There is one thing on which everyone involved in the Baby Travis case agrees: The extremely premature infant already was battling huge odds to survive and suffering burns on his back certainly won’t improve his chances.
Beyond that, however, there is little agreement about how the injuries could have occurred, whether they even are burns–or just a “skin condition”–or whether someone at Cook County Hospital can be held responsible for Baby Travis’ difficulties.
The baby was born Friday night at County Hospital 17 weeks’ prematurely. As with any infant born that early in pregnancy and weighing just about one pound, he has only a 20 to 40 percent chance of surviving his first tenuous weeks of life under the best of circumstances. But, when doctors looked at the infant on Saturday, they noticed a “discoloration” on his back, said Dr. Philip Ziring, chair of the pediatrics department at County Hospital. The infant’s “condition continued to evolve” until it erupted into a “small blister.”
Tracy Travis, a 20-year-old first-time mother, had her son transferred to Loyola University’s Ronald McDonald Children’s Hospital on Monday because she had lost faith in Cook County Hospital’s ability to care for him, said Travis’ sister, Christine Williams.
The family has also retained attorney Robert Clifford, who said Monday night that he plans to sue Cook County Hospital and the manufacturer of a medical device the family blames for the injuries.
Doctors at Loyola found “skin lesions similar to contact burns” on the baby’s back and are treating him with antibiotics and ointments, said hospital spokesman Mike Maggio. The doctors had no theories about the cause of the lesions, he said. In fact, skin injuries are common in such fragile, tiny infants. Doctors at Loyola are much more concerned about the condition of the infant’s heart, lungs and fluid intake, he said.
“The primary medical problem is not the burns, it’s the extreme prematurity of the infant,” Maggio said. “The burns don’t help, but if the child dies, it will be more the result of those other issues.”
Williams said a County Hospital doctor told the family on Sunday that Baby Travis had third-degree burns over 50 percent of his tiny body.
However, at a brief news conference Monday morning, Ziring said Baby Travis’ skin condition, “resembles a burn. But it also resembles other types of skin conditions we see in premature infants.”
Ziring said doctors at County who were investigating the cause had ruled out foul play and had no reason to believe the infant was “deliberately or accidentally exposed to anything injurious.”
Though they had no definitive answers, the doctors were attempting to determine whether Baby Travis’ injuries might have been caused by a commonly used medical device known as a bilirubin blanket, Ziring said. Other experts in neonatal care said they thought it unlikely the bilirubin treatment would be found to be responsible for the injuries.
Bilirubin is a potentially toxic chemical created in the body that is processed by a healthy liver. However, low-birth-weight babies often have immature livers and cannot process the bilirubin in their systems, sometimes leading to high concentrations of the chemical that turns the skin a yellowish color known as jaundice.
Doctors use photo therapy such as the bilirubin blanket to help the tiny infants process the chemical.
The bilirubin blanket used on Baby Travis at Cook County uses fiber optics to carry light from a halogen light source that can be as much as 10 feet away from the baby. The treatment exposes the child to practically no excess heat because fiber optics conduct only light, not warmth, according to Dr. Dan Polk, chief of neonatal care at Children’s Memorial Hospital and Northwestern Memorial Hospital.
“I would hate for people to get the impression that photo therapy puts babies at risk,” Polk said. “We think photo therapy is one of the most benign things we do.” Polk said he knows of no case in which photo therapy has inflicted harm on a child.
Fragile, poorly developed skin is just one of the severe health problems that arises for babies who are so tiny. Even premature infants who survive the tenuous first few weeks of life risk serious lung damage, brain injury, blindness, weak bones and heart disease.
“These infants teeter on the borderline of life,” said Dr. Jeremy Marks, a neonatologist at the University of Chicago Hospitals. “Their skin is susceptible to injury from the slightest contact that wouldn’t bother you or me.”
For example, Marks said doctors and nurses need to be careful when putting medical tape on the skin of severely premature babies since their skin is so delicate it can tear off when the tape is removed.
“Premature babies often look like they have significant skin diseases, simply from the normal wear and tear of caring,” Marks said.
