse the patient. A straight flush was done using 18 liters of MHP-2 (our washout solution).

Due to delays in obtaining the doctor’s signature on the death certificate, transporting the patient to Arizona was nearly delayed an extra day. Because he was a neuro patient, we chose instead to perform a cephalic isolation in California. Doing this eliminated the immediate need for a transit permit, because the brain is considered a tissue sample and is not subject to the same regulations as human remains. It was a choice of last resort, and was only done because an additional 24 hours delay would prevent us from being able to cryoprotect the patient. The patient arrived at the lab at 00:25 on 1 May, almost exactly 18 hours after pronouncement.

We needed a half hour to prepare the patient, including making the burr holes and cannulating. The cryoprotection went exceptionally smoothly, and the only problem encountered was leaking that developed in two separate thermocouple ports in the circuit. These leaks did not impact the patient at all, but they were already an issue we knew had to be dealt with in future circuit designs. This experience simply gives us more reason to ensure we find alternatives sooner rather than later.

Cryoprotection concluded at 05:33 when we achieved (and sustained for 30 minutes) target concentrations, and the first stage cooling began shortly thereafter. Cooling concluded without incident, and he was transferred to long-term care on 15 May.

A-1026 is our 81st patient.