Child Safety Tips: As mercury goes up, so do safety risks for kids!

By picpoke.com

Yes, it is really getting hot out there this week!!!  Coming from Florida to DC last year, I thought “OK, so it will not get nearly as hot up here, or at least not as early in the summer.”  Yes, I was wrong.  This thought brought me to thinking about some of the fun things to do in the summer, but also the dangers for our little ones during this time if we are not extra careful.  Lo and behold, I found this article today, courtesy of the Dallas Morning News and reprinted by the Kansas City Star:

Emergency-room professionals have their own name for the long, lovely, lazy days that kids look forward to in summer: trauma season. Because that’s when hospitals see a spike in drownings and heat-related accidents.

The article discusses several myths and related facts associated with those myths.  Here are a few samples from the article:

MYTH: Pool parties are safe as long as adults are around.

FACT: Many drownings happen when adults are close by. The problem is too much commotion. The key is to have a designated adult watching the water because that is where the danger is. The pool should be free of excess toys that can block the view of the water.

MYTH: Floaties keep little ones safe in the water.

FACT: Floaties are designed for fun, not safety. They give a false sense of security, can deflate and can slip off.

MYTH: The kids will be fine in the pool for the short time it takes to answer the phone or get a cold drink.

FACT: In a minute, a child can go under water. In two or three minutes, the child can lose consciousness. In four or five, the child could suffer irreversible brain damage or die. According to the Centers for Disease Control and Prevention, drowning is the second-leading cause of unintentional, injury-related death for children 1 to 14 years old, second only to car and transportation-related accidents.

The article states several other myths and facts, which include the hazards of leaving children unattended in cars and car seats, as well as sun exposure and dehydration.  We encourage you to read the article in its entirety.  Let’s all have a safe summer out there, please!!

Actor Dennis Quaid sues drug maker

Last month, we reported in a blog through our website, how actor Dennis Quaid is involved as a patient advocate, after his newborn twins nearly lost their lives back in 2007, from a medical error that could have very easily been prevented.  Put simply, the precious twins were given two doses of Heparin instead of Hep-lock (an anti-coagulant medication widely used for children).  Why is this significant?  Heparin is a drug one thousand times stronger than what the twins were supposed to have received.

Earlier this week, it was reported in the Contra Costa Times, that Mr. Quaid has filed a lawsuit on behalf of his children.  As far as the extent of his children’s injuries, the article states “The children suffered internal injuries and shock, but the extent of what happened to them will probably not be known for years, according to the suit.”  The lawsuit alleges that vials of the 10,000 unit Heparin should have been recalled previous to what happened to his children, because other infants had already died from similar medication errors.  The suit also claims that the company responsible for making the drug, Baxter Healthcare, “was obligated to warn healthcare providers of the previous medication mistakes.”

We wish the best for the Quaid family, and hope that the discovery in this case shines a light on not only finding out exactly what happened in this case, but also makes information available that may be able to save the lives of other children from future similar medical errors.  We will continue to monitor the course of this case.

Medical Malpractice: Newborn Carbon Dioxide Poisoning Results in Verdict of $16.5 Million

Dwight Peterson, Army Staff Sgt., and his wife Shalay presented to Tripler Army Medical Center in Honolulu, HI for an elective cesarean section in January of 2005. Their son Izzy was born a healthy child, but now requires 24 hour care.

The Star Bulletin reported that within just one minute after the birth of Izzy Peterson, pediatrician Army Major Danielle Bird mistakenly administered carbon dioxide, used for stomach surgery, to the healthy newborn. It was not until nearly 42 minutes had passed, and the carbon dioxide tank was almost empty that someone realized this tragic error. Oxygen was supplemented, but by the time this intervention was attempted, Izzy had sustained irreversible brain damage.

Soon after Izzy’s birth, the Peterson family relocated to San Antonio, TX where they have obtained specialized care for Izzy. Izzy is fed through a gastrostomy tube and breathes through a tracheostomy, which he will do for the rest of his life.

Rick Fried, the Peterson’s attorney, filed suit in which it was alleged that Major Bird, a pediatrician doing her fellowship in neonatology, should have noted the difference between the carbon dioxide and oxygen tanks prior to administration. You think?!

