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A routine epidural turns deadly

Julie and Chris LeMoult were excited parents-to-be. But did a hospital infection turn the happiest day of their lives into a nightmare?  Dateline's Chief Consumer Correspondent reports.

It was sunlit, summer Saturday, a perfect day for a wedding— and Julie Ellis and Chris LeMoult are the picture perfect bride and groom.

They were college sweethearts who had been through their romantic ups and downs, but their love grew even stronger over the years.

As husband and wife, their future was as bright as Julie’s dazzling smile.

It seemed as if Julie and Chris had the world on a string. In their late 20s, they have blossoming careers, Julie with the Discovery Channel, Chris in commercial real estate. Theirs is a storyline right out of a Hollywood movie, and the couple knew how the next scene should play.

Julie becomes a mother to be
April 2, 2003: Chris and Julie thought it would be the happiest day of their happy life.

But it wasn’t going to be a routine delivery. In fact, what is about to happen to Julie may be a cautionary tale for anyone heading for the hospital. They could not have imagined that a day beginning with so much joy could end the way it did.

According to Julie’s hospital records, she was admitted at 7:05 a.m., and a half hour later, her vital signs are taken. Temperature, pulse and white blood count were all normal. Julie appears the picture of health.

The excited parents-to-be decide to make a home movie for their new baby.

Chris teases her about her hospital gown. An intravenous line is inserted into her arm, and Julie is given the drug that will induce labor. The business of having this baby begins.

Chris and Julie talk their way through it on the home video.

Chris LeMoult: It is 8:11 in the morning, right on schedule. We’ll get going. Get this show on the road. And there’s Mommy again. Mommy looks great. Say a few words.Julie LeMoult: Excited to meet you, a little nervous but—like I said one needle down, one big one to go. And it will all be worth it.

That “big needle” Julie is nervous about is the epidural, an anesthesia injection into the lower back near the spine. Its drugs numb the abdominal and pelvic area to ease the pain of child birth.

Epidurals are not without risk—but they are used in 60 percent of all births, and usually, there’s not a problem.

Julie gets her epidural at 9:55 a.m., and there is a problem.

Chris Lemoult:  She had a blotchy face, she immediately—felt lethargic and she was having like, you know, like a heaviness in her chest. I mean it was immediate.

The anesthesiologist is called back to check on the epidural line.

Chris LeMoult: Hecomes in and he looks at her and he does a pinprick test and she couldn’t feel anything from her neck down.  I mean, he was pricking her in the collar bone area she couldn’t feel anything.

At 10:30 a.m., because too much of Julie’s body is affected by the epidural, the anesthesiologist stops the flow of drugs.

Lea Thompson, Dateline Correspondent: Was he concerned? Chris LeMoult: He didn’t seem concerned. He made a comment like ‘We’ll just remove it and wait ‘til it wears off.  And, you know, we’ll put it back in.” 

After the effects of the first epidural wear off, the anesthesiologist tries again. It’s 12:20, he gives Julie a new epidural. But while the first epidural seems to overmedicate her, the second epidural doesn’t seem to be working at all.

Pushing the button on the epidural line is supposed to deliver a dose of pain-relieving drugs, but it doesn’t work.

The family asks for the anesthesiologist to come back again. Julie is in pain, but she has to wait.

Donna Ellis, Julie's mother: They were extremely busy. The anesthesiologist was running from suite to suite.

Julie’s parents, Bruce and Donna Ellis, are there watching this all unfold.

Donna Ellis: He come outside the door of the birthing suite, be on his phone or be out. His pager would go off.  The nurses would be running in constantly.

When the anesthesiologist does return to Julie’s bedside:

Chris LeMoult: At that point, he checks the lines and he asks her to sit up.  And he goes, “Oh, here’s the problem.”  And the line, the catheter from her back and the drip line had been just lying disconnected.  And he just goes, “Okay.”  And he just snaps them together.

Now, the rest of Julie’s family starts to arrive for the big event. As if often the case these days in hospital birthing suites,  there’s almost a party atmosphere.

Thompson: There were a lot of people in that room.Chris LeMoult: Yeah there were probably eight people in the room. And no one seemed to say it was a problem with that or anything, they just said “Sure, anyone who wants to be.”

It is now mid-afternoon—and this baby is not waiting any longer.

