Nurse Practitioner (Mother) leaves 21 month old in car for 8 hours

Nicole, NP, left her 21 month old baby, Remy, in the car where Remy remained until Nicole returned at 4:30 when her shift was over. Remy died and Nicole was left to blame herself forever. How do mistakes like this happen?

Nicole was by all accounts a competent, caring Nurse Practitioner. Her patients loved her and her coworkers spoke highly of her.

She was also the proud mother of Remy, short for Remington. Nicole and her husband had tried for 15 years to conceive and they were overjoyed when they had Remy, now 21 months old. Coworkers said she loved to show them photos of little Remy. By all accounts, Nicole was a loving, responsible parent.

In the morning of June of 2018, Nicole was working at Evergreen Family Medicine in Roseburg, Oregon. That morning, she drove into the clinic’s parking lot as usual. She got out, locked her car, and went to work her shift at the very busy clinic- as usual.

In doing so, she left her 21 month old baby, Remy, in the car where Remy remained for hours until Nicole returned at 4:30, when her shift was over.

Nicole discovered Remy unconscious and blue. Nicole screamed for help and attempts were made to revive the toddler, but she was pronounced dead.

Supporters and Haters

The community quickly divided into supporters and haters. What happened to little Remy is almost too horrific to contemplate. Sides were taken.

Both sides felt empathy- empathy for the mother and the suffering she would never escape from. Empathy for Remy, a vulnerable child who suffered a horrible death.

The supporters felt ‘This could happen to me”. An understanding that “There, but for the grace of God, go I.” They found room for forgiveness and compassion.

The haters responded with “She isn’t competent to be a mother”. Some called for Nicole to be punished. Initially charges of second degree manslaughter were filed but they were dropped.

How could this happen? As we understand more how the brain works, we understand better how mistakes can happen. To anyone.

She Was Out of Routine

Usually Nicole’s husband dropped Remy off at daycare, but he had worked night shift as an EMT and Nicole wanted him to sleep.

Thankfully, being out of routine usually results in errors such as remembering to bring in a journal to work but forgetting to take your lunch.

I forgot to lock my car! I always lock my car. Oh, right, I was waving at my neighbor when I got out and walked across the street to talk to her.

She Was Distracted

Nicole no doubt was thinking of her shift ahead of her at the clinic. There was a lapse in temporal memory. Her brain was filled and looking forward. Maybe she was wondering who the medical assistant would be on duty that day, or if the antibiotics she prescribed the day before had helped her patient.

She had to remember to ask her boss if she could order large size disposable BP cuffs and she had to renew her license soon. Did she have enough CEs?

There was no trigger to cause her to look in the back-facing car seat, where Remy was soundly asleep. No visual reminder. No audible alarm.

I was interrupted by my phone during med pass and thought I unclamped the secondary tubing for the antibiotic.

She Was on Autopilot

In the police affidavit, Nicole said “I thought I dropped her off at daycare this morning”.

I thought I took my birth control pill this morning. Or was that yesterday?

Called inattentional blindness, we all have operated on autopilot. Memory experts tell us that the basal ganglia takes over and suppresses the prefrontal cortex for many reasons, including when we are tired, as in the case of new parents.

Kids in Heated Cars

Kids do not do well in heated cars. Approximately 30-40 children each year succumb to death in overheated vehicles. Some were forgotten in cars, others accidentally locked themselves in.

Babies and young children are particularly sensitive to the heat as they have larger surface areas and less efficient cooling mechanisms. A child’s temperature rises faster than an adult’s, up to 3-5 times faster. The temperature in a car can rise to 125 degrees in just a few minutes.

The prevalence of back facing car seats accounts for the young age, as infants and small children can easily be asleep or not able to communicate. Rear-facing car seats look no different whether or not there is a baby or toddler inside.

Conclusion

What happened to Nicole can happen to anyone. It will happen again this summer, when the death toll from kids in cars typically rises.

What would prevent this? Jailing Nicole would not prevent this.

Maybe educating parents similar to education around infant co-sleeping and the use of seat belts. Public service announcements. Supporting initiatives to increase awareness such as Look Before you Lock and occupant detection systems.

Perhaps placing a necessary item in the back seat next to the child, such as a purse or cell phone. Kids and cars.org even suggests placing your left shoe in the back seat.

Most of these suggestions are to trick the brain out of autopilot and the brain state that allows these accidents in the first place.

Mistakes are not intentional but prevention and compassion are.

Related Articles

When Nurses Make Fatal Mistakes

Nurse Gives Lethal Dose of Vecuronium

Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

8 minutes ago, hppygr8ful said:

You all know my opinion - I'll not take the bait of name calling etc.... My siblings all of whom worked full time jobs have managed to raise 21 children and none of them ever got left in the back seat of a car. From the time my son was born I have always had him in the back of my mind - always aware of where he is and how he's doing. Even when I was stressed and tired this would have never have happened to a child of mine.