Bird…would have had to adjust the upright regulator of the free-standing cylinder clearly labeled carbon dioxide, different from the clocklike regulator attached to oxygen tanks…

Attorneys for the defense tried to claim early on that Izzy had been born with some type of defect; an at-home video of Izzy’s birth as a healthy baby boy proved otherwise.

“You see him take his hand, trying to brush it (the carbon dioxide) away,” Fried said. “Even at birth he knew it wasn’t good for him.”

Although severely brain damaged, Izzy maintains self awareness, can track movement with his eyes and recognizes and responds to his parents. Izzy can feel pain and kick a ball, but will never perform as an average child.

Not present for the decision, the Petersons were informed that federal judge, David Ezra, ruled in favor of the family. Dwight and Shalay Peterson were awarded $16.5 million, which will help to pay for Izzy’s extensive medical care.

Tripler’s Maj. Gen. Carla Halwey-Bowland said in a news release: “Tripler Army Medical Center accepts responsibility for this tragic incident and respects the decision made by the Honorable David Ezra. Our command and well-trained staff are committed to doing whatever it takes to ensure an incident similar to this never happens again, such as improvements in medical gas safety — how they are labeled and handled and staff education.”

Tripler Army Medical Center is the largest Army hospital in the Pacific basin. It contains over 200 hospital beds and provides medical care to almost 400,000 eligible patients. The Medical Center is accredited with providing the best medical care in it’s region, but even in the best hospitals, mistakes can be made.

Infant Safety – drop-down crib hazard; CPSC issues recall

In February of this year, we reported on the Consumer Product Safety Commission’s (CPSC) commitment to crack-down on the defective crib issues that have resulted in multiple deaths of infants on our blog site.  A report just released by the CPSC, which involves a comprehensive review of crib-related fatalities since January 2000 revealed the tragic statistics:  32 deaths since January 2000 and hundreds of related instances related to drop-side detachments in cribs:

In addition to the 32 deaths the CPSC staff associated with the drop-side detachments, CPSC has received an additional 14 reports of infant fatalities due to entrapment in cribs that could be related to a drop side. The information obtained was insufficient for staff to conclusively determine whether or not the drop side was involved. Of the 32 deaths that were analyzed, some occurred in cribs where the drop side detached without caregivers noticing the detachment, while some other deaths occurred after a consumer tried to repair the detached drop side, but the repair ultimately failed.

As a result, the CSPC is issuing a voluntary recall of ALL drop-side cribs, effective June 1, 2010. There will be new improved mandatory standards for cribs as well.  The CPSC announcement also provides cautions regarding older cribs and reminds parents to not use cribs with broken, missing of loose parts.

Let’s hope these new standards save infants from injuries and death!

Fetal Pain and Suffering: New Nebraska Abortion Law Sparks Debate – When Does a Fetus Feel Pain?

An online article posted yesterday in NewScientist raises some interesting issues that will no doubt be the subject of much debate in days, months and years to come – does a fetus feel pain and if so, when? The true focus of this article was the recent (April 13, 2010) passage of new legislation in Nebraska, which essentially prohibits abortions after 20 weeks.  Ostensibly, Nebraska has become the first state to ban abortions on the basis that fetuses feel and appreciate pain.

The law, according to a report in LifeSiteNews.com, goes into effect on October 15, 2010, and has, at a minimum, the following legal implications:

Abortionists who break the law would face a Class IV felony charge, which carries a penalty of a five year maximum prison sentence, $10,000 fine, or both. Women who obtain abortions of their unborn children would face no criminal penalties.

The bill would allow women and even the fathers of aborted unborn children to sue and seek damages from abortionists who violate the law.    

I say “at a minimum” since there are other civil law implications arising from  the rationale behind this legislation. One of those issues often litigated throughout the various courts of the United States is a parent’s right to sue for conscious pain and suffering for fatal or non-fatal injuries to a fetus.  That analysis is beyond the scope of this blog. What is of present importance is the so-called ‘science’ behind this legislation and the response of the scientific community that may well have far-reaching implications in the field of civil litigation.

Before engaging in this discussion, note well: it is not my intention (or desire) to become embroiled in the abortion issue.  That is not what we do in our firm.  It is the state of  science that intrigues me in terms of how that may have relevance to what we do – litigate civil cases involving matters such as fetal death in utero or death or injuries sustained by fetuses due to the negligence of third persons (e.g. medical malpractice, catastrophic automobile accidents and the like).

