While coverage of Jahi McMath’s case usually focuses on what happened after her catastrophic brain injury, the events leading up to her procedure warrant just as much attention, posits Pacific Standard.

Jahi McMath was 13 years old when she was brought to Children’s Hospital Oakland in December 2013 for a surgery to treat sleep apnea, a problem likely exacerbated by Jahi being overweight. Instead of beginning with less invasive approaches, such as prescribing a CPAP machine to facilitate breathing while asleep, an ear-nose-and-throat surgeon named Frederick Rosen recommended taking out Jahi’s tonsils, her adenoids, the soft palate of her mouth, and other nearby tissues.