SAN DIEGO, Calif. – Today, 6-year-old Daniella Jennings can run and play, but a few months ago she was more like a limp rag doll, gravely ill and no one could figure out why.
One day Jennings threw up so much blood that her mom, Marcia Maldonado, rushed her to the hospital.
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"I can hear the nurses literally say, ‘She's not going to make it, she's really weak,'" Maldonado said. "I'm just going crazy, [I was] like ‘what do you mean she's not going to make it?'"
Maldonado wanted answers, and she got several. First, doctors said it was allergies. Then, it was mumps and an infection. Three doctors told her it was gastritis. Another said migraines. Then, a different doctor said he needed to split her jaw in half, and cut out what he thought was a tumor in her throat.
"I'm just sitting in front of him thinking, ‘This is really not happening to me,'" Maldonado said.
Something didn't seem right, so Maldonado took Jennings to yet another doctor. After three months of watching her little girl dying, she finally found what was wrong with her daughter.
"It's not a tumor, it's her main artery [and] it's about to burst," Maldonado explained. "I felt like we finally have the right diagnosis."
Dr. Alexander Khalessi, Director of Endovascular Neurosurgery, Surgical Director of NeuroCritical Care, Assistant Professor of Neurosurgery, University of California, San Diego, discovered that Jennings had an aneurysm the size of a racquetball growing in her mouth. It happened when surgeons injured an artery during a routine tonsillectomy that had been performed six months earlier.
"If there was a breakthrough bleed from this aneurysm, you could bleed to death from your mouth," Khalessi said.
Khalessi filled the aneurysm with coils to prevent blood from entering. He then used stents to rebuild the artery. It was the first time this surgery had ever been performed that preserved the artery.
You have a responsibility as a surgeon to use that opportunity to innovate for the benefit of your patient," Khalessi explained.
Jennings would have died if her previous doctor removed the mass.
"I would have literally lost my child," Maldonado said.
Between 10 and 20 percent of all medical cases are misdiagnosed. A report from the National Center for Policy Analyses found that 28 percent of diagnostic mistakes were life-threatening or resulted in death or permanent disability.
In a survey, 96 percent of doctors said diagnostic errors were preventable, and half reported that they encountered at least one a month.
"I've had experiences where I think that if that patient arrived at a different hospital, at a different time, had a different set of doctors, that outcome may have been different," Khalessi said.
Today, Jennings is back to being a kid.
"I'm thankful every day that she's at home, dancing and playing," Maldonado said.
The National Patient Safety Foundation provides a checklist for getting the right diagnosis.
Additional Information:
ANEURYSMS: An aneurysm is a bulge in the wall of an artery and if it grows to a large size it can burst and cause bleeding or even death even though there may not be any symptoms beforehand. Aneurysms can form in various parts of the body but the most common area is the aorta, the main artery traveling from the heart. (Source: www.nih.gov)
SIGNS: It has been estimated that about half of all aneurysms burst and typically there are no signs up until the aneurysm ruptures. While sudden death would be the most obvious and severe sign of a ruptured aneurysm, other times the signs are mistaken as something else and treatment is not sought. Some signs of a ruptured brain aneurysm are:
- A sudden extremely painful headache is the most common sign of a ruptured brain aneurysm.
- Vision changes, eye lid drooping, lethargy, speech impairment and seizures may also be the result of a burst brain aneurysm and some of these signs may also signify a stroke caused by the rupture.
Unfortunately, aortic aneurysms tend have more fatal consequences when they rupture than brain aneurysms. More than 90% of ruptured aortic aneurysms are fatal so the best chance of survival is detection of the bulge before it bursts. There usually are no symptoms unless the aneurysm grows large enough that puts pressure on other organs. (Source: www.womenshealthresearch.org)
DR. KHALESSI: "If I didn't think that where you got care mattered then it would be very difficult for me to do my job the way I do. This temptation to essentially to be skeptical and not trust the advice you're giving and essentially level the playing field and say that everything is essentially the same. The inconvenient truth is that everything is not the same. And so there's no question that over the course of my career that I've had experiences where, I think, that had that patient arrived in a different hospital at a different time, had a different set of doctors, that the outcome may have been different. I think that we actually have a responsibility in the medical community to educate patients about their options, make them aware that there are solutions to things that maybe in other environments you wouldn't actually find that solution. I'm not at all naïve to think that we can cure every patient of cancer or treat every stroke, but the truth is that there is an art to medicine in addition to the science and I think that there is an advantage to getting care in institutions that are at the leading edge of what that science is. Because then I think you actually have doctors who could be judicious about when you need to be conservative and when it's important, in cases like Daniella's, to push the envelope because you have an opportunity to save someone's life."