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Lisa Belkin

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The Death Of Rory Staunton: When Parents Know More Than Doctors

Posted: 07/12/2012 11:04 am

For a moment, an emergency room doctor stepped away from the scrum of people working on Rory Staunton, 12, and spoke to his parents.

"Your son is seriously ill," the doctor said.

"How seriously?" Rory's mother, Orlaith Staunton, asked.

The doctor paused.

"Gravely ill," he said.

How could that be?

So begins a heartbreaking piece by Jim Dwyer in the New York Times this morning -- one that will have you hugging your children and, I suspect, second-guessing your doctor then next time your own child gets sick.

A cut on the arm during a basketball game led to full-blown sepsis, which killed Rory three days later. Along the way well-intentioned doctors (and imperfect systems) missed warning signs and just plain didn't hear what Rory's parents were telling them.

As Dwyer writes:

"We showed her the cut on his elbow, and I saw her follow up his arm from the cut," Ms. Staunton said. "She said, 'The cut's not an issue.' She focused on his stomach. We said, 'Although you see him throwing up, that's not what he's really complaining about.' Rory and I both said to her that it's the pain in his leg that's really bothering him."

And it was the pain in his leg that was, with clear hindsight, a sign of "invasive" infection.

The next day, when Rory was so weak that he could barely get to the bathroom, the family called for help again:

The doctor suggested fluids and crackers.

"'I told her, 'I'm not sure you're getting the picture...' " Mr. Staunton said. "'I can't even get him to sit up. I don't know how you expect me to get food into him.' "

As I read Rory's tale I thought of the time my son's pediatrician said it was just a lingering cold and the X-rays (which I insisted on) showed double pneumonia. And of the time the doctor said "every parent thinks their child's snores are apnea, it's rarely really apnea," but it was. Or the time when the doctor told us to encourage our second grader to walk on his "just bruised" leg, which turned out to be a spiral fracture of the tibia.

I also know that in every one of those cases the doctors were caring, and concerned, and knew their medicine.

But they didn't know my child like I did.

The reason the Staunton's turned over Rory's medical files to Dwyer, they said, was "we know that Rory would want no other child to go through what he went through."

Nor any other parent.

 
 
 

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For a moment, an emergency room doctor stepped away from the scrum of people working on Rory Staunton, 12, and spoke to his parents. "Your son is seriously ill," the doctor said. "How seriously?...
For a moment, an emergency room doctor stepped away from the scrum of people working on Rory Staunton, 12, and spoke to his parents. "Your son is seriously ill," the doctor said. "How seriously?...
 
 
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FaceReality2
Democracy in the U.S. is an illusion
02:08 PM on 08/01/2012
We can spend more on "defense" than the next 20 biggest military spenders combined, but we cannot afford to put a kid in the hospital for a day or two of observation.
Craigzz
God must like pinball
08:16 AM on 07/23/2012
This is a sad case, Doctors are under pressure these days to restrict the use of antibiotics because some bacteria are resistant to all but one type of antibiotic, and the more antibiotics which are prescribed, the more resistant they become, its an increasingly dire situation.

Unfortunately cases such as this occur, which in days of old would have been given antibiotics as a precautionary measure. The answer to the problem is obvious, test test test, don't just presume, if your not certain of your diagnosis, TEST.

Surely Doctors see enough patients to know the signs of a hypochondriac over the genuine concern of a mother's intuition.
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NotEve
Facts are of no use against the irrational
01:12 PM on 07/16/2012
Medicine is not an exact science. It takes years and years of training, diagnoses can be difficult, misleading and complicated - even in seemingly routine scenarios, disease processes are not as routine as textbooks and webMD would suggest. Furthermore, Drs are human, just like everyone else posting on this board. And the idea that any PCP is in it "just for the money" is laughable.

No one benefits from the kind of arm-chair quarterbacking and baseless questioning of integrity that permeates so many of these posts.