Apparently, the ‘scientific basis’ for this Nebraska legislation is the research of Kanwaljeet “Sunny” Anand, a professor at the University of Arkansas for Medical Sciences.  Dr. Anand testified in 2004 on the federal partial birth abortion ban.  He provided his opinion testimony that after 20 weeks gestation, an unborn child would experience “severe and excruciating pain” from an abortion.

Dr. Anand’s opinions are not without numerous critics.  What is significant, however, is that even many scientists, who challenge Dr. Anand’s opinions that 20 weeks of gestation is the point at which a fetus can feel and appreciate pain, do accept the proposition that there is a point in the life of fetus where they can and do appreciate pain and suffering.

Dr. Mark A. Rosen, the Director of Obstetrical Anesthesia at UCSF’s Fetal Treatment Center, in 2005 co-authored an article in JAMA (abstract) that some refer to as the ‘seminal review on fetal pain.’

One of the opinions expressed in that paper defines what is at the center of this discussion – what is meant by ‘perception of pain’?

Pain perception requires conscious recognition or awareness of a noxious stimulus. Neither withdrawal reflexes nor hormonal stress responses to invasive procedures prove the existence of fetal pain, because they can be elicited by non-painful stimuli and occur without conscious cortical processing.

In the NewScientist posting, Dr. Rosen provided rebuttal statements to the premise inherent in the Nebraska legislation that fetal pain occurs at 20 weeks of gestation.

Dr. Rosen states, “The first brain pathways associated with pain perception “are not complete before approximately 29 weeks of gestation”, so although fetuses develop brain wiring from about 23 weeks onwards, the connections are not there to enable them to experience pain.”

Whether it is at 20 weeks or 29 weeks, one common principle exists – according to a number of scientists, there is a point prior to birth that a fetus can appreciate pain from a medical-scientific standpoint – the ‘wiring’ is in place. If this is true scientifically, how does this affect the right of recovery by a parent or the estate of an injured fetus in those jurisdictions permitting conscious pain and suffering damages for injuries to a fetus?

For instance, if a fetus is at 35 weeks gestation and by all other accounts is totally viable with ‘the wiring in place,’ does that fetus and/or the parents have a claim for conscious pain and suffering should injury to the fetus occur?

Does any jurisdiction recognize the right of a fetus to recover for injuries sustained in utero?  Absolutely – it just depends which jursidiction(s) you are considering.  For example, the District of Columbia, in 1946, was the first jurisdiction to recognize the right of a fetus to bring a separate cause of action (Bonbrest v. Kotz). This was an action for damages being brought on behalf of a fetus allegedly injured ‘in the process of being removed from its mother’s womb.’ “Under the civil law and the law of property, a child en ventre sa mère is regarded as a human being from the moment of conception.”

In 1984, the D.C. Court of Appeals, relying in large part on Bonbrest, stated:

Although this court has never considered this question, we note that every jurisdiction in the United States has followed Bonbrest in recognizing a cause of action for prenatal injury, at least when the injury is to a viable infant later born alive.

Note the key conditions: “…when the injury is to a viable infant later born alive.

This posting is already perhaps too long – this topic is multi-faceted and more the subject of a treatise, white paper or a law review article, not a blog.  What is apparent (at least to me) is that this new Nebraska legislation will undoubtedly rekindle the fires of fascinating litigation about fetal rights, fetal and parental causes of action and fetal pain and suffering claims. Stay tuned – there will undoubtedly be much more to come.

How Dennis Quaid Became a Patient Advocate

On Monday, Dennis Quaid appeared on “The Early Show.” He talked about how he and his wife almost lost their newborn twins in 2007 as a result medical negligence.

According to Quaid, Thomas and Zoe Quaid were supposed to be given the anticoagulant drug, Hep-lock soon after their birth.  Hep-lock is a widely used anticoagulant designed for children. It is not nearly as potent as its adult counterpart, Heparin. By mistake, the newborns were given two doses of Heparin, which is 1,000 times stronger.  Quaid noted that the Heparin administration reduced the consistency of the newborns’ blood to that of water.  There was no justification for administering Heparin instead Hep-lock.

While the newborns managed to survive this ordeal, this experience has transformed Quaid into an active patient advocate. The actor helped create the Quaid Foundation, an organization dedicated to reducing medical errors. According to the article by CBS News:

Quaid has testified to Congress on behalf of patients’ rights, and Monday, he was to speak at the National Press Club to address the problem of dangerous medical mistakes.