I didn't call you or anyone names so don't make me out like I did.

I appreciate that you or your family have never had this tragedy... it is uncommon, afterall. I'm just saying the causes are unintentional and rooted in the human condition. We can work with it to help prevent it from happening to other children and families.

2 hours ago, kcochrane said:

One more other thing. So let’s say we have alarms for this sort of issue. What happens when it malfunctions? Who is to blame then? Relying on technology to parent is a bad idea. And as much as I can understand it as an extra check you know as well as I do that many will use it as the only check.

I am less concerned about placing blame and more about providing tools to prevent it from happening.

Specializes in Psych, Addictions, SOL (Student of Life).
14 minutes ago, cleback said:

I didn't call you or anyone names so don't make me out like I did.

I appreciate that you or your family have never had this tragedy... it is uncommon, afterall. I'm just saying the causes are unintentional and rooted in the human condition. We can work with it to help prevent it from happening to other children and families.

I didn't say you called me names but I did say I don't want it to go there. We have a difference of opinion that's all. If more of the cases were prosecuted those who have trouble remembering the human life in the back seat would have more incentive to remember. However in a society that is currently advocating for legal abortion up to the moment labor begins - there is little value placed on the sanctity of human life.

Hppy

On ‎4‎/‎16‎/‎2019 at 4:23 PM, VivaLasViejas said:

Maybe I'm a terrible person, but I ain't buying it. I get being on autopilot, but you don't just walk off thinking you dropped the baby off at daycare, you check the back seat before you lock the car doors and go to work. I'm not saying the mom did it intentionally, and putting her in jail would serve no purpose; but it's a horrific case of neglect that should NEVER have happened. What that child went through is almost beyond comprehension.

I couldn't quite wrap my mind around this either. How does someone not recall dropping their child off at daycare? One literally has to get out of the car, unstrap the child from the car seat, and physically walk them to the daycare.

9 hours ago, Wolf at the Door said:

I don’t buy how you miss the baby when you look in rear view mirror

Just a comment on this one aspect: Simple - - the car seat is always there and the child isn't. Their heads don't stick up over the back of the car seat, either. So if they're quiet, I assume it feels about the same as driving around with an empty car seat.

Specializes in Nurse Leader specializing in Labor & Delivery.
20 hours ago, Here.I.Stand said:

At the same time though, any other time these stories hit the news have we scrambled to explain it?

Perhaps not here, at a nursing site. But yes, when similar cases have happened with other parents, these same conversations inevitably take place.

That poor child died a horrible horrible death. May his soul rest in peace

I barely forget my phone in the car let alone forgetting my child. I don't understand how a parent can forget that they strapped their child in the car seat before leaving the house.

Specializes in Nurse Leader specializing in Labor & Delivery.
54 minutes ago, Born to be A said:

I don't understand how a parent can forget that they strapped their child in the car seat before leaving the house.

Read the articles I linked in the post above yours.

This has got to be one of the most depressing things I've ever heard of. I can't even begin to imagine what horrifying intolerable pain this family has felt. I'm not sure I'd be able to remain living if this happened to me, and it's very scary that this happens as often as it does. I'm still not so sure that Georgia dad who was convicted of murder should have been. I simply don't think he intentionally left his child in his car, because it would take a complete sadistic sociopath to do something like that on purpose.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

I remember this mom was on suicide watch following her arrest; I was also glad to read that she wasn't going to be charged. She has had enough pain and punishment in the death of her child. I just tear up when I think about that poor little girl in her seat, wondering where mommy was and being scared. I just can't, it hurts my heart. Like Nicole, my daughter is my miracle that I never thought I'd have, and I just can't imagine this ever happening. But I take a lesson from it, and my phone is in the back seat and her daycare bag is in the front seat every day when I take her to daycare. If her dad drops her off (which is out of the norm), I check in with him after drop-off to ask how it went.

2 hours ago, Pixie.RN said:

I remember this mom was on suicide watch following her arrest; I was also glad to read that she wasn't going to be charged. She has had enough pain and punishment in the death of her child. I just tear up when I think about that poor little girl in her seat, wondering where mommy was and being scared. I just can't, it hurts my heart. Like Nicole, my daughter is my miracle that I never thought I'd have, and I just can't imagine this ever happening. But I take a lesson from it, and my phone is in the back seat and her daycare bag is in the front seat every day when I take her to daycare. If her dad drops her off (which is out of the norm), I check in with him after drop-off to ask how it went.

I did the same thing when my kids were smaller because I was aware that these kinds of things can happen. Sometimes my husband would say, don't worry, I dropped him off at the daycare.