Monday, Feb. 13, 2006 | 5:04 a.m.
Foster parents caring for two prematurely born infants who died had not been given enough information about their fragile condition to watch over them properly, according to medical records and Metro Police.
The two deaths occurred months apart and involved two separate foster parents.
Genesis Acosta-Garcia was nearly 3 months old when she died of a viral infection Nov. 19 at University Medical Center. The infant, born two months premature to an 11-year-old, was placed in the care of a foster mother. But according to hospital records, the foster mother was told little about Acosta-Garcia's fragile medical condition or history.
Two months later, Ryan Ellison died four days after being released to a foster mother. Born prematurely, Ellison weighed less than 2 pounds and tested positive for drugs when he was born. He remained at the hospital for almost three months before being released on Jan. 13 to a foster parent.
The cause of Ellison's death is not known. Lisa Teele, supervisor of Metro Police's Abuse and Neglect detail, said police found "no evidence of any sort of maltreatment. It's truly a medical death."
In neither case had Clark County Family Services employees given the foster parents enough information to care for the children, according to hospital records. The foster parents also were told little about the infants' medical histories.
After children born prematurely are discharged from hospitals, they generally remain more prone to health risks than babies carried to full term, said Dr. Jack Lazerson, professor emeritus of pediatrics at the University of Nevada School of Medicine. Parents or caregivers are usually made aware that these children may need special attention, Lazerson said.
"When these children are discharged, they are stable and doing well," he said. "But the instructions to the parents are: Remember this child came from a difficult situation. They have to be cognizant of the child's possible complications."
Donna Coleman of Demanding Justice for America's Children, a Washington-based children's advocacy organization, said that foster parents of medically fragile children need to be told everything about their histories and special needs to care for them properly.
"If it was your own child, you would know the history and you would look more closely at certain things," Coleman said. "You would know if a child had histories with a certain illness. A cold might be not be so important with one child, but with another it could be life threatening."
The responsibility for advising foster parents ultimately lies with the Family Services Department, which is to act as the final link in a chain of information. If a child is considered medically fragile by hospital staff, the relevant information is to be sent to Family Services medical workers. Those employees are then to turn the information over to caseworkers, who are supposed to advise the foster parents.
Susan Klein-Rothschild, director of Family Services, said she could not comment on the cases specifically because of confidentiality restrictions. But she said that the agency's policy is to provide foster parents with necessary information, including anything having to do with the child's medical, dental or educational needs.
"Our responsibility is to give full information - we provide that information to the foster parent," she said.
Klein-Rothschild also said that not all medical information is passed along to caseworkers. Some might be shared only between medical staffs because "there is a different level of communication for medical professionals."
"There is information shared," she said. "Is there always enough information? That's a good question."
In Acosta-Garcia's case, a doctor examined the baby at Child Haven, the county's emergency foster care agency, on Nov. 13 after the foster mother reported that the child seemed to have flulike symptoms. The foster mother had taken the baby in for a visit with the birth mother.
The examining doctor old her "not to worry" about the baby, even though she had not been eating, according to UMC records.
Three days later, the foster mother rushed Acosta-Garcia to UMC, where the infant was found to be suffering from septic shock and severe organ failure. The hospital staff determined that Acosta-Garcia was in critical condition and that "prognosis is grim," according to a hospital report taken on Nov. 16.
Medical records from UMC show that the foster mother had little information about her. A nurse noted that "foster mother unsure of birth info."
The attending physician wrote that the past medical history on Acosta-Garcia is "not completely clear ... the child had some kind of infection, had an episode of sepsis in the neonatal period, but was discharged home with no medication."
Although Acosta-Garcia remained alive for three days, there was little hope she would survive.
On Nov. 18, the birth family made the decision to place the baby in the "do not resuscitate category," according to the hospital records. The next day, Acosta-Garcia's heart stopped and the hospital staff did not resuscitate because of the family's decision. The child died at 8:45 a.m.
Medical authorities concluded that a viral infection was the cause of death.
Acosta-Garcia's grandmother, Maria Garcia, said she is still looking for answers in her granddaughter's death.
"Every time I called the social worker, they told me the baby was OK," she said. "I called on Monday and she is OK? Then how can you tell me she is real sick three days later?"
Metro Police are investigating the circumstances of Ellison's death, Teele said.
Ellison died after his foster mother drove him to Child Haven for a visit with his birth parents. A social worker who came to the car to help remove the child from the backseat realized something was wrong. Paramedics were summoned. Ellison died that day.
The initial stages of the investigation show that the foster parent had little information about the baby, Metro reported. "The foster mother was not appraised of the follow-up care needed for baby Ellison," Teele said.
Klein-Rothschild said her agency is seeing more premature children or children with medical issues these days. She said she plans to meet with hospital officials and medical professionals to discuss sharing more medical information between all parties involved.
"We said, 'let's bring these officials together and ask are we on top of the most recent information? What do we know about their care? What do we need to know?'" she said.
David Kihara can be reachedat 259-2330 or [email protected].
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