The article further notes that the Centers for Disease Control and Prevention estimated that approximately 99,000 deaths every year are due to preventable medical errors. This is shocking to say the least.

Contributing author: Jon Stefanuca

Obstetricians’ Opinions Divided Over Umbilical Cord Blood Banking: Some Doctors Refuse to Cooperate

Earlier this week, ABC Australia posted a fascinating report on a modern practice by parents paying significant sums of money to store  (or bank) their baby’s umbilical cord blood.  While cord blood has been used widely by patients (not related to the donor) in other medical settings such as bone marrow transplants, this new practice is designed to help the donor babies later in life for treatment of conditions that they hope science will discover meaningful solutions for in the coming years.  According to the report, “The hope is that the young, versatile stem and immune cells in the blood could eventually be used to repair damage caused by anything from cystic fibrosis to a heart attack with no risk of rejection.”

What is occurring, however, is that not all physicians are accepting of this concept.

The subject of this news story, a West Australian mother, Barbara Ayling, has cerebral palsy.  This is one of the conditions that parents and researchers are hoping will prove to be treatable through stem cell research using umbilical cord blood.  Ms. Ayling and her husband had made arrangements to have their baby’s cord blood stored through the age of majority.  The plan went awry when the obstetrician who agreed to participate in this collection and storage process was unavailable and the delivery was performed by a different doctor who refused to carry out the procedure.

“It’s a choice that I have the right to make. Apart from anything else, I’m spending a phenomenal amount of money to do this,” Ms Ayling said.

“I’ve made a very informed decision and I would have liked that to have been more respected.”

The doctor declined to be respond when asked to do so by the station.

Further details about this banking program were provided by an online video.  The reporter asks her audience the opening question: “How much would you be willing to pay to guarantee your child access to a yet unproven but potentially life-saving cure for potential disease?”  It turns out that at least in Australia, that price tag varies between $3,000 to $6,000.  Unfortunately for some, this ‘investment’ in their child’s future health went the way of many investments – it tanked when the company storing the blood went out of business.

It is clear that this practice is not restricted to Australia.  More to the point, there are a number of companies in the United States ostensibly offering parents the same banking of their child’s umbilical cord blood.  For instance, a company called Alpha Cord, which according to its website has been in business since 2002, promotes the fact that it is different from other cord blood banking operations in the United States since it provides parents with an additional layer of security for their investment.

In the unlikely event the bank you’ve chosen should dissolve, we will move your cord blood to another licensed and accredited facility in our system. If you bank directly, there is typically no automatic or seamless provision for an adverse event such as this. (Source Alpha Cord website’s FAQ’s)

Alpha Cord provides its site’s visitors with videos about the process, purpose and benefits of storing a baby’s umbilical cord blood cells.  The benefits range from future transfusion needs to potentially successfully treating later disease and/or injuries.  Alpha Cord advises that currently hundreds of thousands of parents have elected to store their baby’s cord blood.  In its comparative pricing chart, it compares its reduced price (ostensibly due to networking discounts) and parents are offered a geographical locator for participating banks and then an online calculator with options for how many years one may want to store their child’s cord blood.

60 Minutes Picture of Keone Penn cured by stem cell treatment

For example, if a parent were to store their child’s cord blood in Utah, the initial fee would be $775; whereas, storage in Chicago, New Jersey or Colorado would cost $1,395.  Annual storage fees for Alpha Cord are $115 with a 20 year storage plan amounting to $2,180.  If you would like to get a ‘comparative shopping list,’ Alpha Cord provides such a chart.

Given the unwillingness of the Australian mother’s obstetrician, parents planning to utilize this service might be well advised to confirm that their obstetrician and those who might be covering for him/her are on board with the collection process.  If  you have had experience with this or similar programs but have encountered resistance by your obstetrician or hospital, sharing your experiences might be of great value to others considering banking of their child’s cord blood.

CDC Features – Data Show 1 in 303 Children Have Cerebral Palsy

Cerebral palsy – how common is it? A recent “Features” posting by the CDC (Centers for Disease Control and Prevention) provides some answers and gives parents some ‘early signs’ of which to be aware.

