An Infection, Unnoticed, Turns Unstoppable

An Infection, Unnoticed, Turns Unstoppable
By JIM DWYER
Published: July 11, 2012
Retrieved from http://www.nytimes.com/2012/07/12/nyregion/in-rory-stauntons-fight-for-his-life-signs-that-went-unheeded.html?_r=1&pagewanted=all

Orlaith and Ciaran Staunton with their children, Rory and Kathleen, in 2008. For a moment, an emergency room doctor stepped away from the scrum of people working on Rory Staunton, 12, and spoke to his parents.
“Your son is seriously ill,” the doctor said.
“How seriously?” Rory’s mother, Orlaith Staunton, asked.
The doctor paused.
“Gravely ill,” he said.
How could that be?
Two days earlier, diving for a basketball at his school gym, Rory had cut his arm. He arrived at his pediatrician’s office the next day, Thursday, March 29, vomiting, feverish and with pain in his leg. He was sent to the emergency room at NYU Langone Medical Center. The doctors agreed: He was suffering from an upset stomach and dehydration. He was given fluids, told to take Tylenol, and sent home.
Partially camouflaged by ordinary childhood woes, Rory’s condition was, in fact, already dire. Bacteria had gotten into his blood, probably through the cut on his arm. He was sliding into a septic crisis, an avalanche of immune responses to infection from which he would not escape. On April 1, three nights after he was sent home from the emergency room, he died in the intensive care unit. The cause was severe septic shock brought on by the infection, hospital records say.
Because sepsis, a leading cause of death in hospitals, can at first look like less serious ailments, a campaign to aggressively identify it for early treatment has been undertaken by a consortium of 55 hospitals in the New York region, including NYU Langone.
Yet nowhere along Rory’s journey, from boy with a bellyache on Thursday to gravely ill boy on Friday night, did anyone act on strong indications that he might be fighting for his life. Critical information gathered by his family doctor and during his first visit to NYU Langone was not used, was not at hand or was not viewed as important when decisions were made about his care, records show.
Moments after an emergency room doctor ordered Rory’s discharge believing fluids had made him better, his vital signs, recorded while still at the hospital, suggested that he could be seriously ill. Even more pointed signals emerged three hours later, when the Stauntons were at home: the hospital’s laboratory reported that Rory was producing vast quantities of cells that combat bacterial infection, a warning that sepsis could be on the horizon.
The Stauntons knew nothing of his weak vital signs or abnormal lab results.
“Nobody said anything that night,” Ms. Staunton said. “None of you followed up the next day on that kid, and he’s at home, dying on the couch?”
NYU Langone declined to discuss any aspects of Rory’s care or hospital procedures.
“Our deepest sympathies go out to the family at this difficult time,” said Lisa Greiner, a hospital spokeswoman.
The Stauntons shared Rory’s medical records with a reporter for The New York Times who had met the boy last summer in a social setting. A full airing of the case, along with a commitment to reforms, his parents said, could save lives. They have hired a lawyer, Thomas A. Moore, but have not decided how they will proceed.
Rory Staunton, 5 feet 9 inches tall and 169 pounds, was big for his age and a student of the world. “The most profound 12-year-old I had ever met,” his debate coach, Kevin Burgoyne, said. For his birthday, his parents gave him flying lessons after Rory, who spent hours on a flight simulator, tracked down an aviation school that accepted students at 12. He devoured the memoir of Chesley B. Sullenberger III, the pilot who safely brought down an airliner on the Hudson River.
“I told him, ‘Sully did some fast math landing that plane,’ and for a short while, he was paying attention to math,” said Ciaran Staunton, Rory’s father. “Then he came

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