See What Happened To This Baby’s Foot While She Was In Hospital’s Care
At St. Joseph’s Medical Center in Houston, a nurse performing a routine test on a newborn made a mistake that resulted in serious burns to the baby’s foot. While the injury is not life-threatening, it shows the need for medical staff to exercise caution even when performing the simplest of tests.
According to the child’s father, Spencer Lewandowski, baby Isabel Lewandowski suffered “severe second-degree burns” to her foot and ankle. Photographs of the baby’s foot show reddened, peeling, and blistered skin. The Lewandowskis have retained an attorney to sue the hospital. This attorney, Tim Culberson, said that he has represented injured children for sixteen years and has never seen a case like this.
Baby Isabel was being tested for phenylketonuria (PKU), a rare genetic disorder in which the body is unable to process the amino acid phenylalanine. It is important to determine whether a baby has PKU before he or she starts nursing. Before birth, the mother’s body filters out phenylalanine from the fetus, but after birth, a baby with PKU must be put on a low-protein diet. Failure to do so can result in permanent damage to the nervous system, including seizures, developmental delays, and brain damage, as a result of excess phenylalanine building up in the body.
The test for PKU involves drawing a few drops of blood from the heel with a small needle. This is usually referred to as a “heel stick.” The blood drops are gathered on paper circles and tested for the presence of the enzyme that allows the body to digest phenylalanine. They can also be used for a variety of other genetic tests.
While the heel stick is not deep and heals quickly, it can be difficult to draw enough blood for the test. To make it easier, nurses used to wet a cloth diaper in warm or hot water, then wrap the baby’s foot in the warm, wet diaper. This increases blood flow in the area, making the heel stick puncture bleed more freely. However, most hospitals have banned this practice since careless nurses sometimes used too-hot diapers. This can lead to burns on the foot and ankle, although rarely as severe as those suffered by baby Isabel.
In this case, the nurse made two additional mistakes: she used a disposable diaper with a gel filling that retained much more heat than a cloth diaper does, and she heated the diaper in a microwave. Microwaves heat unevenly, making it more difficult for the nurse to judge just how hot the diaper really was. These mistakes made what should have been a safe procedure into a dangerous, harmful one.
St. Joseph’s Medical Center administrators announced a full investigation of the incident in response to the injury and the Lewandowskis’ lawsuit.
While the results of this case are horrifying, the PKU test is performed routinely and safely in hospitals across the country every day, and many states legally require that it be done within 24 hours of birth. The harmful effects of untreated PKU are severe enough that all new parents should be certain that their baby has been screened for PKU.