$4.5M to be paid in girl’s death
Published by The Boston Globe, January 18, 2001
$4.5m to be paid in girl’s death – 4-year old in for routine test died at Newton-Wellesley
Marlborough, MA – Five Newton-Wellesley Hospital doctors and nurses have agreed to the payment of $4.5 million to the family of a healthy 4-year old girl who was admitted for a routine diagnostic test and died of cardiac arrest the next day.
The test, to trace the cause of chronic constipation, turned up nothing, but Adara Carvalho fell into a coma in July 1996 from which she never awoke.
“I walked in with a happy, healthy child, and I didn’t go home with her,” said her mother, Noel Goyette of Marlborough.
The pretrial settlement, to be finalized tomorrow, is believed to be the largest ever paid in a child’s death in Massachusetts, according to the family’s lawyer, Andrew Meyer. It is one of several settlements stemming from a series of unexplained deaths at the hospital in 1995 and 1997.
“The death of Adara Carvalho represents one of the most tragic cases of medical malpractice in the Commonwealth of Massachusetts,” said Meyer. “Adara’s death was unnecessary, and the result of the failures of the system to appropriately respond to her needs and condition. ”
Lawyers for the doctors and nurses, who still work at Newton-Wellesley Hospital, wouldn’t comment on the settlement, which will be covered by malpractice insurance. But they said their clients accept no blame.
“It’s a terribly unfortunate incident that occurred, and we’re all glad this aspect of it is over,” said Charles P.Reidy III, the lawyer representing Dr. Aubrey Katz. “Everyone’s sympathy is with the parents…. Nobody really knows what the cause was. ”
Said Robert L. Bouley, the lawyer for the nurses and the hospital: “We feel very strongly that our clients acted in a professional and appropriate fashion in dealing with a difficult situation, and nothing the hospital or nurses did was in any fashion negligent. ”
But according to the family’s lawsuit, a succession of doctors and nurses misread a series of obvious signs that Adara was in trouble. Over several hours on July 25, 1996, the suit alleges, they stood by, baffled, as she slipped away.
When they realized at 9:45 a.m. that they had thrown her blood chemistry out of balance – by withholding food and water the night before the test, then overloading her with plain water the next day – they still didn’t act, according to the suit.
Though the condition would have been simple to correct, doctors did nothing until 10:45 p.m., an hour before her heart stopped, according to the Department of Public Health.
Adara’s brain swelled from sodium deprivation, and she went into cardiac arrest, the state agency found.
The agency’s investigation concluded that the staff failed “to recognize and respond [to her condition] in a timely and appropriate manner,” among other deficiencies.
Said Noel Goyette: “Doctor after doctor, nurse after nurse missed it. You and I could have figured it out. ”
A year after Adara’s death, the couple, who have since divorced, decided to sue the hospital and doctors Timothy Buie, Mark Blumenthal, and Aubrey Katz, as well as nurses Deborah Martin and Susan Doiron.
“This is not about the money,” said the child’s father, Emerson Carvalho, a supervisor in a North Andover baking plant. “We’re not looking to make a dollar over our daughter’s life. I’d rather live in a shack and have her running around than a pile of money to spend without her. ”
Since Adara’s death and earlier back-to-back deaths in 1997 of two women in the maternity ward, Newton-Wellesley Hospital has poured millions of dollars into quality controls.
“Newton-Wellesley has invested numerous resources to assure there are systems of checks and balances to make patient safety the watchword of the institution,” said Leslie G. Selbovitz, the hospital’s chief medical officer.
“Humans make errors,” Selbovitz said. “You need to have systems in a hospital which capture those errors. We’re not only a pioneer in the design of those systems of checks and balances, but we have also been recognized on the national stage for what we’ve done. ”
But Meyer, the family’s lawyer, said his firm has continued to receive complaints about the hospital.
“We continue to be concerned that there have not been enough steps taken to correct the extreme deficiencies that harmed so many people,” he said.
Adara’s story began when her mother, then 24 and living in Lowell, brought her to the hospital at the suggestion of Buie, a pediatric gastroenterologist with a practice in Waltham.
The child had been constipated, and Buie wanted to perform a colonic motility study to make sure nothing was seriously wrong.
After admitting her overnight, and with Adara sedated, Buie used a scope to see how here intestines were functioning. He then left the hospital.
A nurse performed the second part of the test, flushing plain water through her body. Though her sedative was supposed to wear off by noon, Adara was still groggy. She vomited and complained of a headache.
The vomiting got worse until around 3 p.m., instead of sending her home, the doctors sent her to a room to be monitored by a nurse. They told her increasingly anxious parents that Adara would be fine.
“One doctor [Mark Blumenthal] tried shaking her, slapping her to wake her up,” said Adara’s father.
At 6 p.m., Katz, now covering for Buie, believing the girl was having a bad reaction to the sedative, gave her medicine to reverse the drug.
“Adara woke up,” recalled Noel Goyette with tears in her eyes. “She said, ‘I love you,’ and went back to sleep…. She never spoke again. ”
Soon thereafter Adara began having seizures. When her father asked the nurse why, she told him it must be bad dreams, he said.
For several hours Adara’s family sat by her bed as her condition worsened. At 11:55 p.m. she went into cardiac arrest and was rushed to Children’s Hospital. She was already brain dead, being kept alive by a respirator.
Buie, who had been in phone contact with doctors but didn’t return to Newton-Wellesley until after Adara’s heart had stopped, escorted the parents to the door of the emergency room at Children’s then left.
The next day, at a meeting to discuss organ donation, Children’s Hospital doctors explained to Adara’s parents what had gone wrong.
Buie was at that meeting.
“The first thing that came out of his mouth was something like ‘This isn’t about suing, or lawsuits,’” recalled Emerson Carvalho. “The thought hadn’t even crossed my mind. ”
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