"You can't imagine what Mark and I have been through," Debbie Troch says. "You can't imagine how we feel." And for this we consider ourselves lucky.
Though we all experience personal loss, in some form, at some point, in our lives, there is no way to imagine the pain of the parent who survives a child. "Every parent's nightmare" it is called. And Debbie and Mark Troch have been living it.
Others have lived it -- the Orioles' Tim Hulett and his wife, Linda, to name two -- and many have managed to put tragedy behind them and go on. Or so we like to think.
Debbie and Mark Troch, however, are dealing with something far more complicated than the sudden loss of a child. They are dealing with anger, broken faith in a hospital they trusted and the lingering fear that they made the wrong decision when they took their daughter there for treatment.
After seven months of crying, agonizing, talking and arguing, after consulting with attorneys, after knitting together bits and pieces of information about their daughter's death, after revisiting the dark memories of Holy Thursday 1992, Debbie and Mark Troch decided to file negligence claims against St. Joseph Hospital, the firm that manages its emergency department, and two doctors who were on duty the night their daughter died. The Troches have hired one of the top medical malpractice attorneys, Marvin Ellin, to represent them.
The suit does not attach a specific dollar amount to damages, and Debbie Troch says her case is not about money; it's about holding a hospital responsible for a tragedy that, she says, could have been avoided. It's about warning other parents.
"The whole point is getting to the truth," she adds.
Readers of this column in The Evening Sun, especially parents of teen-agers and children, will remember the Tiffany Troch story. It was reported at length, albeit from the Troches' point of view only, last spring.
April 16, the Thursday before Easter, Tiffany Troch was injured in a fall of between 8 and 9 feet from a rope swing, known as "the Tarzan rope," in her neighborhood, the Oakhurst development in Baltimore County. She came home complaining of abdominal pains that, it turned out, were symptoms of a lacerated liver. Her parents drove her to St. Joseph.
It was 5 p.m. when Tiffany, an honor student at Perry Hall Middle School, walked into the emergency room. She was pronounced dead at 6:20 the next morning.
What happened? The negligence claim the Troches filed this week with the Maryland Health Claims Arbitration Board charges that the hospital waited too long to consult with a surgeon about Tiffany's injury and that this delay contributed to her death. It contends that St. Joseph was not equipped to handle Tiffany's trauma and "failed to maintain even minimal emergency room facilities" and that "there were no surgeons present and available to treat an acute injury with obvious internal bleeding."
The suit further charges that:
* The surgeon on duty "failed to either immediately take Tiffany to surgery or to provide for another surgeon to render emergency medical care."
* It was not until 7:40 p.m., two hours and 40 minutes after she arrived at the hospital, that Tiffany received her first unit of blood. During her ordeal, the suit claims, Tiffany's internal bleeding resulted in the loss of 90 percent of her blood.
* It was not until 7:55 p.m., when Tiffany's blood pressure was "down to severe shock level," that the emergency room physician called another surgeon, Dr. Freidoon Malek. Dr. Malek, summoned to the hospital from his home, "determined upon arrival that the patients' life was in extreme danger."
The suit says Tiffany was rushed to the operating room after her lips and fingertips had turned blue and she was "cold, pale, clammy." Surgery commenced at 8:10 p.m.
The Troches remember Malek pulling off his sport coat, ripping back the privacy curtains in the emergency room and shouting commands to nurses. "They tore down the hall with Tiffany," Debbie Troch recalled. "And they threw me all the papers [consent forms]. I was dumbstruck." Mark Troch said, "The doctor handed me his card and said, 'I'm going to try and save your daughter."
From the moment he arrived at the hospital, Dr. Malek, who is not a defendant in the case, worked long and hard in an attempt to save Tiffany's life, performing surgery to repair her liver, giving her drugs, fluids and oxygen.
But, the suit contends, the effort came too late. "Had a surgical intervention occurred promptly upon her arrival at the defendant hospital," the suit alleges, "then the blood loss would have been avoided, severe shock would not have occured and, based on reasonable medical probability, Tiffany Lynne Troch would not have been subjected to becoming critically ill and ultimately dying."
St. Joseph, which has officially declined to comment on Tiffany Troch's treatment, has conducted an internal review of the case. Lori Vidil, the hospital's director of public relations, says that, while it was aware of the action brought by the Troches, the hospital was reserving comment until it could consult with attorneys. Other defendants named in the case, including Osler Drive Emergency Physicians Associates, the firm that manages the emergency department at St. Joseph, either could not be reached or declined comment.