Articles Posted in Injuries to Minors

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Last week’s announcement that OHSU’s children’s hospital has acquired a state-of-the-art MRI unit for use during operations is excellent news for Oregon families that may someday be faced with traumatic brain injuries or other injuries to children requiring sensitive surgery.

According to a recent account in The Oregonian the $2 million machine and its accompanying $19 million surgical suite are significant because this type of MRI can be used during operations in the operating theater itself, in contrast to traditional MRI units which are housed separately and can only be used before or after surgery. “The MRI travels overhead on rails and then retracts after the pictures are taken, allowing surgeons to see what’s going on while they’re operating,” the paper reports. The machine is scheduled to go into service next month.

This is significant because, as OHSU’s head of neurological surgery tells the paper: “Brain surgery often succeeds or fails by a millimeter, but during surgery the brain can shift by 10 times that much.”

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Following up my blog last month about the scandal and abuses at the Give Us This Day foster care center I am pleased to report that the Oregon legislature is making progress to address the important issue of injuries to children in Oregon’s foster care system.

As reported recently by The Oregonian, the Senate’s Human Services Committee has unanimously approved SB 1515 under which “Oregon’s foster care officials would have to produce public reports listing confirmed findings of abuse and neglect every three months.” The drive for this legislation was spurred by the scandal at the now-shuttered Give Us This Day facility which, the newspaper writes, is accused of misusing more than $2 million of public funds even as it “tolerated more than a decade of child abuse.”

The key thing to remember is that this scandal is not about one particular center, but, rather, about the entire way foster care is handled by the government here in Oregon and how much insight the public ought to be able to have into both the state’s actions and the providers with whom it works.

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A lawsuit alleging sexual abuse at a state youth correctional facility is calling attention to the responsibility Oregon and other states have to protect young people placed in their care. According to a recent article in The Oregonian a man in his early 40s has filed a suit in Marion County court alleging that “as a teenager in 1991 he was repeatedly coaxed into a laundry room and a bathroom and then sexually abused by two female staff members at MacLaren Youth Correctional Facility in Woodburn.”

This case caught my eye because it is a powerful reminder that injuries to, and sexual abuse of, children can and should be addressed by our justice system even if a significant amount of time has passed. According to the paper the victim, identified in the suit only as “John Doe” had not “reported the MacLaren employees to police or others, the suit says, because he didn’t see the behavior for what it was.” No person who has suffered in this way should be denied justice solely because they were too afraid to come forward at the time the offense was committed. Therefore it is heartening to see this case proceeding despite the passage of nearly 25 years.

Even more importantly, “the suit states that sexual abuse at the youth prison in the 1990s wasn’t just isolated to Doe. The suit claims that the two women abused at least three other boys – and that one of the women ended up marrying a youth offender after the two had a sexual relationship at MacLaren. The lawsuit faults the Oregon Youth Authority for allegedly ‘fostering’ an atmosphere where sexual abuse of youths was known and ignored or condoned.”

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A harrowing story in the magazine Pacific Standard highlights how loosely regulated midwife-supervised births often are, and the tragic consequences that can result. As the article’s sub-head notes: “in 30 states, Certified Professional Midwives are licensed to practice medicine with virtually no medical training.” This, in turn, can lead to serious injuries to children and even, as in this case, to deaths.

The article focuses on the experience of a Nevada couple whose baby died a few minutes after being born. As it lays out in detail, the warning signs about this particular pregnancy were clear for any trained professional to see. The problem was that by hiring a midwife in a state with particularly lax regulation the parents were left getting advice from someone fundamentally unqualified. “Had (the baby) been born in a hospital under the care of a nurse-midwife or physician, he almost certainly would have lived,” the magazine concludes.

The article goes on to note that it was only after matters had gone too far that the parents discovered that the ‘supervising physician’ listed by the midwife had never met her, and that the woman in question had moved to Nevada to evade a license suspension in California.

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As the scandal surrounding, Give Us This Day, a foster care provider, and its oversight by the state grows it is becoming clear that a number of state officials did not have their priorities in order when it came to preventing Oregon injuries to children.

As outlined in a recent Oregonian article, newly released documents show that state officials were warned nearly seven years ago about possible abuses at the center. The potential dangers there grew from an operation where, according to a 2009 memo from the head Oregon’s child welfare programs, the site was unlicensed, and there were “numerous concerns… the most serious of which is that every single staff person has a criminal record.”

Yet, as the newspaper goes on to note, the event that eventually prompted the state to stop placing children with this questionable facility involved money rather than safety: allegations that Give Us This Day “had misspent nearly $2 million in state funding.” The newspaper reports that the latest batch of records released to the public “add to disturbing questions about state officials’ willingness and ability to crack down on troubled (foster care) providers.”

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A lengthy article published earlier this month by the New York Times (see link below) is a fascinating addition to the growing public conversation here in the United States on youth sports and concussions.

