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While the details of Alyssa's case are extraordinary -- the Grandma Betty trick, the escape from the hospital with police on their heels -- the core of her story is not uncommon in many ways, according to patient advocates.Dr. Julia Hallisy, founder of the Empowered Patient Coalition, says families often tell her that a hospital won't allow their loved one to transfer to another facility. Often, they're afraid to say anything publicly or on social media."You sound like a crazy person -- that your family member was held hostage in an American hospital," she said. "People can't believe that would happen. It's like the stuff of a science fiction story."Kristen Spyker said it happened to her family.When Spyker's son was born with a rare heart defect, she says she told doctors at the Ohio hospital where he was born that she wanted him to have a surgical repair at a hospital with a larger pediatric heart program.She said the heart surgeon at the first hospital refused to send her son's medical records to other hospitals. She also says a surgeon resisted her efforts to transfer her newborn son to another hospital to get a second opinion on what surgery he should have for a rare heart defect."The surgeon said, 'This is my patient. This is my show. I'm the boss, and I say what happens,' " she said.She said a social worker, accompanied by hospital security guards, then came into her son's hospital room and said she was worried that Spyker had postpartum depression that was affecting her ability to make decisions for her son's care.Spyker said the hospital discharged her son only after she threatened legal action.Her son then had a successful procedure at another hospital -- a different procedure than the one recommended by the first doctor.When she told her story on Facebook, Spyker said, other parents shared similar stories."It was parent after parent after parent saying 'this happened to us,'" she said. "They had been so embarrassed to talk about it, but they felt freer when I said it happened to us."Spyker was one of several people who spoke with Alyssa's parents last year while their daughter was at Mayo.In a statement to CNN, the American Hospital Association addressed conflicts between families and hospitals."Communication between physicians and patients is extremely important in working to identify the best treatment," said Dr. Jay Bhatt, senior vice president and chief medical officer of the organization. "Each patient is unique. It is for this reason that the majority of hospitals have patient advocates on staff to help patients and families navigate the care process. Hospitals recognize that patients are critical members of any care team and many are employing new strategies to ensure their voice and perspective is heard and accounted for."When hospitals and families get into intense conflict, Hallisy, a dentist who practices in San Francisco, says human emotions can run amok. She says she saw it happen when her daughter, Katherine, was being treated for cancer."People think that doctors are immune to petty disagreements, but they're human beings, and sometimes ego and primitive emotions take over," she said.She said that in Alyssa's case, she wonders whether a sensitive hospital staffer, perhaps a social worker, could have prevented the situation from becoming as contentious as it did.She thinks back to her daughter, who died at age 10. She remembers the sadness and fear of having a very sick child, as well as the stress of taking care of her two other children and keeping her dental practice afloat while her daughter was in and out of the hospital.She thinks about how Alyssa was near death and how her parents had five younger children 130 miles away, as well as farms and a family business to run."They were under incredible stress," Hallisy said. "They'd almost lost a child, and they had other responsibilities, too. You would think that someone at Mayo would be trained to see that." 3956

Working separately from Gates' trial lawyers is the well-known Washington defense attorney Thomas Green. Green, who has known Mueller personally for years, is negotiating Gates' plea deal, according to people familiar with the case. He has visited the special counsel's office multiple times in the last several weeks. Green appeared with Gates yesterday in court, but is not handling his trial situation. 405

With about 150 million tons of plastic in the world's oceans -- and that number expected to triple in the next decade -- this type of trash disposal has real implications for climate change, the safety of sea life and industries such as fishing and tourism. It can also affect our health if plastic ends up in the food we eat."That plastic is still going to be there in one year. It's still going to be there in ten years," said 24-year-old Ocean Cleanup founder and CEO Boyan Slat. "It's probably still going to be there in 100 years, so really only if we go out there and clean it up this amount of plastic is going to go down."The trash collects in the middle of the U-shaped pipe until a garbage boat comes to collect it. The device has satellite pods that communicate with the company's headquarters in the Netherlands and other boats to share its location. It's controlled remotely and has two cameras located in the center.The Ocean Cleanup team has been researching and testing the pipe for the past five years. In 2013, the project raised over million through crowdfunding and has since raised over million.The group hopes the pipe will collect 50 tons of trash by April 2019 and clean 90% of the world's ocean plastic by the year 2040.But some experts question whether how much a system like this can be a real impact on such large oceans. It's also faced criticism for its inability to capture small pieces of debris and the possibility of some sea life getting trapped inside. Some critics also worry if the device could break down, whether due to malfunction or storms, and create even more ocean garbage.Eben Schwartz, the marine debris program manager at the California Coastal Commission, said his main concern is the percentage of plastic that floats and could be collected this way is too small to make a difference. He believes focusing on trash reduction with land-based efforts will be more effective."It's much more effective from a cost and prevention effort to stop trash from entering in the first place," Schwartz said.Schwartz added that his water and beach cleanup volunteer group collected between 7 and 10 times the amount of trash Ocean Cleanup wants to capture by spring 2019."We did it in three hours and for a fraction of the cost of The Ocean Cleanup's project."Although Schwartz said that cleaning up the oceans is important, he believes the attention around the project could curb other efforts to reduce waste."If this makes people feel like they don't need to worry about recycling because this thing is out there, that's a serious negative consequence," he said.The need to clean up our oceans is getting attention beyond this project. Last week, President Donald Trump signed the Save Our Seas Act, which aims to help clean ocean waste by extending its own ocean cleanup initiative, the Marine Debris Program, for five more years.It may not be the only effort around, but Slat believes his pipe will make a big difference."Back in the day people said, 'Well, there's no way to clean this up. The best thing we could do is not make it worse,'" Slat said. "But to me that's a very uninspiring message. Everyone wants the future to be better than the present, and that's what we hope to achieve." 3241

With Bianchi at the wheel, the officers chased Smith at speeds of more than 80 mph before the crash, according to the criminal complaint. 137

Witnesses told officers the driver of the Corvette was speeding westbound on El Norte Parkway and, after passing Fig Street, lost control of the vehicle and crashed into the hydrant and tree, causing extensive damage to the vehicle, Walters said. 246

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