November 29, 2013

Justice for a Senseless Case of Untreated Jaundice

Although jaundice is not a welcome trait for a newborn, it’s not uncommon. About 6 in 10 U.S. newborns are at least mildly jaundiced — they have a tell-tale yellowish cast that signals elevated blood levels of bilirubin. It’s a naturally occurring reddish-yellow pigment in bile and blood, but if levels that are too high are left untreated, it can cause brain damage.

Usually, the danger is effectively neutralized with light therapy that turns toxic bilirubin into a water-soluble form the bodily easily eliminates. More difficult cases might need blood transfusions to rid the tiny body of its poison.

Six years ago, New York Methodist Hospital discharged a newborn without a proper exam despite his symptoms of jaundice. Even though his mother reported his yellowing skin, his doctor, Ioanis Atoynatan, did not follow up.

Six years later, Jaelin Sence, brain-damaged and permanently handicapped, received a $26 million judgment from a jury for the tragic case of malpractice.

“I don’t know if I’ve seen a more preventable case,” said his attorney, Thomas Moore, on the “It’s heartbreaking to see a child like this.”

Jaelin can’t use his arms and legs, and has never said “mama” or “dada.”

Fewer than 48 hours after he was born, Jaelin was sent home from Methodist Hospital despite rapidly yellowing eyes. Nurses apparently disregarded his mother’s concerns, and told her the problem would resolve on its own.

But Jaelin grew worse, and when he began vomiting, his parents rushed him to Kings County Hospital, where was diagnosed with hyperbilirubinemia (kernicterus) — the severe jaundice that causes brain damage and cerebral palsy.

Doctors performed two blood transfusions, but they couldn’t save Jaelin from the dire damage.

“They couldn’t save my son’s brain, but they saved his life,” Myrtho Sence told the Daily News.

The defense said it plans to appeal the jury’s award, but if it stands, it will allow the Sence family to provide 24-hour-a-day care for Jaelin.

All newborns are at risk for jaundice, but certain factors can predispose a baby toward it, including premature birth, incompatible mother-child blood groups and bruising.

To learn more about this kind of preventable brain injury, see our backgrounder.

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October 12, 2012

Chronic Conditions in Kids Raise the Risk of Hospital Medical Error

About 44 in 100 pediatric inpatients suffer from chronic illnesses such as asthma, diabetes, epilepsy and cancer, according to the journal Pediatrics. And these sick kids are more likely to experience a medical error during the course of their treatment than patients who are seen for acute conditions.

In the study, medical errors were defined as abnormal complications to a specific medical procedure, adverse reactions to medications, infections and bedsores. But it is unclear how severe the medical mistakes were or if they caused significant or long-term harm.

Logic tells you that the increase in probability of a medical error is higher in someone who’s chronically ill—after all, the longer someone’s hospitalized and the worse his or her condition is, the higher the chances of complications from it. Duration and difficulty make treatment more challenging and exposure to infectious agents more likely.

The study involved 38 states in the 2006 Kids’ Inpatient Database (KID) to determine medical error rates. As reported on, not only was the medical error rate higher per 100 hospital discharges in children with chronic illnesses, but it was also higher per 1,000 inpatient days in children with chronic conditions.

In the 2006 KID:

  • more than 22 in 100 pediatric inpatients had one chronic condition;

  • nearly 10 in 100 had two chronic conditions;

  • 12 in 100 had more than three chronic conditions.

The researchers said that as many as 43 in 100 U.S. children have at least one chronic health condition, and almost 20 in 100 have two. These patients represent an increasing proportion of pediatric hospitalization, and account for the majority of noninjury hospital admissions. Children with special medical needs also are more susceptible to errors in emergency situations.

A report by the Institute of Medicine (IOM) found that nearly 98,000 people die in hospitals each year from a medical error that could have been prevented.

The message of the Pediatrics study was simple: The more chronic conditions a child suffers, the greater the likelihood that an error will occur when they are in the hospital. And the greater the need for parents to be strong patient advocates. To learn how, see our newsletter, “Protecting a Loved One in the Hospital.”

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