Haleigh Poutre was Failed at Every Level

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Haleigh Poutre was hospitalized on Sept. 11, 2005, with a damaged brain stem that authorities say resulted from blows inflicted by her adoptive mother and stepfather, who were charged with assault (with a baseball bat). The beating came after Department of Social Services received no fewer than 16 abuse or neglect reports.

Doctors gave the little girl a death sentence by characterizing her as "virtually brain dead" and in a "permanent vegetative state". Less than three weeks later, the Massachusetts Department of Social Services pushed to remove Haleigh's feeding tube and respirator and won approval from the State Supreme Court to so.

Well, the young girl fought, and she lived. Today, she is in a rehabilitation facility.

Despite her "hopeless" condition, and her status as "virtually brain dead", she began showing signs of improvement and was weaned off her ventilator. She is now in rehabilitation, able to eat scrambled eggs and cream of wheat, and has tapped out drum rhythms during physical therapy.

Understandably, Gov. Mitt Romney created a commission in January to investigate the state's handling of Haleighs case.

Today, the commission released its results. Here are summaries:

Forbes/AP:

An alarming string of mistakes by state agencies and medical professionals contributed to the poor care given to a 12-year-old girl before and after a beating that left her severely brain-damaged, a panel appointed by the governor reported Tuesday.

Boston.com:
The panel delivered a list of 15 recommendations the governor said his administration would implement. Among them: requiring DSS to obtain a second opinion and consult ethics panels when considering removing a child from life support; establishing a system to identify high-risk cases; urging the Legislature to extend the period for investigating abuse reports from 10 to 20 days; making sure pediatric hospitals have child abuse teams on staff.

Boston Herald:
The panels recommendations are so very basic to the welfare of the children who come under the DSS umbrella that it is horrifying they have never been in place, yet alone even considered, before. DSS should place on retainer panels of medical professionals in the areas of child abuse and psychiatry, including specific expertise in post-traumatic stress disorder, the report insists.

Gov. Mit Romney's Office:
Haleighs case highlights a frightening confluence of a health care system ignorant of abuse and a child protective system ignorant of medicine. -- Christine C. Ferguson, former Massachusetts Department of Public Health Commissioner

We did not find carelessness or a failure to make best efforts to meet Haleighs needs, said Ferguson. Instead, we found health, mental health, child welfare systems that, for a variety of reasons, were unable to penetrate the proffered explanation for Haleighs injuries, unable to ask the questions that could have protected her and were ill-equipped to provide her with the care and assistance any of us would want for our children.


Although the panel ripped the system and recommended more government, procedures and processes, Ive seen no admission of guilt or acknowledgement of a fundamental problem related to the diagnosis of PVS and its subsequent use to terminate a patient. What in the world is a state agency doing attempting to euthanasize a young girl shortly after her incapacitation?

Standards for diagnosis of PVS have not even been widely accepted by the medical community. Yet this designation is the death sentence for wards of the state?

Studies indicate PVS requires considerable skill to diagnose, requiring assessment over a period of time; diagnosis cannot be made, even by the most experienced clinician, from a bedside assessment. Accurate diagnosis is possible but requires the skills of a multidisciplinary team experienced in the management of people with complex disabilities. Recognition of awareness is essential if an optimal quality of life is to be achieved and to avoid inappropriate approaches to the courts for a declaration for withdrawal of tube feeding.

Here are some of the results:

  • Out of 40 patients diagnosed as being in a persistent vegetative state, 17 (43%) were later found to be alert, aware, and often able to express a simple wish. The study is one of the largest, most sustained analyses of severely disabled people presumed to be incapable of conscious thinking, communication, or awareness of their surroundings. The author, London neurologist Dr. Keith Andrews, said, "It is disturbing to think that some patients who were aware had for several years been treated as being vegetative.

  • Studies show PVS patients feel pain indeed, a Univ. of Mich. neurologist, in one of the most complete studies, concluded that, when food and fluids are withdrawn [to impose death], the patient should be sedated.

  • A study of 84 patients with a "firm diagnosis" of PVS found that 41% regained consciousness by six months, 52% by three years. These statistics certainly discredit the terms "persistent" and "permanent".
In practice, the terms of PVS have become so elastic as to categorize Christine Busalacchi, a young Missouri woman, as PVS even though she said "Hi" to a doctor, made sounds to indicate which soap opera she wanted to watch, pushed buttons on a cassette recorder to play tapes and recognized her father on TV.

Despite all of this, the PVS diagnosis was used in an attempt to end a young girls life support and end her life through dehydration and starvation.

It is now widely known that Haleigh was the victim of a fatally broken bureaucracy. Even worse, she was almost a fatality of a defective and crumbling death oriented medical system and a twisted judicial process.

Updates:

Typical bureaucratic answer: everyone and no one - Michelle Malkin

Erring on the Side of Death - Jivin


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