To Whom it May Concern, 

I want to explain why I marked that I would not recommend your Hospital to friends on the survey you sent us. I first want to note the positives, because we met some wonderful people and were treated kindly by all the staff and we truly appreciate the service we received. The nursing staff especially was efficient, kind, informative, and attentive. I am a nurse myself, and I know how hard it is to stay on top of everything sometimes, but we were treated with care that went above and beyond excellence in every way from nursing staff to transport people. Everyone was amazing and if I could remember names, I would like to thank each one in person for their kindness and respect.

The following is a list of the problems we had and why I would not recommend this hospital to friends, especially with young children who have been injured:

  1. Privacy. I noted on the survey that we never had the privacy we wanted with physicians and other staff, and this is not an exaggeration. We shared a room with another child and our medical information was shared freely between both of our families as there is no way to have private conversation when a room is shared. I also want to note that putting a child who has a head injury with a child who has a fever of unknown origin when the word “virus” is being thrown around, the fear of it being contagious was just another added worry when we were already going through a very stressful time. 
  2. Policy. I am going to try and remain polite throughout the rest of what I’m about to say, but please note that your policy is unacceptable and if I believed that suing would effectively change your policy, I would do so in a heartbeat. Not for money, but so that other parents do not have to suffer the trauma we are still recovering from.

The policy I’m talking about is your policy in the case of a child coming in with a fracture under the age of 1 year. To my understanding, the actions you have in place for these criteria are as follows: full body x-rays, calling CPS, assessment and full body pictures taken by nurse who works with abused children, and multiple questionings.

First of all, I want to say that I am all for catching parents who abuse their children. They should absolutely be stopped and it is the Hospital’s job to do this to the best of their ability. I have to ask, though, are your rates of catching child abusers much higher than other hospitals who have a comparable population? Because if this rate is not increased by a large percentage, I beg you to change the extreme approach other hospitals do not engage in while catching much the same amount of criminals in the act of abusing their children.

 I have no problem with being questioned multiple times. I told our story what felt like 100’s of times and since the questions were asked without an accusatory tone, I complied without any difficulty and I feel that this is a smart way of assessing if the parent is lying. Please continue to do this. 

I don’t have a problem with calling CPS. I know that it is necessary for certain injuries, and since a fracture under a year old is probably rare, I think having CPS involved is probably a good thing, even if it a horrible stresser on the innocent parent. Please continue to do this.

The nurse who came to question us, assess our baby, and take full body pictures was actually a good experience, and I encourage you to continue to do this. She was experienced, kind, very forthright, and thorough. 

Full body x-rays, however, are unnecessary, uncalled for, and certainly something I implore you to change. 

To give you a glimpse of the stress of this whole ordeal, when we first took our child to the urgent care clinic here in Farmville, we had to strap him down for a CT a little while after the doctor saw him. It was traumatic for him, and as a result, it was traumatic for us as parents. The anguish of hearing him scream as his sore little head was strapped down for 7 minutes (or more) was bad enough, but then we had a c-spine x-ray we had to hold him down for when we got to your emergency room, even though he showed no signs of his neck being injured in any way and held his head normally as was very apparent to anyone who assessed him. The next day, I was told by one of the doctors that it was “policy” to do full body scans with this type of injury. I questioned it because I felt that Lucas had had more than enough radiation already, but was told that “sometimes, even if the child acts totally normal, we find something. This is for his safety, and we carefully make a risk/benefit analysis for each case, and the radiation is very minimal.” I was told later by social work that this was policy for any fracture under the age of 1. I do not understand the justification for this. We were told multiple times that the Hospital had no suspicion that we were abusing our child, and still, we were subjected to full body x-rays, because you are “eliminating bias”, and therefore, everyone who meets the criteria is automatically treated as a child abuser.

After the torture of holding our child down for full body x-rays, we were later told there was a “spot on his arm” and they wanted to do two more views. I balked at this and we came very close to refusing. The only thing that made us agree to more x-rays was the silent threat of being accused of hiding an old injury by CPS in the future. We knew we had nothing to hide, and we wanted to prove our own innocence, as we were being treated as guilty until proven otherwise. It ended up being “artifact” and that extra two views of his arm is something I don’t think we should be charged for. The bills are rolling in, and the amount of money you’re making off us without ever once treating our child is appalling. 

Later that afternoon, we were subjected to an MRI and even though it is only 5 minutes long, listening to your child cry in pain, fear, and exhaustion after everything else he was put through left me weeping with him, and tears still gather every time I relive this experience. The bill was almost $4,000 for those 5 minutes, and we just discovered another MRI is required before the neurosurgeon even assesses him for our follow up appointment. I want you to know we are refusing this, and will not agree to this exorbitant display of unwarranted excess.

I have counted up (over and over) the amount of x-rays he received in this short period of time, and without counting all the times the angle wasn’t “quite right” or he moved and they had to redo the view despite us holding him as carefully as possible, he received at least 29 x-rays on top of the CT. A short internet search reveals that literally everything we know about radiation exposure shows we should proceed with caution when it comes to unneeded x-rays, especially in children. WebMD says that most children receive 7 by the time they’re 18 and that statement is under the heading, “too much radiation?” It also mentions a study showing that children who received 2-3 CTs were 3 times more likely to develop a brain tumor or leukemia in the decade following their first scan, compared to children who were not scanned. Given this, shouldn’t we limit radiation to when it is absolutely necessary?  My sister in law has a child who is prone to breathing problems and has been diagnosed with bronchitis several times. His doctor at one point refused to do another x-ray because he had already received 5 in his lifetime, and this doctor said that was too much radiation for him as a 2 year old. Since most chest x-rays are two views, I’ll be generous and say 10 is too many. My child is 7 months old and he received at least 29 x-rays! I want to know what possible benefit there would be to him if that doctor was telling the truth and they carefully make this decision? And do you truly know the risks? What studies are you using to support this much radiation and acting like it isn’t going to cause harm down the line when it’s on top of a CT scan and other x-rays? I call BS on that statement. My baby was perfectly healthy. Anyone with the gift of vision could have assessed him properly and seen that he had no injuries. But because y’all are “eliminating bias” we were subjected to trauma and he was forced on the possible equivalent of a walk through Chernobyl. 

