Communications at the hospital break down, and a teen-age girl dies


May 04, 1992|By Dan Rodricks

At the wake, some well-meaning friends, not knowing what to say, told Mark and Debbie Troch their daughter had died because "it was her time." Though Mark Troch understood how difficult it is for mourners to express their sympathy for parents who have lost a child, he rejected the sentiment. "We lost our daughter," he would say after the funeral, "but we know it wasn't her time to die."

It might never be possible to convince him or his wife otherwise.

The questions surrounding their daughter's death will hammer at the Troches' hearts and minds every time they recall the 13 1/2 hours between 4:30 p.m., Thursday, April 16 and 6 a.m., Friday, April 17. That span of time began with an accidental injury to their 13-year-old daughter, Tiffany, and ended with her death, the cause officially listed as cardiac arrest.

Every time the Troches think about those hours, they wonder whether enough was done at St. Joseph Hospital to save their daughter's life. Apparently, the Troches are not the only people who are trying to get complete information about the hospital's handling of the case. A hospital spokeswoman says a review committee at St. Joseph, headed by its chief operating officer, Dr. Robert Mahon, is conducting an investigation, standard procedure when questions are raised about treatment. Beyond that statement, hospital officials will not comment on the specifics of the case.

Debbie and Mark Troch, however, decided to tell their story, and in excruciating detail, with the hope that their experience might provide warnings to other parents and children. This is how they remember it.


That Thursday afternoon, Tiffany Troch, an honor student at Perry Hall Middle School, was at home in the Oakhurst development. Her mother thinks it was between 3:30 and 4 p.m. when Tiffany grabbed a granola bar, put on her jacket and asked permission to walk to a friend's house with another girl, Shannon Harris. Tiffany's destination was "just down the road and across the street."

"But," Debbie Troch said, "Tiffany and Shannon decided to detour through this wooded area. There's a rope in a tree there. Everyone calls it the Tarzan Rope. Everyone in Oakhurst knows about the place. It's in a tree at the top of a hill. Kids get a running start and then swing out on the rope over the hill, then swing back and jump off on level ground."

Tiffany, Shannon and Tiffany's 12-year-old brother, Marc, played on the rope. Tiffany locked her teeth around the granola bar while she took some swings. On what she had announced would be her last turn, Tiffany swung out over the hill. The rope started spinning. The granola bar slipped out of her mouth. Tiffany tried to catch it. She lost her grip. She fell, her mother estimated, about "8 1/2 or 9 feet" and landed on a small tree stump, hard against her stomach.

Once she managed to get home -- a neighborhood woman drove her there -- Tiffany confessed how she had been injured. "Mom," she said, "I was down at the Tarzan Rope."

Though Tiffany was in pain, mostly from her abdominal area, there were no cuts on her body.

"I checked Tiffy's stomach and noticed some swelling and it seemed warm," Debbie Troch said. "I said, 'That's it, we're not fooling around with this.' We took her to St. Joseph's Hospital. We didn't call 911. We thought all she needed was an X-ray. My husband and I drove her there. We got her there at 5 p.m. We left our house about 25 minutes to 5."

Tiffany walked from her parents' car to the emergency room of the Towson hospital.

The Troches hoped for the best, of course -- nothing serious, no internal bleeding, just a bad bruise. Whatever it was, they believed, the hospital would take care of it. They had done their duty as parents.

A triage nurse examined Tiffany, helped her into a wheelchair and sent her to the emergency room, where a staff doctor examined her. The Troches said the emergency room was not crowded on that Holy Thursday before Easter.

The emergency room doctor suspected internal bleeding, with possible damage to the spleen, abdominal wall or the liver. Tiffany's blood pressure was stable, but her heart rate was faster than normal. Debbie Troch said she was told this meant "the body was being compensated for blood loss."

"We were under the impression there was going to be an operation," Debbie Troch says. "We were told that Tiffany needed a CAT scan because that would give a better view of the area. . . . I was with her the whole time while she [lay] there in the emergency room. She was conscious the whole time."

But the whole time, Debbie Troch was becoming increasingly nervous about her daughter's condition. As the clock ticked away, the questions started forming in her mind: Did she and her husband make a mistake in bringing Tiffany to St. Joseph instead of having her taken by ambulance to a shock-trauma center? If she had suffered an injury to an organ, which one? Would surgery be needed? If so, when?

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