Absence of rectum goes undetected for two weeks at Duke N.I.C.U

Yes, you read correctly. A team of nurses and doctors in the Neonatal Intensive Care Unit
failed to notice that my granddaughter did not have a rectal opening. How does that
happen? I had 4 children and I can clearly remember a nurse taking rectal temperatures of
everyone of them immediately after delivery. She also had to be catheterized for surgery
the day after delivery, yet still nobody noticed. The nurse even commented that there
were feces in her urine at one point. We would later discover that she had been pooping
out of her vagina. This was the final straw after a series of disappointments and filthy
conditions had already chipped away at the false sense of security we were given about
this world renowned institution.
Now let me give you some history on how and why we chose Duke. We were advised
after an ultrasound when my daughter was 5 months along; that my granddaughter had
hydrocephalus. This was devastating for us to say the least. But we were told wonderful
things about Duke's NICU and that they offered the best neonatal neurologists and
surgeons. We completely put our faith in them from that point on. They explained the
surgery and verbally helped to ease our worries and fears. We were given a desperately
needed sense of security; which would later be shattered repeatedly during the course of
their stay.
The shunt placement surgery went well from what we were told and the baby seemed to
be doing OK. My daughter was not allowed to care for her yet as she was being kept in the
NICU, but at this point we had no reason to worry. My husband and I were at the hospital
every day, and it didn't take long to discover how filthy the hospital was and how
unprofessional many of the nurses were. I filed several complaints during her stay but am
unaware of the outcome of those complaints. After a few days we were allowed to see
and hold the baby but most of the care was done by the nurses. After a week we were told
that the baby had an infection in her stomach and needed antibiotics. Being uneducated
about this condition, we figured this was normal since the fluid from the shunt drains into
her stomach so it can be reabsorbed into the body. It would not click until much later that
it was not normal and had nothing to do with the shunt draining but with the absence of
her rectum and the fact that she had been pooping out of her vagina. The doctor advised
us that we could take the baby home the next day and of course we asked about the
infection. He told us there was no infection; just to keep giving the antibiotics to be safe
but that we could definitely go home. The next day as we were preparing to do just that;
another doctor came in and asked what we were doing. When told we were getting ready
to be discharged he loudly exclaimed "No No No, you can't take her home yet, she has
an infection. She will need to be here at least another week." I'm sure you can imagine
how upset we were. In hindsight we should have left and sought a different/better facility
at that time.The infection cleared up and one week later she was discharged. This was on Friday,
February 19,2010. We were so excited to finally bring her home. That evening, as I went
to change her diaper for the first time, she passed gas and some poop came out. That's
when I noticed that the poop was coming from her vagina. I wiped her vagina and was
about to wipe her butt and noticed that there was no opening. That moment will forever
be embedded in my mind. This can't be happening; it has to be a dream. I immediately
called my sister; frantic and in tears. She contacted Chapel Hill and explained the entire
situation to a pediatric surgeon and was advised to get the baby to them immediately.
Upon arrival we were advised further about this condition and researched it on the
internet as well. We discovered how imperative it is for this condition to be discovered
immediately after delivery so that it can be corrected while the anal area is still sterile. At
this point we faced the possibility that the baby would have to be given at least one and
possibly two colostomy's to allow that area to become sterile so they could do the
corrective surgery. This poor baby had already been through so much and now this.
We're talking about four or five more surgeries in the next few months to correct this;
when it all could have been avoided if the nurses and/or doctors at Duke had simply done
what they were trusted to do.

Comments

no excuse for this malpractice

Sadly, even if a person can access health care, and even supposedly the best there is, something like this happens?

So lots of tests, medicines, but no common sense examination of the baby.

Only YOU saved your grand baby.

Malpractice like this should never have happened and should not ever happen again.

What ever happened to common sense? Isn't it high tech enough?

I am not surprised about this happening at Duke

I am a very detail-oriented anal type person and I kept watch over my mother like a hawk when she was seen at Duke. She was getting radiation treatments at Duke, and I believe those led her to develop hemorrhagic cystitis, which caused a urinary tract infection which led her to be hospitalized. She was in DUMC for 5 of the last 6 weeks of her life (one week spent when they sent her to a nearby rehab facility). She was practically comatose several times in the hospital, and no one could figure out what was going on. She ended up dying from septic shock and her kidneys shut down.

The thing which both saddens me and enrages me is that I knew she was getting fuzzy in her thinking during her 5-week radiation treatment (from mid August to late September 2009) and I mentioned it to the docs. Since she was being treated for a tumor on her spine, I wondered if the cancer could have gone up the spine and attacked her brain - therefore, should they do an MRI? The doc asked me what good would that do - if she had a tumor in her brain, knowing it wouldn't improve her quality of life. I felt that testing to figure out what was going on would help her out - and help us out.

The nurses and staff were so fixated on wanting to know what drugs she was taking and didn't seem to give a damn that she was peeing quite a bit. After the radiation treatments were finished, she did OK for a few days, then went downhill.

Today is Thursday, September 30, 2010. October 1, 2009 was the last good day my mother had at home in her life. She really started to go downhill. It got so bad that on October 5, 2009 I had to carry her down three flights of stairs (we live in a split-level home) to put her in the car and take her to the Duke ER in Durham. Later that night I was told by my sister that she had a bad urinary tract infection. I told my precinct vice chair about this, and she told me that UTIs in older women usually manifested themselves in frequent urination and fuzzy-headedness.

How come my middle-aged precinct vice-chair knew this, but doctors at Duke did not? The radiation treatments directed at the spine obviously hit other vital organs, and such exposure could cause radiation-induced hemorrhagic cystitis, which is most common in patients receiving pelvic irradiation (10% of patients receiving pelvic irradiation get it).

If there was a 10% chance of my mother developing hemorrhagic cystitis, and the docs were made aware of her symptoms suggesting a UTI in elderly females - why didn't they check for it?

That and some resident not knowing the difference between a femur and a humerrus (the cancer had caused an bone fissure that led to the bone breaking while my mom was in the hospital - undetected even though my mom had been complaining about pain in that leg for over a year) makes me not ever want to go to Duke UMC ever again!

Chris Telesca
Wake County Verified Voting
http://noirvnc.blogspot.com
http://statewideirvnc.blogspot.com

Duke

Whats sad is that nothing is being done to change their neglect and mishaps. We have found great doctors at Chapel Hill. I wish you and your mother the best. And hopefully one day Duke will make the necessary changes for the good of their patients.