Julie’s delivery goes perfectly
Julie gives birth to a healthy, 9 lbs.4  ounce baby boy: Logan Donnelly LeMoult.

Chris LeMoult: I was looking at Julie and at that moment I had never loved her more or been more proud of her.  And I was happy to have a son. But I was looking at her going, “I’m so amazed that you just did the way you did it and we’re crying and just saying, “I can’t believe this.”

But as afternoon turns to evening, the joy of Logan’s birth begins to be overshadowed by concerns for Julie. She complains to Chris and her mother of a severe headache. Donna Ellis says, when they look for help, they can’t seem to find any.

Donna Ellis: For the five or six hours I was there after, while she was in this unit, the nurse never came back.

It’s now after 10 p.m., the hospital turns quiet, and Chris and Julie have a few minutes alone with their new baby boy. When Logan goes back to the nursery, Julie and Chris try to get some sleep. But at about 11:30 p.m…

Chris LeMoult:  I hear this, “Chris, Chris.  Wake up.  Wake up.” And I wake up and Julie is saying, “You know, my eyes feel like they’re kind of swelling.  My headache’s getting really worse.” I had never seen Julie this nervous about a headache.

Chris runs out to the nurses’ station, and finds help. Julie is given Percocet, a powerful painkiller. But 45 minutes later, she’s in even more pain.

Chris LeMoult: The euphoria of having a child is gone. And we are really nervous about what’s going on with Julie right now.  At this point I just thinking here “I’m alone with her in this hospital, and what’s going on here? We’re not getting attention. So I run down there and I said, ‘You need to get a doctor in here immediately.’”

It’s now 12:40 in the morning, Chris says a doctor gives Julie Benadryl, tells her to calm down, then leaves.

Chris LeMoult: And I look at the fear in her eyes and hear in her voice and it’s getting worse. I mean she has a fever that was escalating through the night.Thompson: So a call was put out to the obstetrician.Chris LeMoult:  Yes.Thompson: Did he come in to the hospital?Chris LeMoult: No, not at that time, no.

The obstetrician doesn’t come in, but orders the hospital staff to give Julie an antibiotic. A rising fever can be a sign of infection, and an antibiotic might stop it.

Chris LeMoult: The fever started getting really bad. I mean, I was scared.

Julie is put on fluids to try to bring the fever down, but then, at about 2 a.m., Chris says, the woman he loves starts crying out in pain.

Chris LeMoult: My mouth was in her ear and I’m just trying to calm her down and just saying, “So I’m here—I’m here Julie, I’m here.  You know, I’m not going anywhere.” And I heard her say things like, “I don’t want to die.  I don’t want to die. I don’t want to die.” And she just started having what looked like kind of like a seizure.  She started trying to rip the IV’s out of her arms.

Suddenly now, the room fills with doctors and nurses.

Chris LeMoult: I’ve never been so scared and so helpless in my entire life.

It’s 2:40 a.m., and Julie is rushed to intensive care.

Chris LeMoult: I just started crying. I’m thinking, "What just happened? What just happened?"

Barely 12 hours later, Chris says the happiness of becoming a father was overtaken by the fear that he might be losing his wife. Julie had been running a fever all night, and had gone into convulsions.

Chris LeMoult: And then it was like her pupils like dilated. And like she was looking at me like she wasn’t looking at me anymore. 

At 2:40 a.m., Julie was rushed to intensive care. 

Chris LeMoult: I couldn’t even ride the elevator with her.  And I just ran down the flight of stairs down to the ICU.  And I ran back there with her.  And she’s having seizures the whole way.  And I get there and they ask me to—“Oh, I’m sorry sir, you have to wait out in the waiting room.”Thompson: And that must have been a nightmare.Chris LeMoult: Oh yeah, I’m sitting back here, and I’m sitting alone in a waiting room by myself.

How can an apparently healthy, 28-year-old woman go downhill so quickly while in a hospital? Desperate to find an answer, doctors perform a spinal tap on Julie. The news is not good.

An infection from an unknown source... and a painful choice
Julie has meningitis: an inflammation in the brain and spinal cord which is causing her brain to swell. Meningitis can very quickly cause irreversible brain damage.

Lab tests show Julie’s meningitis is caused by an infection. Her family is called back to the hospital.

Bruce Ellis, Julie's father: Chris said “Julie is in trouble, you have to come to the hospital right away.” So...we were out of here in a flash, not knowing exactly what happened.”

