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One mistake or moment can change the rest of your life forever!

Posted Nov 03 2009 12:00am
This picture was taken of Gavin shortly before he suffered his stroke. He was about 7 months old. Wasn't he cute?!



He was doing quite well in this picture. He was still in the hospital, after having been for almost 4 months. He had gone through 3 surgeries and almost 2 1/2 months of being intubated and on a ventilator. He was finally making great improvement and was working hard on getting to come home again.

He was then transfered to another hospital, that was closer to our home. This is where mistakes were made and Gavin suffered his brain injury. One mistake and a matter of a couple of days changed his and our life forever.

About a month ago I totally broke down thinking about this time in Gavin's life. I do this a couple of times a year. Usually I'm in the shower, alone with my thoughts and the dam breaks loose. This time I was reading an article in the October 2009 Good Housekeeping magazine. There was a story in it called, Life after Josie, which was about a toddler who got burned in the bath tub and ended up in the hospital with 1st and 2nd degree burns. Her parents were told that she was going to be fine, but that they needed to keep her hydrated and watch for infection. She was still hospitalized while she healed from her burns. She was in the hospital for a couple of weeks, healing and getting narcotics for the pain. She was doing great and they were planning on sending her home again soon.

This is when things went down hill fast! While reading this story, this is where I lost it and started sobbing. I couldn't believe how similiar our very different stories started to become! This is where I could put myself in this mother's shoes and ached for what she had to go through.

Her daughter started to act thirsty all of the time. She would cry for something to drink, but was told that she could only have ice chips. She would suck on her washcloth during bath time. She was getting dehydrated! Her mother asked for IV fluids to be given to her daughter, but she was told that her daughter was just fine. She was NOT fine!

The next day she became unresponsive and her mom was very worried. The mother was told that she was fine and that it probably had to do with weaning from the narcotics. So, the doctor discontinued the narcotics. Later that day, the order to not give narcotics anymore was changed, and a nurse gave her methadone. Minutes later Josie went into cardiac arrest. She went from almost going home, to on a breathing tube and tons of machines! The doctors thought she had an infection, but her mother knew that it was because her daughter was dehydrated and given the narcotics. This proved to be the case!

Josie's organs began to shut down and she was pronounced brain dead. Josie died from this mistake! They later learned that Josie did die from dehydration.

Reading this story made me so sad for this mother! It also made me wonder why Gavin is still alive today?

Gavin's story started out very differently. He was born with a heart defect and this is how his hospitalization began. Josie suffered burns and she died from complications that arose from mistakes that were made!

Although their stories started out very differently, the ending was almost the same! Gavin almost died from the very same thing! Gavin was so much more sick than this little girl to begin with and yet very similiar mistakes were made, and Josie died and Gavin lived. WHY???

When I think back to those horrendous few days in the hospital, I almost get physically sick! It's like a bad movie playing in my head. Gavin went through SO much, things that could have been prevented! I remember having to watch Gavin suck frantically on his fists trying to get some fluid from them. I remember watching him shake and shake and shake! I remember him continually fussing and trying to tell us that something was wrong! I remember him and I being awake for a couple of days straight and then he finally fell asleep. In the end, this sleep was not a good thing, it was because he had suffered his stroke!

The thing is, I KNEW that something was wrong before this! I told doctors and nurses that something was wrong! I told them that I thought that he was dehydrated and that he needed IV fluids! The doctors kept telling me that they wanted him to be dehydrated, because his lungs needed to get clear. I told them that I understood that, but "What about the rest of his body?!"

Of course, I was just his mom! The doctors did not take into account the fact that Gavin had C-Diff and was constantly having bouts of diarrhea. They didn't take into account the VERY HIGH doses of dieuretics that he was getting. They didn't take into account the fact that Gavin's mom might actually know her son better than all of them put together! The doctors did finally give Gavin an IV, but it was too late!

Gavin suffered his brain injury and it's all because he was dehydrated! Gavin ended up back on the ventilator and on tons of machimes. Gavin's organs even began to shut down. His kidneys and liver weren't working properly and he was a mess! Shortly after this is when Gavin began having seizures as well!

I thought that he was going to die. Doctors and nurses thought that he was going to die. I knew that it was from dehydration, but no one wanted to commit to this reality.

In Josie's story, she died and doctor's told her parents that "this shouldn't have happened and if we had listened to you, her mother, she would be alive today." This is what the mother had been waiting to hear. The hospital offered this family a settlement for their loss. The family didn't want this money, but they took it and started a foundation with the money. They wanted their daughter's death to have good come from it.

Obviously, Gavin did not die from the mistake that was made. But, his life and our family's life has changed forever because of this mistake! Gavin could be sitting up, crawling and even walking today if things had been done differently. This is a hard pill to swallow everyday!

The Josie King Foundation created ways for hospitals to not make similiar mistakes, mistakes that took their daughter's life. They started something called, "a rapid-response team." This is a team of doctors and nurses that are on call to come investigate a patient's condition. This team can be called by a family member, who may think that something is not right with their family member or they can be called by a nurse who is concerned with the condition of one of their patients. The number is given to the patient or family when they are admitted into the hospital. This team will come and check the patient thoroughly and make sure that things are not being missed.

Man! I wish that the hospital that Gavin was in had had this team on board for me and him! I surely would have called this number and insisted that his care be investigated further!

This type of thing could have saved Josie's life and it could have prevented Gavin's stroke! I have been told that the "ball was dropped in Gavin's care" and that things should have been done differently. This doesn't change the fact that Gavin will always be like an infant. And, it sure does leave this Momma feeling guilty every day of her life, thinking that things could have be very different today if I had just fought harder for my son!

After reading this article and crying, I got on the phone with our hospital and talked with the patient relations department. I asked if this type of response team was a part of their hospital today. I was told that it was recently added to their team. While this made me happy to hear, it also made me wish that it had been done sooner for Gavin and others like him! There are statistics that say that between "44,000 and 98,000 people die each year from medical errors." The article said that it is "one of our country's top killers and that 70 percent of all unexplained medical events resulting in death or serious injury occur because of a breakdown in communication, as in Josie's case" and as in Gavin's case.

I have to live with this mistake forever. I wonder why Gavin is still alive today and Josie is not? I feel the need to make good come from this mistake. So, please inquire with the hospitals in your area, about whether or not "rapid-response teams" are set up in your hospital! This could make all the difference for you or someone that you love!

Gavin is here today for some reason and I am so thankful that he is! His life may be very different than it could have been, but it's still a full life and he brings so much fullness to others that are blessed to know him! God has a plan for Gavin and a plan for all of us! Be ready to fulfill God's plan for you each and every day! And, be thankful for the abilities that He has given to you!





"Bear one another's burdens, and so fulfill the law of Christ." Galations 6:2
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