A young boy was left in a vegetative state for six years after his brain was deprived of oxygen during an operation his family deemed unnecessary.
Carlos Blanco, now 8 years old, was born with subglottic stenosis. Subglottic stenosis is a narrowing of the airway that can cause infants to make whistling noises and shortness of breath while breathing.
While most children are encouraged to grow out of the situation, the Blancos were told their son would need surgery to widen his windpipe.
However, during the surgery Carlos, then 2 years old, went into cardiac arrest, cutting off the blood supply to his brain.
After doctors were finally able to restart his heart, he suffered severe brain damage as his brain cells died due to lack of oxygen.
His family is now suing doctors and a New Mexico hospital, claiming their actions took the boy’s young life and caused “serious debilitating and permanent injuries.”
Carlos Blanco before his surgery at age 2
Today, Carlos is “just alive” and can only breathe through a machine that must be constantly monitored and cleaned.
Although his eyes are open, he is unable to talk, walk, feed himself, dress himself, go to the bathroom, or do anything that a boy his age can normally do.
Carlos’ case was disclosed in a court filing in the First Judicial District in Santa Fe, New Mexico.
The toddler underwent two successful surgeries to open his airway in April and June 2018 at Presbyterian Hospital in Albuquerque, New Mexico.
But when he developed a new cough, Dr. Jonathan Owens, a surgeon based in Las Cruces, New Mexico, near his family’s home, recommended a third surgery in September of that year.
Dr. Owens offered to perform the surgery himself to avoid the family having to make a third trip to Albuquerque, about 320 miles away, and the family agreed.
It was during this procedure that her then 2-year-old son went into cardiopulmonary arrest, a medical emergency in which his heart stops beating, according to court filings.
Doctors performed cardiopulmonary resuscitation (CPR), but Carlos’ brain was deprived of oxygen for a long time and suffered severe damage. He was diagnosed with anoxic brain injury.
Court filings say the cardiac arrest was a 15-minute “mismanagement” during which cardiopulmonary resuscitation was performed and medication was administered.
According to the Cleveland Clinic, brain tissue is highly sensitive to interruptions in oxygen supply, and brain cells begin to die within minutes in hypoxic conditions.
After his heart restarted, doctors discovered that Carlos was unable to breathe on his own, and the toddler had to be placed on a ventilator for 13 days.
Two weeks later, doctors performed a tracheotomy. This is a procedure that creates an opening in the throat for a tube to be inserted to allow breathing.
Carlos was discharged from the hospital to his mother, Josefina Blanco, on October 9, 2018, and returned home, where he has been in a vegetative state ever since.
After the surgery, Carlos (pictured above before surgery) was in a vegetative state.
Carlos has no hope of recovery and now requires 24-hour care and the use of a breathing machine.
Carlos’ mother is suing Memorial Medical Center Hospital in Las Cruces, New Mexico, and Dr. Owens, the otorhinolaryngologist (also known as an ear, nose and throat specialist) who recommended and performed the surgery, for medical malpractice. .
She is seeking an undisclosed amount for her son’s “serious, debilitating and permanent injuries.”
“In this case, we have a young boy in a vegetative state who requires 24/7 care,” Adrian Vega, an attorney representing Carlos and Josefina, said in a statement.
“(Subglottic stenosis) is an airway problem that generally resolves once most children reach infancy, so they actually outgrow the condition as they get older.”
In a statement to the Las Cruces Sun-News, a Memorial Medical Center spokesperson said, “As a matter of practice, MMC does not comment on ongoing litigation, and federal law precludes us from discussing specific patient issues. It is forbidden.”
Memorial Medical Center and Dr. Owens did not respond to DailyMail.com’s requests for comment.
Carlos, a twin, had mild to moderate subglottic stenosis, which caused breathing difficulties but not enough to warrant regular hospitalization, a person close to the case told DailyMail.com. .
There are no official guidelines on whether children with mild symptoms should undergo surgery, but doctors say the decision is often between doctors and parents.
But Dr. Satinarayan Hegde, a pediatric pulmonologist at Access Pediatrics in Florida, said if the child has mild but well-managed symptoms, he would likely choose “wait and see” rather than surgery. .
“Even if we do the test and find subglottic stenosis, if we see that the child is coping well, we might decide to wait and see,” he told DailyMail.com.
“The decision to operate depends on clinical judgment and the wishes of the parents. Some parents prefer surgery, while others prefer to avoid surgery.”
As a child grows during the first 6 to 7 years of life, the airways widen, which can minimize the symptoms this disease causes.
But Dr. Jonathan Ida, a pediatric otolaryngologist at Northwestern University in Chicago, disagrees and says he aims to treat most patients with subglottic stenosis with surgery.
“If you’re told you have some degree of subglottic stenosis, you’ll want to visually assess it with an airway endoscopy,” he told DailyMail.com.
“Little children are very resilient and we are often surprised when we find visual impairments compared to their respiratory status during exams.”
Studies have shown that surgery to treat subglottic stenosis has a case fatality rate of less than 5 percent. It is not clear what proportion of pediatric patients will die if subglottic stenosis is left untreated.
According to a 2012 study in JAMA, the success rate of Carlos’ dilation procedure for subglottic stenosis in children is about 70%.
The diagram above from the Cleveland Clinic shows a normal airway (main) and an airway with subglottic stenosis (inset).
Dr. Ida added, “Generally, most people who are delayed end up being treated for subglottic stenosis.
“In medicine, we talk about the first three ABCs needed to save a life. The first is the airway.”
He explained that if stenosis is left untreated, there is an increased risk of complications in the future if intubation is required due to pneumonia, so surgery is often recommended.
He also said it is easier to treat patients early in life, while they are still young.
Warning signs of subglottic stenosis in babies include wheezing or high-pitched whistling sounds when your baby breathes in and out, and recurring respiratory infections.
Young children with this condition may have a persistent cough and shortness of breath.
Treatment options include endoscopic dilation. This is a type of minimally invasive surgery in which the surgeon divides the narrowed area of the trachea from the front and back and inserts a small balloon into it to dilate it and create a larger area.
This typically has to be done several times in infants because the area may close again during the healing process.
In some cases, the surgeon may perform a cricotracheotomy, or removal of the narrowed portion of the airway just below the voice box.
