Baby's brain damage cited in complaint

March 23, 1996|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

A malpractice complaint filed yesterday alleges that a newborn baby suffered brain damage because a home health nurse, and later a physician, failed to diagnose and treat jaundice.

The issues in the case are at the heart of a national debate over how health plans handle maternity care. Earlier this week, the Maryland House and Senate each passed separate bills that would guarantee mothers and their babies a minimum two-night stay in the hospital.

The infant, Sheiku Koroma, appeared healthy at birth. The complaint says his reflexes were good and he began nursing almost immediately. But within five days, he was in a neonatal intensive care unit, getting a blood transfusion. At 15 months, Sheiku can't sit up or even roll over.

"There's too much emphasis in the health care industry on cost control, and not enough on quality control," said Baltimore malpractice attorney Howard Janet, who is handling the complaint along with Zev T. Gershon. "This is a perfect example of that."

In a claim before the Health Claims Arbitration Office of Maryland, the family is seeking compensation from the insurer, Optimum Choice Inc.; the physician, Dr. Cynthia D. Sadler; the home nurse company, HomeCall Inc., and its nurse, Patricia M. Peyton. The claims office is the first step toward filing suit in Circuit Court.

The physician and attorneys for the health maintenance organization did not return phone calls yesterday. HomeCall Inc. and Ms. Peyton could not be reached.

Sheiku's parents, who live in Greenbelt, declined to be interviewed.

Sheiku was born Dec. 11, 1994, at Prince George's Hospital Center. About 24 hours later, he and his mother, Mariama Jalloh, were discharged, according to the complaint. The next day, Ms. Peyton went to their home and identified the baby as jaundiced.

Jaundice occurs in more than half of all newborns. This yellowing the skin, which usually clears up itself within a few days, is caused by an excess of the chemical bilirubin in the blood. The chemical is removed from the bloodstream by the liver, but in newborns, the liver may not function normally. If bilirubin builds up, it can cause brain damage, but that rarely happens, since the condition is easily treated.

In Sheiku's case, Mr. Janet said, the home health nurse failed to tTC follow up on the infant's condition. The day after her visit, she called Ms. Jalloh to ask about the jaundice, but didn't order any tests or referrals. The next day, Sheiku's parents took him to Dr. ++ Sadler and, Mr. Janet said, the physician failed to diagnose the baby's jaundice and intervene.

On Dec. 16, Ms. Jalloh tried to talk to a physician, then paged an on-call nurse with HomeCall, the complaint says. The page was returned five hours later by a nurse who said she would try to reach a pediatrician. The nurse told Ms. Jalloh to go to an emergency room if she didn't get a call back. No call came, according to the complaint.

When Sheiku arrived at Children's National Medical Center, he was diagnosed with hyperbilirubinemia. According to the complaint, the levels in his blood were more than three times the normal amount, causing brain damage.

Studies show conflicting results on early discharge. In California, where the majority of workers are enrolled in managed care plans, many HMOs discharge new mothers and their babies 12 to 16 hours after birth.

In Maryland and many other states, the issue has erupted in a public debate.

The Koroma case shows that wherever the care is delivered, quality is the bottom line, Mr. Janet said. Had the nurse or later the physician taken action, he said, the child could have been helped before it was too late.

Pub Date: 3/23/96

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