At the hospital, Chris is being told by a doctor Julie’s infection may have been passed along to the baby.

Chris LeMoult: I’m thinking, “Oh no.” I mean like—“Now my son’s gonna be sick.”

It’s now about 4 a.m., Logan started on antibiotics and placed in quarantine in pediatric intensive care.

More testing comes back and Chris gets more devastating news. Julie’s brain shows massive edema. The doctor says Julie has massive brain damage.

Chris LeMoult: “Are you saying that Julie might die from this?” And she said, “Oh yes, that’s an extremely real possibility.” 

Chris rushes back to Julie’s side.

Thompson: And was she conscious? Chris LeMoult: No, she’s on life support. It was like, “How does this go so wrong?” At this point, we were just thinking, “What can be done to save her life?”

The doctor’s tell him nothing can be done: Julie will never wake up. Chris says he isn’t ready to let go. So, he sits alone with Julie, just holding her hand, as he had all day.

Chris LeMoult: And I asked myself, why did this happen to Julie? I don’t understand.Thompson: Think you will be ever able to answer that? Chris LeMoult: No, no.

Less than 12 hours ago, he was celebrating Logan’s birth. Now, Julie is near death. And Chris and the family have a terrible choice— keep Julie alive on life support, or let her go. 

Bruce Ellis: And there was a time to say goodbye. So we did. Thompson: For all intents and purposes she was gone. Bruce Ellis: She was gone.Thompson: And she wasn’t going to come back.Bruce Ellis: Her soul was in heaven, and her body was just left with us. So we said goodbye. Donna Ellis: I know she would have been a great mom, and now we just hope that she’s guiding all of us to be what she wanted to be to Logan.

What happened to Julie LeMoult?
Julie LeMoult's autopsy found she died from “acute bacterial menin-geo-encephalitis”—a swelling of the brain caused by infection. Hospital records show that it the infection was strep— the same type of strep that causes strep throat. It’s spread by coughing, sneezing and touching.

But the question is, how did Julie get the infection, and how could it kill her so quickly?

In a letter to “Dateline,” Sibley Hospital officials say Julie’s “death was not the result of a hospital acquired infection.”

So, did she already have it when she arrived at the hospital that morning?

Chris LeMoult: I know she didn’t walk into the hospital with it.Thompson: Are you sure? Chris LeMoult: I’m positive. To the day I die, no one can ever tell me that she walked into the hospital with it. Her vitals were perfect when she walked in. She looked beautiful. She was smiling, she was happy, she didn’t have a fever, nothing.

Chris says the hospital’s own records show Julie had a normal white blood count that morning. Medical experts the family consulted told him if Julie had an infection when she went in, her white blood count would have been above normal.

So what could have happened to Julie in the hospital? Could she have been infected from the hospital’s sheets, or when she received stitches after her delivery? Or could she have picked it from the many family members in her room that day?

Chris says it’s possible but doubts it. The family’s medical experts say the strep infection was most likely introduced directly into Julie’s spinal fluid during an epidural and traveled up her spinal cord to her brain.

Chris LeMoult: What I believe now is what happened during the first epidural procedure is that bacteria got on the needle and entered immediately into her spine. Thompson: What you’re saying is somehow or another, during that epidural, the strep infection was basically main-lined to her brain?Chris LeMoult: Exactly.Thompson: Through her spinal fluid?Chris LeMoult: Yeah.

That first epidural had to be removed by the anesthesiologist.

Chris and Julie’s family charge in a lawsuit her infection was the result of a “failure to maintain a sterile environment” by the hospital and the anesthesiologist. Chris recalls how busy the doctor was.

Chris LeMoult: In fact, he was touching his cell phone and touching his pager, turning it off, during the procedure.Thompson: Did he wear a mask? Chris LeMoult: No.

The family’s lawsuit also charges that Julie’s infection came from “the introduction of a needle into the patient’s spinal canal without use of sterile face masks.” But anesthesiologists say there is no clear, written standard as to whether they are required to wear a mask during an epidural.

Infectious disease specialists say it is often difficult to pin down exactly how an infection is passed along... but they do say the right antibiotic might stop it. Remember, Julie’s obstetrician did call in an antibiotic prescription for her that night.

