Family outraged as hospital ends life supportMorphine overdose?By Tara Ravens
December 20, 2007 04:12pmA NORTHERN Territory family has reacted with anger as well as sorrow to the death of a man hours after a court ruled he be taken off life support.
The Melo family yesterday lost an 11th-hour bid to keep 29-year-old Paulo Melo on life support when they failed to prove to the NT Supreme Court in Darwin that he could come out of his coma.
The court agreed with doctors that further treatment would be futile.
Ninety minutes later, at about 4.30pm (5pm AEDT) yesterday, the Royal Darwin Hospital turned off the machines that were keeping Mr Melo alive.
He died about 9am (CST) today, shortly after the hospital gave him a morphine injection, said his family, who have welcomed a coronial inquiry into the death.
"My brother didn't pass away, he was forced on," Nelson Melo said today following his brother's death.
"We are devastated but we are also very, very angry."
Mr Melo had been on life support since his spinal cord was severed and he sustained serious head injuries in a head-on car crash in Kakadu National Park two weeks ago.
His family said even after his life support was turned off Mr Melo was breathing well and seemed to be talking.
"At eight o'clock this morning he was breathing well, he actually seemed to be breathing better than he had on the machine," Nelson Melo said.
"We were actually very confident and the family this morning had a sense of calm.
"Last night my mother, myself and the priest were at the hospital and he seemed to be talking. It sounds like 'hurt, hurt' and then 'dad, dad'."
The hospital told the family earlier this week that Mr Melo would never breathe independently again.
But the family claimed Mr Melo had begun to respond to them, moving his eyes and showing signs of breathing alone.
On Tuesday the territory's chief justice gave the family 24 hours to secure medical opinion that their son could survive his extensive injuries.
But yesterday afternoon Justice Dean Mildren rejected a request for another extension to fly a Sydney neurosurgeon to Darwin to make an assessment in person.
"On the medical evidence before me the case is futile," he said yesterday, as the court erupted into sobs.
Nelson Melo said today the family had already spoken to the coroner, who said she would investigate the matter fully.
"My mother is devastated, everyone in the family is....because of my brother's strong response (when he was taken off life support)," he said.
"We were happy and joyous because he seemed to be talking and that was the most anyone could hope for.
"Then for this to happen after they gave him the injection is so devastating and terrible."
The hospital's medical superintendent, Len Notaras, yesterday said every effort had been made medically and more than 20 specialists had agreed Mr Melo would not recover.
Asked if the hospital could have waited until after Christmas, Dr Notaras said there was no right time for something like this to happen.
It doesn't have to be an overdose to get the job done.
.
"Then for this to happen after they gave him the injection is so devastating and terrible."
============================================================
"Opioids are relatively potent agents with narrow therapeutic
ranges and effects on multiple organ systems.
Physicians are trained to exercise care in their use.
Morphine-like opioids characteristically induce
respiratory depression, hypotension, nausea, vomiting,
dizziness, sedation, mental clouding,
dysphoria, pruritus, constipation, increased pressure
in the biliary tract, myoclonus, and urinary retention."
http://www.ama-assn.org/ama/pub/category/13672.html
-------------------------------------------------------------
ADVERSE REACTIONS THE MAJOR HAZARDS OF
MORPHINE, AS OF OTHER NARCOTIC ANALGESICS, ARE
RESPIRATORY DEPRESSION AND, TO A LESSER DEGREE,
CIRCULATORY DEPRESSION, RESPIRATORY ARREST,
SHOCK, AND CARDIAC ARREST HAVE OCCURRED.
.
www.terrisfight.org