Florida woman goes into hospital to have baby, leaves as a double amputee

[UM Review RN]

How tragic! How frightening! This could happen to ANY of our patients! The rest of the story here:

http://www.wftv.com/news/6253589/detail.html

Woman Becomes Quadruple Amputee After Giving Birth

POSTED: 5:59 pm EST January 19, 2006

UPDATED: 4:06 pm EST January 20, 2006

ORLANDO, Fla. -- A Sanford mother says she will never be able to hold her newborn because an Orlando hospital performed a life-altering surgery and, she claims, the hospital refuses to explain why they left her as a multiple amputee.

The woman filed a complaint against Orlando Regional Healthcare Systems, she said, because they won't tell her exactly what happened. The hospital maintains the woman wants to know information that would violate other patients' rights.

Claudia Mejia gave birth eight and a half months ago at Orlando Regional South Seminole. She was transported to Orlando Regional Medical Center in Orlando where her arms and legs were amputated. She was told she had streptococcus, a flesh eating bacteria, and toxic shock syndrome, but no further explanation was given.

The hospital, in a letter, wrote that if she wanted to find out exactly what happened, she would have to sue them.

"I want to know what happened. I went to deliver my baby and I came out like this," Mejia said.

Mejia said after she gave birth to Mathew last spring, she was kept in the hospital with complications. Twelve days after giving birth at Orlando Regional South Seminole hospital, she was transported to Orlando Regional Medical Center where she became a quadruple amputee. Now she can not care for or hold her baby.

[UM Review RN, ASN, RN]

Good point.

And we truly don't have all the answers here.

I do have to say something - my first thought when I saw the video was when she said she couldn't hold her child - I looked at her arms and thought, well, yes she can. She doesn't have hands but she can hold her child in what is left of her arms.

Not saying anything as rude as she should be grateful . . . I was just thinking that she actually could hold her child.

I've worked with many disabled folks - they manage to touch and hold their loved ones in spite of disabilities.

steph

But you also know that this is too fresh, too recent, too devastating for her personally, to be able to get past right now.

Maybe later--years later--she will be able to. But right now, she has every right to her feelings of loss and grief over her missing limbs and her dream. The motherhood experience that she dreamed of is gone.

She's really saying, "I can't touch my baby with my hands. Can't feel him, hold him, care for him the way I might have a scant two months ago. Because I have no hands."

You and I know the disability superheroes who can manipulate pens with toes, and ski on one leg. This girl never prepared for that possibility, never thought she had to.

And if it's a matter of simple infection control, then we all need to wake up and smell the coffee and realize that THIS is what can happen. Lives are devastated by something so mundane we can't see it.

For the hospital to claim a HIPAA violation is essentially to admit that some breach of infection protocol occurred. Else why would they say that? Why wouldn't they just give the standard CDC spiel about the bug being fairly commonplace and there's no real way to trace it?

Oh yes, she deserves answers. Yes she does.

[fergus51]

It's horribly sad. The hospital may be to blame, they may not. I know nurses are usually the first to be blamed, but we really don't know how she became infected. Hopefully she'll get the answers she needs.

[SharonH, RN]

*sigh* Those of you that think my comments are callous and/or don't understand how quickly decisions need to be made in a situation like this OBVIOUSLY have spent no time in an Intensive Care Unit.

PLEASE research DIC (disseminated intravascular coagulation) and educate yourself in this horrible, yet very common, complication.

We if *we* don't understand how quickly decisions need to be made in a situation like this, then surely the patient doesn't understand it....ya think? THEREFORE she has every right to demand answers, no? Do you think the average layperson could grasp the intricacies of DIC in a 10 minute interview with their surgeon, in an emergency situation? Do you believe that just by signing the consent, they relinquish any further right to ask questions?

[DutchgirlRN, ASN, RN]

The story about the young person which developed pain in the lower leg (posted above) but with no obvious skin infection..is also scary.

So this bacteria can be under the skin and a person doesn't know how she/he got it?

This patient lost her leg due to a blood clot and the s/s were not caught by her primary nurse, PACU nurse, or physician. (blue foot, cold, no pedal pulse, pain)

[DutchgirlRN, ASN, RN]

This woman has every right to demand answers, all this business about how she should just be glad to be alive and quit asking questions is quite callous IMO.

I agree with Sharon + we should not question her level of education. I don't think I would be just glad to be alive. Can you imagine, actually imagine, having no arms and no legs? I cannot. I still want to know who signed the surgical permit. If the surgery was necessary then so be it but not without a permit.

[Spidey's mom, ADN, BSN, RN]

Um, i wouldn't say that.

I have no idea whether or not the surgery WAS necessary, since it seems HALF the story is still missing.

I agree Marie.

How many other medical stories have we read in the paper with either the wrong information or missing information?

Journalists, unless they are medical journalists, are in foreign territory when it comes to reporting on these cases.

There is much that is missing in this story.

steph

[Spidey's mom, ADN, BSN, RN]

But you also know that this is too fresh, too recent, too devastating for her personally, to be able to get past right now.

Maybe later--years later--she will be able to. But right now, she has every right to her feelings of loss and grief over her missing limbs and her dream. The motherhood experience that she dreamed of is gone.

She's really saying, "I can't touch my baby with my hands. Can't feel him, hold him, care for him the way I might have a scant two months ago. Because I have no hands."

You and I know the disability superheroes who can manipulate pens with toes, and ski on one leg. This girl never prepared for that possibility, never thought she had to.

I agree that she is in shock probably - this is all too terrible.

I mentioned that I was not trying to be rude . ... . but that what happened to me when I saw that video was that I thought "wait a minute, she has arms left to hold her baby".

