Shannon, my dear friend, was awakened in the middle of the night by screams coming from her daughter Ellie's bedroom. She rushed to her rescue, and immediately to the ER only to be turned around by Children’s Hospital healthcare staff. With a spiked fever of 103.5 Fahrenheit, and a mother’s desperate cry for help, the health specialist finally admitted Ellie after several days had passed. A long trail of events occurred that opposed the ethical values of beneficence and nonmaleficence, which initiated the moment she was forbidden to enter the ER. Proper protocol was mismanaged as doctors failed to provide an MRI, CT, or ultrasound upon admittance. Once scans were performed and reviewed, doctors failed to learn why fluid was in her pelvic region. Even worse, Ellie was released under the notion she had some rare condition that wasn't identified. They hadn’t done anything, and Ellie was still in excruciating pain. Just two days prior to her release, the doctors stated she was terminally ill and was not going to make it. Ellie’s body became so weakened to the point where she lost all vital signs and crossed over to the other side.
According to Ellie, she was experiencing something new and phenomenal as she watched herself outside of her body while doctors and nurses swarmed her. In a blink of an eye, she was in heaven. Ellie, only nine years of age, at the time, had a powerful, graphic glimpse of heaven. With much excitement, she spoke of the depth of love, peace and beauty that resided there, and the conversations she had with Jesus. Shannon, on the other hand, was falling apart as she whispered a silent prayer to what she knew as an unreal God. Miraculously, Ellie’s lifeless body was revived! Once released, Shannon decided to change hospitals because a friend referred her to a gastroenterologist at Rocky Mountain. Upon examining Ellie, he found dead white blood cells from her appendix in her biopsy and ordered an immediate surgical procedure. It was clear Ellie had perforated appendicitis at this point.
I was surprised to find that appendicitis is considered the most common form of abdominal surgical procedures in children. I discovered a study where 755 children came into the hospital with abdominal pain. Diagnosis of appendicitis can be challenging to identify. However, this study sought the utility of clinical pathways in a less difficult and frictionless way in order to improve the diagnostic process. Laboratory analyses of white blood count and ultrasound imaging are the best sources used to determine diagnosis, which are usually coupled together along with observing signs and symptoms known as risk factors.
Why did this hospital turn my friend around? I believe that while our nation is in the thicket of this COVID-19 outbreak, many caregivers were in panic mode and shaken by this unparalleled catastrophic event in its infancy. However, the cost must be considered when one has chosen the pathway of care. What caused the doctors to be so negligent in treating and diagnosing Ellie accurately? This paper cannot contain all the adversity Shannon and her family fought through with physicians who seem to not know what they were doing or possibly stressed and/or exhausted from the demands of COVID-19. One problem is clear: this hospital care team was not in compliance with ethical guidelines. Sure, challenges arise like the difficulty to determine diagnoses when children are not providing an adequate description of symptoms and/or a close collaboration between departmental heads are absent. However, one should not be released from the hospital on suspicion they have a rare condition, and without investigating the evidence provided through imaging that something was certainly wrong.
Shannon is immensely grateful for how everything occurred. Although carried out inappropriately with the first hospital admittance, she believes God allowed it to happen for a greater reason. She said things have changed drastically for her family since she has been awakened to know God is real, and that it was all a pure blessing in disguise.
Glass CC, Rangel SJ. Overview and diagnosis of acute appendicitis in children. Semin Pediatr Surg. 2016 Aug;25(4):198-203. doi: 10.1053/j.sempedsurg.2016.05.001. Epub 2016 May 10. PMID: 27521708.
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