Thompson: Was it ever given?Chris LeMoult: No. Thompson: She never even got an antibiotic?Chris LeMoult: No, no one ever followed up to see if she had received it.  No one ever asked me, when she was having seizures, did she get the antibiotic. We just know in the notes she was prescribed an antibiotic and it was never given to her. 

That antibiotic, the family believes, might have saved Julie’s life. 

Bruce Ellis: Everything lined up wrong. We might have changed one thing in this scenario that she went through, maybe just one thing, she’d still be with us, probably having her second or third baby now.

In a written statement, Sibley Hospital says “words cannot express the sadness” at Julie’s death, and it offers “deepest sympathies” to the family. The hospital says:

“Julie LeMoult’s death was not the result of a hospital-acquired infection or illness nor any specific action or lack of action on the part of Sibley Hospital.”

The hospital says it “met the standard of care in every respect... including staffing.”

Sibley Hospital officials declined our request for an on-camera interview, but did meet with us.  They said they believe the findings of Julie’s autopsy support their view that she had some type of infection when she entered the hospital.  But they also acknowledge that no one can definitively say where or how this young mother was infected, or why she slipped away so quickly. The case of Julie LeMoult, they hospital said, is a “medical mystery.”

Sibley Hospital officials also told us in order to “reach a higher standard” of patient care, they are now requiring masks be worn by the doctor, and anyone in the room, while an epidural is being given. And they pointed out that just this year, the Joint Commission on Hospital Accreditation rated Sibley a “top tier” community hospital.

So whether Julie LeMoult died of a hospital-acquired infection and whether the hospital is responsible for that, is now for a court to decide.

But members of Julie’s family are not waiting for an outcome— they want to warn people about how dangerous hospital infections can be.

The dangers of hospital infections
It's a mission shared by Dr. Barry Farr of the University of Virginia medical center. Dr. Farr is not involved in Julie’s case, but he is alarmed about the spread of hospital infections.

Dr. Barry Farr, expert on hospital-acquired infections: We allow tons of it in our health care facilities.  Our nursing homes are riddled with it.  Our hospitals are many of ‘em full of it. 

He says what’s especially frightening is more and more of those deadly hospital bugs are growing resistant to antibiotics, and the health care industry is not doing enough to fight the problem.

Dr. Farr: The patients are paying the price. They’re paying it as increased health care bills because we have higher costs because of it.  And they also have a higher risk of dying from the infections.

In fact, the government’s Centers for Disease Control says one in every 20 patients—nearly 2 million people— will get an infection while they are in the hospital. An estimated 99,000, Americans will die this year from hospital acquired infections.

Betsey McCaughey, public health expert: These infections kill as may people in this country each year as AIDS, breast cancer, and auto accidents combined, and they’re largely preventable.

Public health expert Betsy McCaughey says there is a lot patients can do to protect themselves. McCaughey and her group, the Committee to ‘Reduce Infection Deaths’ (RID), has published a list of tips for patients things most of us would never think of.

McCaughey: For example, if you are going in for surgery and you know it ahead of time, buy chlorohexadine soap at the drug store and begin showering with it.Thompson: Now why is that? McCaughey: It will help remove dangerous bacteria from your own skin that could go into your surgical wound and cause a serious infection. Also tell the caregivers in the hospital not to shave you before surgery. Shaving creates small nicks in the skin through in which the Bacteria can enter.

And, she says, watch to make sure your doctors and nurses wash their hands and use gloves, masks and clean gowns.

Logan's future
Logan never did develop an infection, and today is a healthy little boy.

Fortunately, Chris does not have to raise him alone. Julie’s whole family is pitching in. Christianne Ellis, Julie’s younger sister, quit her job and has become Logan’s full time nanny.

Christianne Ellis, Julie's sister:  My sister meant the world to me, and I wanted to do her proud.

Christianne says every time she is with Logan she sees her sister.

Christianne Ellis: His smile just lights up a room like Julie’s did. 

Chris says not a day goes by he doesn’t wish he could go back and redo April 2nd, 2003. But he can’t go back.

So he goes on, with Logan.

Chris LeMoult: I have to believe that she’s there watching over him, but I don’t get to see that, and Logan doesn’t get to see that. And he’ll never really realize all the things that I fell in love with Julie about. He’ll never really get to experience that. He’ll only see her smile in a picture. 

There is a national effort underway to try to get hospitals to report their infection rate. Seven states have now adopted legislation to require it, and 33 states have legislation pending.