The piece tells the story of one family’s struggle to change the laws related to concussions and youth sports in Scotland after their 14-year-old son “died after being hit in the head multiple times during a rugby match in which he should have been pulled from the field.” In the wake of their son’s death the bereaved parents became very public advocates for a re-thinking of youth sports and partnered with some of Britain’s most prominent doctors to “produce some of the most comprehensive concussion guidelines in the world.” The key difference between Scotland and the United States, according to the paper, is that the governing bodies of individual sports are no longer allowed to set their own protocols for when an athlete should be pulled off the field and how he or she should be assessed. Instead, “blanket guidelines aim to protect all amateur athletes and take the guesswork out of assessing potential concussions by calling for players to be removed from the game at the first suspicion of injury.”

While no equivalent national standard exists here in the United States we in Oregon are lucky enough to have something along these lines at the state level. In 2009 legislation known as “Max’s Law” required Oregon school districts to use a standard set of concussion guidelines. Four years later a companion piece of legislation known as “Jenna’s Law” extended that requirement to non-school athletic programs such as club sports, travel teams and leagues organized at the municipal or county level.

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As the holiday season kicks off this is a good moment to remind ourselves how important safety is, particularly when it comes to preventing injuries to children, especially since some dangers are not as obvious as one might imagine.

A recent report from Michigan Radio, the state’s public radio network, focused on potentially hazardous toys and other common items, taking its cue from an annual survey issued by the state’s Public Interest Research Group. The good news from the PIRG report is that “none of the toys this year tested positive for lead,” but the radio network went on to note that other hazards remain. In particular it quotes an emergency medicine specialist urging parents “to look out for toys that can break into small parts.”

A particular focus of the report is devices that are not toys but which children are apt to play with such as key fobs, small flashlights or inexpensive watches that may contain small ‘button-style’ batteries. These can be “particularly dangerous” if they are swallowed: the moisture in a child’s body can activate the battery’s contacts leading to dangerous burning of the esophagus. The report notes that many of the potential dangers stem from the fact that by law “button batteries have to be held in place on toys with screws – but that’s not a requirement for other common devices.

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An article this week in The Oregonian described an unexpected appearance by the governor at a State Senate committee hearing considering ways to prevent injuries to children by overhauling Oregon’s foster care system. As the newspaper explained, the hearing, which it described as “tense”, was prompted “by accusations that officials did little as a Portland provider neglected vulnerable children.”

The governor made “a surprise appearance before the Senate’s human services committee, (and) offered details on a promise this month to order an independent review of the Department of Human Services. The assessment… will focus on abuse investigations, licensing practices and how the far-flung agency can better share warning signs, among other topics.”

The hearing was prompted by the discovery that state officials continued to place children with a Portland facility even after they were aware of abuse allegations there, according to the paper. The investigation was set in motion by the state’s justice department but raises broader legal questions. If a child were to die at such a facility both state officials and the people directly responsible for caring for the children could be the subjects of an Oregon wrongful death action. Injuries to children are especially serious, which is why the law needs to allow for swift and tough action in both criminal and civil courts.

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A groundbreaking three-part series published last week by the New York Times has drawn much-needed attention to a problem threatening almost everyone in America despite the fact that many people are not even aware that it impacts them directly.

As the paper reports in part one of the series: “Over the past few years it has becomes increasingly difficult to apply for a credit card, use a cellphone, get cable or Internet service, or shop online without agreeing to private arbitration. The same applies to getting a job, renting a car or placing a relative in a nursing home.” As the series goes on to detail, while arbitration may originally have been conceived as a way for businesses to resolve disputes among themselves more quickly and cheaply than by using our courts it has become a more-or-less routine way for corporations to tilt the field in their favor in any dispute with their customers. The newspaper quotes a federal judge in Boston who aptly describes this development as “among the most profound shifts in our legal history… Ominously, business has a good chance of opting out of the legal system altogether and misbehaving without reproach.”

What makes the new realities outlined in the Times so scary is how widespread they have become in the years since 2011 when a Supreme Court ruling opened the way for wider use of arbitration clauses and made filing class action lawsuits more difficult. The system is particularly lopsided because the growing class of professional arbitrators who administer it generally rely on large corporations to bring them repeat business (an arbitrator must be approved by both sides to a dispute, but large companies have far more knowledge of who they are agreeing to, and can make it clear they will not pick a given individual again if he or she rules against the company) – a conflict of interest that the Times examines at length and which strips away even the thin façade of impartiality that surrounds the arbitration process.

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As an article in today’s Oregonian warns, Halloween has long been a night when pedestrians and drivers alike need to exercise particular caution. This year, however, the fact that October 31 is also the evening when we move from daylight saving time back to standard time makes tonight especially dangerous.

Halloween has always been a night when everyone should be especially aware of the possibility of injuries to children. In the twilight and early evening hours small children – many wearing dark costumes – are running around residential neighborhoods all over the country. The danger of a car accident rises significantly even for the most careful of drivers. The Oregonian reports that Halloween is traditionally the third-worst day of the year for pedestrian fatalities, surpassed only by New Year’s Day and December 23.

In recent decades, however, Halloween has also emerged as an adult party night with a reputation for drinking and driving that rivals New Year’s Eve. According to today’s article “in 2012 when 54 pedestrians died in car crashes on Halloween nationwide, nearly half of those deaths involved a drunk driver.”

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