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DURHAM, N.C. -- Jesica Santillan, the 17-year-old immigrant who came to North Carolina desperate for a new heart, died Saturday at Duke University Medical Center, two days after a rare second heart-and-lung transplant.
Doctors pronounced Jesica dead at 1:25 p.m. after two electroencephalograms showed her brain had no activity. Doctors removed her from a life-supporting ventilator at 5 p.m.
Jesica's convoluted and controversial story took on another layer of intrigue Saturday because of the possibility Duke physicians removed her from life support without her parent's permission -- a legally correct but perhaps morally questionable decision.
Jesica was kept on life support through the afternoon so family and friends could say goodbye, the hospital said in a statement. Medication to keep her heart going was discontinued at 5 p.m. Her heart stopped seven minutes later and a ventilator was then turned off.
Renee McCormick, a spokeswoman for a charity created to pay Jesica's medical bills, said the Santillan family didn't know until then that doctors were taking her off life support.
"They were hysterical," McCormick said. "The family's been treated so poorly. They're very hurt. These are human beings."
Jesica's parents, distraught from watching their daughter's health deteriorate after the first heart-lung transplant used mismatched organs, had hoped to get a second opinion about her condition, a request hospital officials offered and then withdrew, according to Kurt Dixon, the family's lawyer.
After Jesica was removed from life support, Duke spokesman Richard Puff told the New York Times no second opinion was given and none was refused.
Another Duke spokesman, Richard Merritt, told Knight Ridder Newspapers the family did not protest when Jesica was removed from life support.
But the decision was out of the family's hands.
Said Rosemarie Tong, a medical ethicist at the University of North Carolina-Charlotte: "If she is really brain dead, she's dead. She's not in a persistent vegetative state. She's not incurably comatose. It's not a question of whether we should let her die."
Brain death means the higher brain, which governs cognitive function, and the lower brain, or brain stem, which controls heart beat and breathing, are gone. In that case, doctors may disconnect life support without a family's permission.
"Once doctors make that determination of death, that's it," said Charlotte, N.C., health care attorney Keith Korenchuk. "That is a medical determination. The person is dead."
Three years ago, Jesica and her family moved from Mexico to North Carolina so that she could be treated for cardiomyopathy, a life-threatening ailment that left her heart and lungs weak.
She received a heart and lung transplant on Feb. 7 but suffered a heart attack three days later and slipped out of consciousness because the organs did not match her O-positive blood type.
Saturday, Dr. James Jaggers, the surgeon who performed the transplant, said: "I personally told the Santillan family about the errors that were made and then tried to do everything medically possible to treat Jesica and try to save her life."
The family declined a request from Carolina Donor Services to donate Jesica's organs, Merritt said. Duke did not say which organs could have been harvested.
-- Information from Knight Ridder Newspapers, the New York Times and the Los Angeles Times was used in this report.