Jolted back to life? Doctors debunk the mystery behind the viral case

Doctors break the mystery behind the interesting case of UP's brain-dead woman who was apparently jolted back to life by a pothole while being taken home in an ambulance for her last rites and explain what is brain death and how it is caused.

A 50-year-old woman from Pilibhit, Uttar Pradesh, who was declared brain-dead was apparently jolted back to life by a pothole on way back her home in an ambulance where her funeral preparations were going on. Does this sound like a scene straight out of a movie?

But it is as real as it can be.

Another case in point is of a man who was declared dead but woke up at his funeral pyre. He died the next day. It was later revealed that doctors had skipped post-mortem examination which caused the confusion.

However, things might not be as they seem as doctors believe there's much more to the story than what meets the eye.

Dr Vinit Banga, Director-Neurology, Fortis Hospital, Faridabad, said that in the case of the woman, who was pronounced brain dead but later came back to life, was definitely not because of the pothole jolt.

"A pothole shock will not bring a dead person back to life. However, a person who was believed to be dead may still have weak breathing or pulse. The shock may help stimulate the body, increase circulation, or induce reflexes. In most cases, the event may be due to misdiagnosis, drug overdose, hypothermia or a deep coma rather than death," Banga told DH.

He also pointed out a medical phenomenon which mimics the signs of a patient coming back to life.

"In some instances, such as “Lazarus Syndrome,” the heart will begin beating again after CPR is stopped, causing the individual to seem as if they have come back to life," Banga added.

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Dr Lokesh B, Senior Consultant - Neurology, Aster CMI Hospital, Bengaluru, agreed with Banga and said that the people in such instances were probably alive but the condition they had experienced looked like death.

"The conditions in which people enter deep comas through drug overdose and extremely low blood pressure together with almost undetectable breathing patterns need medical equipment for accurate detection. Medical staff will, often, miss weak pulse and quiet breathing in places where they lack proper equipment to monitor patients," said Lokesh speaking to DH.

Before pronouncing someone death, Banga said, doctors check for a few tell-tale signs. "Absence of breathing, heartbeat, pulse, and blood circulation are checked before declaring a person dead. The reaction of the pupils to light, the brain stem reflexes, and the response to pain are also important factors to consider. An ECG test may be used to check for the absence of heart function," Banga explains.

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Can death misdiagnosis happen?

Banga said that false diagnosis of death is a very rare occurrence in contemporary medicine.

"It has a probability of less than 1 per cent in a hospital setting. Such incidents have been reported in the past either prior to the advent of modern monitoring or in a hospital setting where conditions, such as a weak pulse or unusual circumstances, led to the error," he explained.

However, the medical equipment and procedures currently used in hospitals achieve a death diagnosis accuracy rate that is nearly perfect.

"The medical profession has established comprehensive guidelines which mandate multiple examinations and supplemental testing procedures to establish brain death and other forms of death. Most cases where individuals "wake up after being declared dead" happen because medical professionals did not perform proper evaluations or because the patient did not receive constant medical care," Lokesh said.

Is brain death treatable?

Brain death, Banga said, is a medically and legally irreversible condition. The brain cannot be revived when all its functions cease. Brain death remains permanent and cannot be treated.

"The brain remains unrecoverable despite machines like ventilators which can sustain heart function and blood flow. Brain-dead patients may become organ donors when their family gives permission and the organs are still usable. The medical team will discontinue life-support systems because the person has been officially declared dead through medical and legal procedures," Lokesh concluded.

What is brain death?

Brain death occurs when a person completely loses all brain functions including brainstem activity due to a stroke or a traumatic brain injury.  

The brainstem controls essential functions which include breathing and the ability to stay conscious and the automatic responses of pupils and gag reflex. The medical team conducts multiple neurological tests to confirm that these functions have vanished from the patient.

"The apnea test functions as a primary examination which assesses whether the patient possesses the ability to breathe without assistance," Lokesh said.

Banga added that when it is medically confirmed by clinical tests that there is no consciousness, no brain stem reflexes, and no ability to breathe on one’s own, then the person is considered brain dead.