While everyone knows that cerebral palsy (CP) can be a devastating condition, it is less well-known how common CP actually is. The Center for Disease Control recently released new data on the frequency of CP. In its study, it found that CP affects 3.3 per 1,000 eight-year-old children, or 1 in 303 children. This data was collected from select communities in Georgia, Alabama and Wisconsin, not the nation overall. Rates may differ slightly in other localities. However, the CDC pointed out that its most current findings on CP frequency were similar to previous studies which showed that CP affected 3.6 per 1,000, or 1 in 278 children.  

In reporting the data, the CDC also advised parents what to look out for in terms of signs of CP, based on the age of the child. Parents should consult a physician if they notice any of the following signs:

A child over 2 months with cerebral palsy might have difficulty controlling head when picked up, or have stiff legs that cross or “scissor” when picked up;

A child over 6 months with cerebral palsy might continue to have a hard time controlling head when picked up, or reach with only one hand while keeping the other in a fist;

A child over 10 months with cerebral palsy might crawl by pushing off with one hand and leg while dragging the opposite hand and leg, or not sit by himself or herself;

A child over 12 months with cerebral palsy might not crawl, or not be able to stand with support;

A child over 24 months with cerebral palsy might not be able to walk, or not be able to push a toy with wheels.`

Parents, be aware of these early signs!  If you are not sure what to do or to whom you can turn, the CDC offers the following information:

To find out who to speak to in your area, contact the National Dissemination Center for Children with Disabilities by calling 1-800-695-0285 or visiting the Center’s Web site

Of course, you always have your child’s pediatrician as a starting point.

Infant Deaths Prompt CPSC Warning About Sling Carriers for Babies

The Consumer Product Safety Commision (CPSC) has posted a warning about infant sling carriers, due to at least 14 deaths associated with the product.  The warning, posted in a release by the CPSC on March 12th, contains illustrations of the different positions, many of which are dangerous, of how babies are known to be carried in sling carriers.  The release also which infants are most at risk, as well as how to protect a child should the caregiver choose to use a sling carrier:

Many of the babies who died in slings were either a low birth weight twin, were born prematurely, or had breathing issues such as a cold. Therefore, CPSC urges parents of preemies, twins, babies in fragile health and those with low weight to use extra care and consult their pediatricians about using slings.

CPSC recommends that parents and caregivers make sure the infant’s face is not covered and is visible at all times to the sling’s wearer. If nursing the baby in a sling, change the baby’s position after feeding so the baby’s head is facing up and is clear of the sling and the mother’s body. Parents and caregivers should be vigilant about frequently checking their baby in a sling.

The CPSC has now added slings to products that require a mandatory standard.  Because time is of the essence, the CPSC is working with ASTM International to attempt to put voluntary standards in place for infant sling carriers, as soon as possible.  The release also has a link for reporting infant sling carrier problems: www.cpsc.gov/cgibin/incident.aspx.

New Research : Treadmill may help tots with neuromotor delays (such as cerebral palsy) walk

While the study group was a small one (15), researchers at the University of Michigan’s School of Kinesiology have reported supervised treadmill walking may help children with neuromotor delays.   This study was reported yesterday in an article published in The Hindu.

Rosa Angulo-Barroso, Associate Professor of movement science  at the School, and her colleagues followed 15 infants at risk for neuromotor delays over a period of two years.  They tested the changes in physical activity and treadmill-stepping performed with parental supervision in the children’s  homes.   Six of these children had been diagnosed with cerebral palsy.

“We found that in those with neuromotor delays, the pattern of development through time was parallel (but less) than normal kids.” said Angulo-Barroso. “We also found less toe-walking, so foot placement improved.” Angulo-Barroso added. The study also suggests a critical intervention window. Both children without a diagnosis and kids with cerebral palsy improved the most between 10 months and 18 months.

As The Hindu article notes, “The study, “Treadmill Responses and Physical Activity Levels of Infants at Risk for Neuromotor Delay” appears in the journal Pediatric Physical Therapy.

It would be most interesting to see if a larger, multi-center, double-blind  study could produce the same or similar results.  I haven’t personally seen the ‘tot’ version of a treadmill, but a quick search on Google images does show some interesting devices (see picture on left).  As researchers in the etiology and treatment of cerebral palsy keep working, the efforts of others such as reported here will potentially provide a wonderful interim measure toward helping these kids with special needs.  We’ll try to keep an eye on this story and will report should more information become available.