Its sad that its become so in vogue to demonize doctors.
People are so quick to criticize until suddenly they need one.
05:43 PM on 07/18/2012
Active listening skills just weren't there for them or me. An ultrasound result sat on a physician assistant's desk (MD retired two days before this result came in). I was having RUQ pain and thought "gallbladder". Ultrasound done Tuesday; called for result, no callback. On Thursday, told there was only one stone. Not told it was 2.2 centimeters! Should have been an urgent surgical referral. Instead, the boulder (stone) did as expected. It blocked circulation. Gangrene set in. In atrocious pain on Friday, called this PA and was told it was spasms. I knew better with a blood pressure of 160/140 and extreme pain. The PA's advice?--an Rx for Belladonna (spasms). Went to ER; first WBC 85,000. Antibiotics begun, then surgery next day. My liver had started to abscess. Sepsis rapidly evolving. I am alive due to my decision to go to an ER and my own training as a nurse. After recovery, made an appointment with the PA and had to TEACH HER what sepsis is and how one stone can be gangrene risk. These parents did everything right; however,they relied on a system in crisis and readily takes for granted the needs of someone who is stereotyped as "should be healthy". When it's life and death "connect the dots". If this child had seen a nurse practitioner he might be alive today. Many doctors negate symptoms--it doesn't fit into their assessment paradigm. It just couldn't be, no, it couldn't. Yet it was! THINK!
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NotEve
Facts are of no use against the irrational
12:00 AM on 07/19/2012
Well, PAs are not Drs and are less qualified than NPs. Personally I think PAs are over used and given more responsibilities than their limited training qualifies them for.
08:54 AM on 07/16/2012
Last year, my 9-year-old had a resistant strain of strep. I spent a month fighting his pediatrician. I was told it was a GI bug, a sinus infection, and Lyme disease, but DEFINITELY not strep. Luckily, we ended up having bloodwork done (for the Lyme theory.) That day, he was so ill that I almost called an ambulance. I fought our ped and got him a course of antibiotics, but not without much eye-rolling from her.

The next morning, her colleague called, panicked, to say his bloodwork showed a "severe" bacterial infection. She had no idea he'd been seen by her colleague and was already on meds.

Two hours later, her nurse called to say that his strep swab was negative and I should discontinue the antibiotics. I said no. The child has a severe bacterial infection. She argued with me and I told her to check his chart. "Oh. Sorry. Definitely continue the medication."

If my son had a less educated parent (I am a medical writer) he might be dead. We're lucky that I know what I know and I am willing to be That Parent who bears the scathing looks and attitude of our doctors. It's pathetic that all parents need to get educated and micromanage our families' medical care, but that's the state of things. My heart breaks for the Staunton family. There is no excuse for the laziness and hubris that killed their son.
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clownzozo
Magician, Novelist and an Angry Old Git
07:27 AM on 07/16/2012
This horrendous series of events, caused by the 'we no best' syndrome of the medical profession, is unfortunately becoming more common. Only a few days ago, here in the UK, a patient died of dehydration, despite his parents appealing that he be given a drink as he was complaining of thirst. .The nurses ignored them.
When someone dies needlessly it is tragic, but when it is through medical neglect it's unforgivable.
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Amishguy
I'm not really Amish.
08:11 PM on 07/15/2012
If it weren't for all the doctors, we wouldn't need all the doctors.
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Amishguy
I'm not really Amish.
08:11 PM on 07/15/2012
This is what happens when medicine becomes a business. So sad. :(
02:19 PM on 07/15/2012
So very sorry for this family...I have children and cannot imagine the pain. Not to in any way minimalize that, I will say I have several doctor friends and I have heard horror stories from their perspective. The good ones have a hard time sleeping at night worrying about diagnosis' they have made and patients with difficult roads ahead, for whom they are responsible. It is a very difficult and grueling job and despite the years of school it is not always an exact science, unfortunately. My heart also goes out to the doc who didn't catch this. I can assert confidently that she is in horrible pain now herself.
08:56 AM on 07/15/2012
My heart goes out to the Stauntons. Rory didn't have to die like that. All of your instincts couldn't save your little boy because of a system of physicians who are undereducated. It really points to medical school education and how many doctors are not being educated properly. A major flaw in the diagnostic impression is NOT listening to the person who is closest to the patient(i.e., parents) or listening to the patient. That's a cardinal rule in medicine. As for the medical episodes that the author, Lisa Belkin, notes she states "I also know that in every one of those cases the doctors were caring, and concerned, and knew their medicine." No, Lisa they don't know their medicine. They may have been caring and concerned but the medical cases you note are SIMPLE for even a third year medical student to diagnose. It's the serious, rare conditions that a PCP might miss or not refer the patient to a specialist or the right specialist. Most of us have been done that road. However, there is hope. With the passage of the Affordable Care Act, it puts physicians front and center for ACCOUNTABILITY. If they are not doing a good job then there will be consequences. Again, I'm verry sorry for all the agony and suffering that the Stantons and Ms. Belkin had to go through.
NancyY
carpe diem!
08:00 AM on 07/15/2012
From the article: "As I read Rory's tale I thought of the time my son's pediatrician said it was just a lingering cold and the X-rays (which I insisted on) showed double pneumonia. And of the time the doctor said "every parent thinks their child's snores are apnea, it's rarely really apnea," but it was. Or the time when the doctor told us to encourage our second grader to walk on his "just bruised" leg, which turned out to be a spiral fracture of the tibia."

