He would have been 22 months old yesterday and would have celebrated his 2nd birthday in October. He was a joy to his parents, siblings, extended family and neighborhood.
But toddler Jaydan Guy, 21 months, lost his life on the evening of July 28, around 7:00, after six days on a ventilator, brain-dead as a result of not getting enough oxygen while choking on, of all things, a bean.
Director of Health Services, Dr. Michael Pitts, confirmed to Amandala yesterday at his office in Belmopan that an investigation has been opened and that the Ministry takes Jaydan’s death, as it did those of the other prematurely deceased children, very seriously.
While warning against “sensationalism” in reporting the facts of the case by the press, Dr. Pitts admitted that as one of the top health professionals in Belize, it pains him to hear of and have to investigate cases like these.
Once the facts have been gathered, Dr. Pitts says, a peer review will be conducted with health professionals not affiliated with the public system to determine what went wrong.
This investigation features a public hospital – the Western Regional Hospital in Belmopan, and a private one – Belize Healthcare Partners Limited in Belize City.
Jaydan’s parents, Eckert and Anna Guy of New Site, Belmopan, believe that their son’s death could have been prevented. It is the latest in a long, tragic series of incidents involving alleged hospital negligence to unfurl this year.
Andy Jones, Jr., of Punta Gorda; 6-month-old Evander Sho of San Antonio, and the unnamed, unborn babies of women from Corozal and Belize City all met their deaths at local hospitals in the last few months.
We visited Jaydan’s parents at their home yesterday, Wednesday, to get to the bottom of this disturbing story.
And as much as it obviously pained them to relive their child’s last hours for a stranger, Eckert and Anna accommodated this reporter with their account of what happened.
It all began just before 11:00 a.m. on July 22, 2009. Jaydan was at home with his older sister, 17, when suddenly he began to choke. After trying and failing to get her baby brother to cough up whatever was choking him by slapping his upper back, the teenager called her father, Eckert, a technician for Belize Telemedia Limited (BTL), at his work place on Bliss Parade.
Eckert rushed home, where his daughter was waiting with Jaydan. He and Anna, a self-employed businesswoman, rushed the child to the Western Regional Hospital emergency room. On the way, the child had started losing consciousness, and his eyes were rolling upward, but the father kept fighting to keep his child’s passageway open by sticking a finger in his mouth.
At the emergency room, the doctor in charge, a female Cuban, (the parents do not know her by name) determined that Jaydan was having a seizure, despite the parents’ insistence that their child was choking. After briefly examining the inside of the mouth and finding nothing, she sent the distraught parents and a crying Jaydan, who had now regained consciousness, to the X-ray unit.
According to the parents, no form of first aid was performed, not even the Heimlich maneuver.
It was decided that doctors would perform an emergency tracheotomy, cutting open the throat at the windpipe to get to the choking object, but Jaydan, still crying, fought the doctors and his parents as they tried to strap on an oxygen mask over his face and prep him for the surgery. He then lost consciousness again.
At this point, Anna told Amandala, she rushed her disoriented, unconscious son back to the emergency area, running and calling for help. “My baby needs oxygen; he’s going to die! Help!” were her reported words, but it appeared the doctors were bewildered and reduced to discussing tactics.
Finally, one of the doctors opened a ‘superficial slit’ on the throat, not deep enough to reach the trachea, to open up a way for a tube to manually pump air into Jaydan’s lungs, as he continued to go in and out of consciousness for a total of 45 minutes to an hour. The slit was later sutured.
It was decided that nothing more could be done in Belmopan and the doctor in charge, a Dr. Godoy, advised the parents to go to Belize Healthcare Partners. After a further delay when a suitable oxygen tank could not be immediately located (Eckert told us he had to carry out the tank himself when they could not find a staff member to do it), an ambulance drove to Belize City. At no time, according to the parents, were they given any options to facilitate faster care for Jaydan.
Jaydan had been stabilized before leaving Belmopan, but lost his heartbeat five minutes away from the old capital. But Eckert and Anna had made contact with the emergency team from BHPL, and they were ready and waiting when the ambulance arrived and quickly restored Jayden’s pulse and stabilized him. The family was treated, at least initially, with urgency befitting the nature of the situation – and it helped that BHPL was assured of payment through the family’s health insurance plan paid through Eckert’s job at BTL by Sagicor Life Insurance Company.
