Water dangers extend beyond death for children - SanTan Sun News SanTan Sun News

Water dangers extend beyond death for children

July 9th, 2019 SanTan Sun News
Water dangers extend beyond death for children

By Jim Walsh

Staff Writer

Doctors saved the life of Rose Bennett’s son, Ethan, their efforts finally paying off after several failed attempts to resuscitate him.

But while the doctors were able to restore Ethan’s heartbeat, the happy 6-year-old boy she knew was gone forever that day, 10 years ago.

It was “the worst-case scenario’’ when it comes to non-fatal drownings, the severe cases where a patient no longer has a heartbeat and is brought back to life. He was left a spastic quadriplegic in need of care around the clock, his brain damaged from being cut off from oxygen for too long.

Non-fatal drownings such as Ethan’s are not tracked as carefully as fatal drownings — which demonstrate the need for public safety campaigns and constant, uninterrupted vigilance by parents and others when children are around water.

With families across the region planning holiday gatherings around the backyard pool and others heading for vacation spots near water, these non-fatal drownings carry a message no one should ignore:

Lives compromised by long-term, neurologic damage are another important consequence in water-related incidents, leaving lasting damage from preventable incidents.

Dr. Blake Sherman, an emergency department doctor at Banner Desert Medical Center, estimates that as many as two-thirds of victims who have lost a pulse — but have been revived and brought back to life — end up with some form of neurologic damage.

A state Department of Health Services report last year by Dr. Timothy Flood, bureau chief for health statistics, provides a snapshot of Arizona’s drowning problem during 2016, the latest available year for data.

Flood reported that 174 children were admitted at Maricopa County hospitals for water-related incidents, with 14 children younger than 5 dying from their injuries.

He estimated that four victims were left “impaired’’ neurologically, based upon them spending seven days or more in the hospital and being discharged to a rehabilitation center rather than their home.

Flood noted that there is not adequate funding to do a long-term study on the neurological consequences of non-fatal drownings.

Phoenix had the largest number of victims admitted, 86, with 53 of them children less than five years old. Mesa had 31 water-related victims, with 20 of them children; Chandler had 23 victims, with 17 children; and Gilbert had 19 victims, 17 of them children.

Mesa’s Banner Desert Medical Center treated the most victims, 63, with 52 of them small children. Phoenix Children’s Hospital had similar numbers, with 48 of the 58 children admitted four years old or less.

But Flood’s report also reflected major progress on the reduction of small children drowning.

The highest death rate was 22.2 deaths per 100,000 in 1986. The rate dropped steadily after the state passed a pool fence ordinance in 1990. In 2016, the rate dropped to 5.9 deaths per 100,000 statewide.

Sherman, an emergency room physician at Banner Desert Medical Center and Banner Cardon Children’s Hospital, said he typically treats two or three childhood drowning victims a year and he would be thrilled to never encounter another one.

So far this year, the East Valley cities of Mesa, Chandler, Gilbert and Tempe recorded 17 water related incidents, with nine involving children 5 or under.

Five drowning victims have died, but all of them have been adults, according to the Children’s Safety Zone web site.

In Phoenix, there have been 22 water-related incidents, with nine involving pediatric victims. Five victims have died, including one small child and four adults, according to the web site.

Last summer, Sherman said he attempted to save two sisters, 11 months and 3 years old, who drowned in a particularly tragic case, but without success.

He said there is a dramatic difference in the outcome of children involved in near-drownings and non-fatal drownings, such as Ethan’s case.

“Lots of times, when they still have a pulse, and they do CRR, the kids usually do OK,’’ he said.

One key question that Sherman asks paramedics when they bring victims to the hospital is whether the drowning was witnessed and when the last time the child was seen outside the pool. The answers help him understand how long a child might have been underwater.

“The point is to get them back alive and be able to walk out of there,’’ Sherman said.

But in the non-fatal drowning — when there is no pulse detected after the victim is pulled from water — the odds of death or survival with neurological damage go way up, based largely upon how long the brain is deprived of oxygen, Sherman said.

The brain is one of the first organs to die without oxygen, usually in about six minutes, so restoring the flow of oxygen quickly is of critical importance, he said.

“Essentially, they are dead,’’ Sherman said. “The longer you are without adequate oxygen and without adequate circulation, there is neurologic damage.’’

He said it’s difficult to predict the degree of neurologic damage that a patient will suffer in a non-fatal drowning, but he estimated that less than a third will leave the hospital without neurologic damage.

Patients might emerge with a varying degree of neurologic damage, mostly less severe than Ethan’s, such as a limp or damaged cognitive ability, Sherman said.

Bennett cares for Ethan non-stop, waking up every two hours to turn her son over so that he doesn’t get bed sores. She feeds him through a feeding tube. It is an endless, continuous cycle.

But in the end, Bennett would rather have Ethan, even in a highly compromised state, rather than not at all.

“As bad as your life is, you have to say, what is the positive?’’ Bennett said. “If I ever get more than two hours sleep, I dread that day, because that’s the day my son is no longer on earth.’’

Ethan has limited, uncontrolled movements of his arms and legs. He can’t hold a pencil. He still attends high school as a student with special needs. He sits and listens in class and can answer some yes or no questions, but not verbally.

“I will cry every day of my life for the things he can’t do. He lost to ignorance,’’ Bennett said, adding that her son’s brain damage was entirely preventable.

Bennett quit her job at the former University Medical Center, the same hospital where Ethan was treated when he drowned on June 2, 2009.

Ethan spent 7 and a half months in hospitals and rehabilitation centers in Tucson and in Phoenix, where the boy was treated at Barrow Neurological Institute and at Hacienda Healthcare.

She said her son was not adequately supervised, with no one noticing he had slipped under the water. The lack of CPR exacerbated his injuries. The matter was settled in a lawsuit, but no amount of money can restore Ethan’s previous life.

“I’m glad he’s alive, but to this day, I cry,’’ Bennett said. “For the rest of my life, I will never hear my son’s voice.”

Lori Schmidt, a spokeswoman for the Scottsdale Fire Department and past president of the Drowning Prevention Coalition of Arizona, said Bennett has devoted her life to Ethan and her care has helped improve his condition.

“She has taken the care of Ethan upon herself and he has thrived because of her,’’ Schmidt said.

She said families of non-fatal drowning victims typically suffer two tragic losses.

“They grieve the death of the child the day he died. They grieve a day 10 years later when his body gives out,’’ Schmidt said.

After experiencing the anguish and heartbreak of treating drowning victims, Sherman is doing everything he can to protect his son, Jaxson, 7 months, from suffering a similar fate.

He has installed a fence around his pool at his Scottsdale home and is participating in swim classes with his son.

“We went this morning,’’ he said. “It was incredible.’’