A pubmed search reveals a study where the conclusion states, “The use of clinical observation as an alternative to cranial radiography leads to a reduction in the number of imaging tests and hospital admissions of infants with mild cranioencephalic trauma, without any reduction in the reliability of detecting TBI. This option helps to lower the exposure radiation by the patient, and is also a more rational use of hospital resources.” (PMID 27836784) In light of this conclusion, how do you justify unnecessary xrays without actual proof the parents are abusing their child. Especially with a first offense when the child is the absolute picture of perfect health otherwise?

It’s so difficult for us as parents…we are good parents. How are we going to act in future? Will we ever be able to take our children in “just to make sure they’re okay”? I don’t think so. The only way I’ll step foot in an ER/urgent care if something is wrong with my child is if I know something is wrong that can actually be helped. Even Lucas’s head injury, even though his skull was fractured, his behavior never changed, I knew how to keep an eye on him and make sure his brain wasn’t affected. Do you know the anguish of coming to the realization that if we had just stayed home, he would have continued to heal just as he did, without the lack of sleep? Without the endless poking and prodding and test after test? Without CPS having to come to our house? Without the endless bills we will now have to face, and no, we do not have insurance, so this is a concern even though we are a part of a sharing program that will hopefully come through for us. You never once, not once, did you treat him. And every single assessment came with a battery of tests. Is it because he’s so young that doctors can no longer rely on their instincts and training to tell if he is okay or not? Or is it just the way medicine is going? His follow up appointment comes with an MRI. How is this acceptable? Why not assess the patient before you require a traumatic test where the child has to be put into a plastic cage and cry in terror for five minutes at the incredibly loud noise that he so hates? With a study in existence like the one above, was it strictly necessary for him to even get a CT? Especially since it was already over 24 hours since his injury by then. If his behavior was normal and no signs of concussion and no intervention would be necessary if those obvious signs stayed the same, why did we not get sent home to observe him? The ER doctor here in Farmville wanted to do that very thing. But I assume your “policy” was already in motion as soon as you were sent the CT results and saw there was a fracture in a child under a year old. 

One-size-fits-all medicine is bad medicine. We are not all the same. Common sense, intuition, education, etc; these things are not bias. Please stop this madness. Please allow your doctors to make judgments based on their education and their experience. Please stop doing full body x-rays to babies who show absolutely no signs of abuse. Is it truly “best practice” when you are forced to treat everyone who meets an arbitrary criteria as if they are criminals? If you want to treat everyone the same, why not choose a set standard that comes without risk to the patient? Like I said, I see no benefit to the full body scans to Lucas himself. If we were abusing him and you would have found old injuries is the only possibility I can think of, and to risk that kind of radiation, I would think you would want to be very very suspicious that the parents were actually guilty. But we were told over and over that no one was suspicious of us, but that it was “policy” to treat us and our child this way. 

I beg you to change this policy. It is an unnecessary risk to the patient, a traumatic experience to all children (since they’re all under one, I assume none of them understand or enjoy being held down for this) and parents involved. Please return to common sense, to treating each patient as an individual with the use of your education, experience, and whatever common sense you still possess. Please do not arbitrarily subject children to unnecessary testing. It is cruel, even if you’re doing it to “be on the safe side”. I would rather be on the safe side of not exposing my child to inessential radiation. I beg you to change your “safe side” to the side that actually benefits the child in question. Please only resort to these extreme measures in cases where the parents are truly suspect. Use your judgment and clinical knowledge a bit more and your machines a bit less. 

Thank you so much for your time and attention and for taking the time to read this. If you want to contact us, I have included my phone number. If you plan to change this policy, I can’t even tell you how much I would appreciate a phone call to let me know, even if it’s years from now. Knowing that other parents will go through this is a sad heaviness in my heart. When your child is hurt, that is punishment enough. Thank you for all you do. 

May God bless you, 
-Beth Troyer

3 thoughts on “Open Letter to UVA

  1. Beth,
    I have no clue how I came upon this blog post other than maybe someone sharing it on Facebook but I can totally relate. The same thing happened to us when Elijah was 11 weeks old. His sister who was 7 at the time dropped him and being the good cautious parents that we are, we took him to his pediatrician who sent us to LGH. We had no clue how our world was getting ready to be turned upside down. Here we are almost 6 years later and a day does not go by that I don’t replay some parts of our ordeal. I have never in my life been treated like a criminal as I was in that ER and pediatric unit. Heck I’ve even taken care of the ER doctor who tried to convince me that my husband was abusing my baby. I had to pray a lot to God to forgive my thoughts the entire time but I smiled and tried to be the best nurse I could. Thank you for sharing your story!

    Like

    1. It’s absolutely horrible, what they put parents through. I’m so sorry y’all were traumatized too! Was he hurt in any way? I wish so bad there was a better way to catch the people who abuse their children but treat the rest of us with respect and kindness. 😦

      Like

  2. our almost 5 mo old had a head injury and they told us xrays were protocol to rule out old injuries that would point to abuse. while not ideal, I was willing to do them to prove our innocence. it was a very traumatic experience

    Like

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