According to Anna, all procedures were in place for a bronchoscopy, which would have involved searching out the windpipe and lungs for the offending object and removing it.
But while Jaydan was being put on the ventilator, the hospital’s administration informed the family of a shocking discovery: the insurance package Eckert paid for did not cover Jaydan as it did Anna and their older children.
All of a sudden, Eckert had to find $15,000 upfront to keep Jaydan in the hospital for the procedure and recovery over five days. The total hospital stay would have cost $20,000.
Sure that BHPL were mistaken, Eckert told us, he immediately went to see the human resource manager at BTL on St. Thomas Street. While he was out, Anna managed to convince the hospital’s administrator to admit Jaydan on promise of payment – a ‘promissory note’, as she called it (that term being very familiar to BTL and BHPL).
Over on St. Thomas Street, Eckert says, he was being told that BTL could not help because the original application form to Sagicor was missing Jaydan’s height and weight; and that while his situation was “unfortunate,” Eckert would have to consider taking Jaydan to the Karl Heusner Memorial Hospital.
It was a nasty surprise for the technician, who had never been told of the problem despite providing his child’s paperwork and having Sagicor pay costs for Jaydan’s birth and delivery almost two years ago.
Finally, it was agreed that Eckert would borrow against his pension plan, and armed with the cheque, he returned to BHPL an hour after he had left. (Because the couple is still weighing their legal options, they declined to tell us how much money he borrowed.)
Jaydan was moved from BHPL’s emergency room and given a CAT scan, which delivered the final blow to his weary parents: Jaydan’s condition was too far gone for anything to be done. His brain had been damaged from lack of oxygen.
In a formal letter to Dr. Pitts on July 31, the couple has requested a formal investigation of the events at the Western Regional nine days earlier: “We strongly believe that our child Jaydan did not receive the appropriate emergency care at the Western Regional Hospital. We believe that what should have been basic routine emergency procedures that could have saved his life were not carried out. We believe that had proper care been given, our precious child would have still been here with us.”
Anna told us that because of the nature of the emergency, she refuses to blame the BHPL doctors, particularly attending pediatrician Dr. Cecilio Eck, for the death of Jaydan. However, she feels the BHPL administration could have handled the payment matter less clumsily, especially since they were treated so well initially.
Dr. Eck, in speaking to Amandala this evening, lamented that the Western Regional did not have the bronchoscope that would have cleared the object, forcing them to push the bean toward the right lung and opening the left for air. Alternatively, he said, they could have called in a surgeon and anesthetist to open a passageway below the bean.
It is important in all cases of choking to open the airway as soon as the victim is in an emergency room, Dr. Eck said. Despite the fact that Jaydan was put on medication to stabilize his bodily functions, particularly the blood, after the CAT scan, an EEG by an Orange Walk pediatrician who was called in later that week found that the brain was not functioning, and Jaydan languished on life support until his passing.
Eck told us that accidents such as this are the main cause of baby deaths after 9-12 months, and that it is important for parents to store away from reach items kids can get into, such as building blocks, cleaning utensils and detergents, and other such objects, and to pay close attention, although parents cannot prevent everything that may potentially happen, as this case proves (deaths from choking on foreign objects are fairly rare in Belizean children, according to Dr. Eck).
“I appeal to the Prime Minister to take a look at all our public hospitals, especially the Western Regional, and particularly the emergency rooms,” Anna told us. “It is amazing how a facility that handles patients from as far away as San Ignacio, Benque Viejo, and Dangriga could not handle an emergency right in their own backyard.” (The couple live about a five-minute-walk from the hospital.)
Jaydan was the youngest of five. Those who knew him describe him as having been an energetic, outgoing and precocious child who loved to have books read (he would turn off the television when the family got together at night) and to ride horses.
He was buried following funeral services on August 1 at the Belmopan Baptist Church, and is survived by two brothers and two sisters, his grandfather Robert, aunts, uncles, other relatives and friends.
The hospital administrator at Western Regional was in meetings all day Wednesday and unavailable for comment today. The hospital has said nothing publicly concerning the incident.