Me: Good grief, were all these mistakes made by the same doctor? If so, I'd get another doctor!
09:29 PM on 07/14/2012
As a teacher I always tell parents "no one knows your child better than you." when I take my children to the doctor I usually go well informed and I may get on the doctor's nerves with all my inquiries and questions but that is my kid and I need to feel right when I leave a doctor's office or ER.
05:57 PM on 07/14/2012
This is such a sad story. A cautionary tale to take our childrens' health and our health into our our own hands if the experts are clearly not doing their due diligence. Doctors are human, and they make mistakes...sometimes grave mistakes. I feel so badly for this family, their doctors failed them.
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andreabeth7
03:24 PM on 07/14/2012
All ER discharge papers that I have ever seen include the instructions to return to the ER if the patients condition does not improve or becomes worse. The patient or parent is required to read the discharge instructions and sign acknowledging that they have done so prior to leaving the ER. Clearly, the boy's condition was not improving and from what read in the NYT, showed distinct signs of worsening. (My tipping point would have been when the child was too ill to sit up and eat or drink after having been treated at the ER the previous evening.) At this point the parents need to 1) return to the ER where he was initially seen as instructed to do 2) go to a different ER if they were not satisfied with the care they received at the first ER or 3) go to an Urgent Care Clinic. The Urgent Care Clinic would have been their best bet, IMO because it would probably have been less crowded than an ER in the evening and thus whoever saw their son would have had more time to spend going over his condition. Sepsis is not always an easy diagnosis to nail and in this case, the devil truly was in the details. Remember, his initial intake physician does not have to be an ICU specialist, only someone who can recognize that things do not add up and refer him up the chain to someone who can pin down what is wrong.
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Uriella
In the midst of winter I found Invincible Summer
01:09 PM on 07/15/2012
Right on, andreabeth -- very well stated.!!!
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lifehub
I don't answer (to) libs.
04:28 AM on 07/14/2012
Many times doctors don't want to be bothered, so they blow it off or pass the buck on to someone else, like to a 'specialist.' Add to that they often aren't prepared or trained to deal with patients' emotions, and as a result either do nothing or minimize the situation. You take your own life in your hands when a doctor visit is needed, or at the least you're at their mercy.
NancyY
carpe diem!
04:44 AM on 07/14/2012
A family doctor, who is typically a general practitioner (GP) or doctor of internal medicine (less likely) WILL refer a patient to a specialist if they think that patient's condition warrants it. There is no way that a GP or internal medicine doctor knows everything about every specialty. Such a referral is in the patient's best interest, and shows that the referring doctor has his patient's best interests at heart.
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kmchafin
03:20 AM on 07/14/2012
The parents should sue the doctors for everything....I had a similar issue when my doctor would not listen to me and said I was just an anxious pregnant mom....who ended up with eclampsia and a dead baby at 8 1/2 months pregnant...The he said he was "sorry" and admitted he missed the diagnosis...gee my rising blood pressure meant nothing? I did not sue but I wish I had. He went on with his life and mine was changed forever...My marriage ended as my husband was depressed and blamed himself for not being more agressive with the doctor. These guys need to think less about their incomes and "routines" and managed care and more about their patients
NancyY
carpe diem!
04:20 AM on 07/14/2012
Doctors are not gods; they do not know everything. Sometimes a doctor can make a diagnosis, try to treat the problem with one medication which doesn't work, then they have to go with another medication (this happened to me when I got tonsilitis years ago). Some people have compromised immune systems for whatever reasons, so simple problems become complex in a hurry. In this case, unless the doctor's misdiagnosis was a glaring error that she should have caught, she cannot be blamed.
05:33 AM on 07/14/2012
No one is saying that they are gods, they are DOCTORS! They went through training for over 12 years, and they should thoroughly check a patient out, not just assume or ignore certain tests. They were trained to FIND the problem, if someone says there is something seriously wrong, then they shouldnt be blown off.
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Roundels
09:53 AM on 07/14/2012
They may not know everything. but there are quite a few of them who think they do. When you find one who actually listens, you hang on to them for dear life.
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Uriella
In the midst of winter I found Invincible Summer
05:04 AM on 07/14/2012
Amen, km -- you hit the nail on the head. Sending you my heartfelt condolences for all the pain and misery you've suffered as a result of this idiot and his unconscionable misdiagnosis.