Doctors question medical care given to migrant boy who died Christmas Eve

[Dennis Donovan]

Source: CNN

(CNN)Days after a Guatemalan boy died in US custody on Christmas Eve, infectious disease experts say it appears Felipe Alonzo-Gomez likely had the flu, a potentially deadly illness that can often be treated if caught early enough.

US Customs and Border Protection issued a statement Tuesday saying the boy had "possible influenza symptoms" on Monday and was taken to a local hospital.

A detailed account of the child's care released by the federal agency does not mention a flu test being administered to Felipe. CBP did not respond to a question from CNN about whether the boy received a flu test.
"This child's death could have been prevented," said Dr. Flor Muñoz, an associate professor at Baylor College of Medicine in Houston.

Muñoz and another pediatric infectious disease expert contacted by CNN said they would have tested Felipe for the flu if he had been their patient, given that it's flu season and he had symptoms of influenza.

<snip>

The hospital discharged Felipe that afternoon after diagnosing him with a "common cold" and prescribing ibuprofen and amoxicillin, an antibiotic, according to the agency.

That night, Felipe vomited, and a few hours later a border patrol agent brought him and his father back to Gerald Champion Regional Medical Center. During the ride, the boy began to vomit again and lost consciousness. He was pronounced dead at the hospital at 11:48 p.m.

</snip>

Read more: https://www.cnn.com/2018/12/27/health/guatemalan-boy-death-doctors/index.html

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[DRoseDARs]

1. Amoxicillin. For a common cold? No one does that. They knew he had the flu, they sent him to die. nt

[pnwmom]

3. Flu isn't treated with antibiotics either, unless there are complications.

Some ear infections require antibiotics, and many lung infections.

But I agree they'll probably find something in the autopsy beyond a cold -- and maybe even beyond the flu.

[Yosemito]

4. Was the first dead child tested for flu?

Border officials said it was not known whether she ate or drank enough food on the way to the US.
Maybe she died of dehydration, or maybe the flu is spreading in unsanitary US facilities.

[Chemisse]

10. I wondered about meningitis.

But it could've been the flu, especially if the child was weakened by the journey. And the doctors threw antibiotics into the mix 'just in case' which many still seem to do.

[pnwmom]

12. Me, too! But only because I knew a family who'd lost their son to that.

The father, who was a physician, just thought his son had the flu -- and he died at home on the same day he got sick. That's when I realized how fast meningitis could progress, and how easy it might be to miss.

[Yosemito]

2. Flu spreading in CBP facilities

And they didn't even test him.

[Roadside Attraction]

5. I'm an EMT . . .

I'm an EMT in a rural Virginia volunteer rescue squad.

I've heard several reports that the kid had a temp of 103 and was very lethargic.

There are two general rules when dealing with pediatric patients -- "peds:"

1. If the kid is screaming, crying, squalling, then, the kid is okay -- possibly in pain, likely frightened, but okay. Any kid that's screaming is moving air -- breathing -- and if the kid is wriggling around, he/she is pretty normal. Find out what's hurting and deal with it. Keep everyone calm, especially the mother.

2. If the kid is lethargic, you have a BIG problem, especially if you find temp over 100 and/or difficulty breathing. A kid like that will go downhill fast -- because -- little kids' systems do not have the reserve that an adult or teenager has. Of all the stuff an EMT deals with, the most frightening is a small child, clinging to mother or just lying there on the bed, not moving, not screaming, eyes wide open staring at you, struggling to breath.

This kid likely was in respiratory distress -- which leads to respiratory arrest which leads to cardiac arrest, and, in kids, the progression is fast, a matter of minutes. Struggling to breath and not crying or screaming is a sign the kid is barely able to breath. Should have had a neb or duo-neb treatment with high-flow oxygen.

As for the temp, the kid should have had ice packs applied -- crotch, under arms, head -- to help get the temp down.

Then the docs should have tested for flu and hit him with antibiotics and fluids, probably needed an IV.

But, hey, what do I know about it?

[LittleGirl]

6. Thank you for your post

I too believe that they don't give amoxicillin for a common cold or flu.

Which reminds me, I recently finished a 5 day dose of Cipro (and CIPRO ear drops) for an outer ear infection that made my ear swell shut. I'm an old lady so it was totally unexpected by me and the staff in the ER which my doctor sent me to for treatment. They had those ear/nose/throat torture machines that made me cry out loud. I'm all healed now but I was a mess even though I didn't have a fever.

I hope they disclose why this kid died. Thanks again.

[yardwork]

7. Thank you for this. I wonder who saw this child in the ED.

[AllyCat]

8. You know a lot. Thank you for your post.

So true. A lethargic child needs immediate attention and treatment. As you say, they move along and then drop off quickly.

[Chemisse]

11. It's helpful to know what they SHOULD have done.

Because clearly when a child is sent home then later dies, the earlier treatment needs to be examined.

I'm sure there are times when it just could not have been predicted, but given the general attitude of neglect toward the immigrants, it's likely the medical care was less than thorough.

[pnwmom]

13. Yes -- my pediatrician always said that how they acted was more important

than the degree of fever. So a lethargic child with a moderate fever could be much more sick than a child with a high temp who had normal energy. She also said that a mother should trust her gut, because she knows her child better than any doctor. That helped me do the right thing one day when one of my children was very sick -- and only I knew it.

On that day my regular pediatrician wasn't there, and her partner had to see my 2 year old, who was lethargic but only had a fever of 102. I pointed out that there was something funny about how he held his head -- and I could feel giant lymph nodes in his neck. The partner said that my son just had the "virus that was going around," and sent us home. Instead, I took my son straight to the emergency room, where they did a blood test and quickly diagnosed a serious bacterial infection, and put him on a powerful broad spectrum antibiotic.

When my regular pediatrician got back, she said that the lymph nodes could have been meningitis and that I'd done exactly the right thing -- and that she was going to have to talk to her partner, because this wasn't the first time he hadn't listened to a mother.

[Chakaconcarne]

9. Heard on NPR yesterday there is a request for an official count

of children that have died as a result of Trump's horrendous border policy..

The belief is there is a much greater number than 2.