I wasn't chastizing her or criticizing her at all. Just an observation at first glance, that is all.

Your examples of disability heros reminded me of the girl who lost an arm to a shark while surfing.

steph

[KScott]

Why couldn't the hospital explain what happened without violating another patient's privacy? They could explain without naming names. Could you imagine waking up after surgery to find you have no limbs and the hospital saying, "Yes, we cut off your arms and legs, but we're not going to tell you why." What a crock.

No, patients don't need protections from the big corporations anymore than workers do, because we know the big guys have all of our best interests at heart. They always do the right thing and we just need to accept that. /sarcasm

[Mulan]

This patient lost her leg due to a blood clot and the s/s were not caught by her primary nurse, PACU nurse, or physician. (blue foot, cold, no pedal pulse, pain)

I think she is referring to post #36.

[DusktilDawn]

The couple wants to know how she caught streptococcus, during labor or after. She doesn't know. She knows she didn't leave the hospital the same.

This is specifically what the couple wants to know, and unfortunately they may never have an answer to this question. It is possible she had the infection prior to labor.

It seems to me that they want access to other patients records to determine WHO had a streptococcal infection, which can be interpreted as a violation of other patient's rights.

ORMC said Mejia is requesting information on if there were other patients or someone on her floor with the streptococcus. They said, if they release that to her, that would be a violation of other patients' rights.

Even if this couple is granted access to the information they want, it still may not provide the answer they seek.

[ortess1971]

*sigh* Those of you that think my comments are callous and/or don't understand how quickly decisions need to be made in a situation like this OBVIOUSLY have spent no time in an Intensive Care Unit.

PLEASE research DIC (disseminated intravascular coagulation) and educate yourself in this horrible, yet very common, complication.

Yes, this woman lost her limbs. It's tragic and sad. I agree with everyone.

Would she have been better off dead???

Her brain functions: she will be able to see her child grow up, graduate, get married, have grandbabies....... she would miss that if the medical team had not done everything in their power to keep her alive.

Like I said before... the MEDIA doesn't know squat.

Good points brought up here...DIC moves very quickly and is just brutal. Saw a patient that came in for a hernia repair in the morning, and came into our OR around 5pm with DIC and was just oozing blood from her nose, she was mottled and bled so much that we had to put on those plastic knee high booties we wear for cysto and arthroscopies. This woman walked into the hospital that morning as a same day admit and died the next morning. It was pretty horrifying.

[End Game RN, RN]

Sounds like post partum sepsis. She became critically ill, requiring intensive care and supportive measures to save her life. Probably had high fevers, elevated wbcs, other abnormal labwork. perhaps developing multi-system organ failure seconday to sepsis. To support blood pressure in this patient, fluids such as colloids and crystalloids as well as blood were probably given. Other measures were probably pressors such as levophed (anyone ever heard this saying? "leave 'em dead with levophed) I don't believe this myself but it is an interesting saying, I'd like to know the origin of this..but I am off subject. She probably had and a-lin eand cvc line to administer these fluids and medications. Perhaps she was so ill her hemodynamic and fluid status needed to be monitored by a PA line. she was probably intubated, maybe medically paralysed, on propafol, fentanyl..you name it.

With the above sceanario with the interventions as described above. or something similar...the body preserves the vital organs, brain, heart, lungs, liver, pancreas, bowel..what ever..shunting blood circulation to these areas, sacrificing extremities..pressors contribute to this... I have seem this many times with our extremely septic patients',transfered from other hospitals, we being left with treating

these complications. Some developing sepsis in any of our units in our facility..these patients'..trauma..brain, spinal cord, gsw to body and vital organs of body..mva, brain tumors malignant or benign, sah from avm, aneurysms...name it..you can get septic from just about any injury or insult to the body...some are more prone to this than others for a variety of reasons.

I have observed patients' as they progressed from non-palpable distal pulses, unable to find distal pulses with doppler, cold extremities,

toes, feet becomming grey then black, fingers and hands also becomming grey..than black..toes and fingers begin to curl, shrink with skeletal appearance..yet the patient lives with full support. If the patient survives..the dead tissue is still non-viable, possibly endangering the patient with complications related to this phenomenon.

I have seen these various parts of the extremities amputated as well. One rather disturbing event happened with one patient a few years ago..she had her finger tips, some to the second joint turn black and shrivel..the surgical recommendation was simply let the digits fall off naturally. She also survived sepsis, also on full support, recovered with the complication as listed above..but as her family said..it was her life they were fighting for. She recovered fully, minus these digits.

This patient is married, spouse apparently is in her life. No one can

tell me he was not informed of the above..in our hospital with this situation the family/proxy is updated regularly of life saving measures and what are the possible complications of treatment.

I can not believe he was not kept informed, eventually signing consent to save his wife's life, for quadruple amputation. Someone had to be communicating with the husband..you just don't amputated a previously healthy patient's extremities and not notify the proxy. It just cannot be done. First, if she was so hemodynamically unstable she was probably not a candidate for surgery, unless the affected limbs were hindering her recovery from the original sepsis. We do everything possible to reach the proxy or any other family member who have given us their telephone numbers. I just can't see this being a spur of the moment decision by surgeons alone.

Yes, there is a lot missing from this story. Her husband is the key to what he knew and did not know. Perhaps he feels guilty for signing for this surgery..I don't know..His wife was not in a position to make this decision. Hopefully all verbal interactions were documented throughly by medical and nursing staff..or they may be screwed!

Pray for this woman and her family..they need one hell of a prayer chain to assist with her on going recovery.