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Grateful Families Praise Winthrop for Life-Saving Sepsis Care

1-1 Being at the right place at the right time. Some might call it a coincidence – but for eight-year-old Sean Hatzfeld and his family, an experience that led them to Winthrop-University Hospital was perhaps divine intervention.

“At one point, the outlook for our son was very dire,” said Patricia Hatzfeld, Sean’s mother, as she recalls her son’s recent bout with severe sepsis – a blood infection that can cause fever, low blood pressure (shock) and serious respiratory distress. “But in the end, we knew that God made a path for Sean that led him to Winthrop, the very best place he could possibly be.”

After five days of suffering with influenza, Sean developed severe swelling in his eye that occurred overnight. Heeding her intuition that something was not right, Mrs. Hatzfeld took her son to their nearby hospital, where he was diagnosed with orbital cellulitis – an infection in the cells surrounding the eye. Specialists there advised her that Sean be further evaluated by a pediatric ophthalmologist and he was immediately rushed by ambulance to Winthrop.

Within minutes of his arrival at Winthrop’s Pediatric Intensive Care Unit (PICU), Sean broke out into a rash as black dots emerged on the surface of his skin, indicating blood poisoning. It was clear to Winthrop’s pediatric team that Sean was suffering from severe sepsis and was on the brink of multi-organ failure.

Fortunately for the Hatzfeld family, Winthrop is a leader in pediatric sepsis care. Thanks to a quality initiative that began in 2009 by The Children’s Medical Center at Winthrop, designed to advance severe sepsis care for pediatric patients, the pediatric team was ready to tackle this potentially life-threatening infection head on.

“We know that early recognition and prompt therapy save lives, and every hour of delay matters in terms of mortality,” said Lyn Quintos-Alagheband, MD, Associate Director of Pediatric Critical Care Medicine and Physician Quality Officer at The Children’s Medical Center at Winthrop. As Chair of the Pediatric Strike Out Sepsis Campaign at Winthrop, Dr. Quintos-Alagheband has been instrumental in improving

Winthrop’s management of severe sepsis and is actively involved in supporting the implementation of best practices in both adult and pediatric patients.

After days at Winthrop that involved medications to support blood pressure, advanced hemodynamic monitoring capability, mechanical breathing support, sinus surgery by otolaryngologist Bradley Block, MD, to clear out infected tissues in the sinuses, dialysis and physical therapy, Sean finally began to turn a corner. Fourteen days later, he was on his way home.

Grateful for the life-saving care their son received at Winthrop, the Hatzfeld family recently hosted a Golf Outing that raised funds to enable the Hospital’s experts in sepsis to educate Long Island pediatricians and parents on the frequently missed early warning signs of this often fatal illness.

“We believe there was a reason that our son went through this and we want to take this opportunity to help others by spreading awareness so that others can be prepared should they face a similar situation,” said Mrs. Hatzfeld.

Preparation is certainly the foundation of success, and in 16-year-old Jackson Israel’s case, it saved his life. When his parents, Lee and Raquel, became concerned that their son’s flu-like symptoms were growing increasingly serious, they decided to bring him to Winthrop’s Pediatric Emergency Unit. Bacteria from an unrecognized bone infection had spread throughout Jackson’s body, and upon arriving in Winthrop’s Pediatric Emergency Department, he was in septic shock.

Understanding the importance of timely assessment and committed to recognizing and managing pediatric sepsis patients, Winthrop’s Pediatric Emergency Unit uses a team approach so that patients are treated as quickly as possible. The team immediately began early goal-directed therapy – an evidence-based process that involves rapid administration of fluids and medications to reverse shock and timely administration of antibiotics.

“Jackson’s major organ systems had already sustained injury at the time of presentation and he progressed to multiple organ dysfunction,” said Dr. Quintos-Alagheband.

During the next few weeks, Jackson required invasive monitoring, medications to maintain his blood pressure, advanced breathing support and dialysis to support his kidneys. A blood clot spread the infection to his lungs, and he required surgery to control internal bleeding. During his three-month stay in Winthrop’s PICU, Jackson steadily regained his health.

Consultation with various subspecialties was coordinated to assure the best treatment. “This was reassuring for us,” said Mrs. Israel. “We knew every option was being explored.”

Today, as Jackson is enjoying attending school for the first time since he became sick earlier this year, both his family and his Winthrop medical team are grateful.

“It is because of the collaborative efforts and the swift action of many Winthrop professionals that Jackson has overcome a lengthy battle with pediatric sepsis,” said Mrs. Israel, who, along with her husband, Lee, were eager to give back to the Hospital in gratitude for the outstanding care he received.

The Israel family’s generous support has enabled Winthrop to obtain a high-fidelity pediatric mannequin that can simulate life-threatening scenarios to advance the Winthrop medical team’s knowledge and expertise.

“This will strengthen our team’s position as a leader in sepsis education and quality improvement. Further, Raquel Israel is currently an integral part of our Pediatric Sepsis multidisciplinary team and contributes greatly to help us carry our mission,” said Dr. Quintos-Alagheband.

Benefiting from a family-centered approach, George Miller is also grateful that a turn of events led his 14-year-old daughter Elizabeth to Winthrop. Originally diagnosed with mononucleosis, Elizabeth was prescribed steroids by her pediatrician – yet over time her symptoms of fever, pains in her neck and weakness grew increasingly worse.

1-2 Winthrop’s Pediatric Sepsis Care Team is committed to providing timely and safe management of patients with sepsis. Recently, members of the Team gathered with grateful patients and families at a special “Strike Out Pediatric Sepsis” event at Winthrop to raise awareness and improve outcomes.

Upon arriving at their local hospital, the medical team there determined that Elizabeth was on the brink of cardiac arrest and advised that she quickly be transported to Winthrop. Within minutes, two Winthrop physicians arrived and after initial stabilization, transported Elizabeth in the ambulance to the Hospital where she was immediately worked on by a team of experts in the PICU.

“We watched the Winthrop team do their miracle work,” recalled Mr. Miller, who was impressed with how well he and his wife were informed about their daughter’s care every step of the way. “It’s as if she were the President’s daughter, that’s how well we were all treated.”

Despite a one-month Hospital stay, followed by extensive in-home treatment, today Elizabeth is doing well and her father credits her success to the outstanding care she received at Winthrop.

“Anyone would hate to see their child have to be in an Intensive Care Unit, but if you have to go somewhere, Winthrop is the place to go,” he said.

“These patient accounts clearly demonstrate that we provide outstanding care on a regular basis,” said Joseph Stambouly, MD, Chief of Pediatric Critical Care Medicine.

Winthrop-University Hospital’s PICU affords patients the highest level of specialized care in times of serious illness or injury.

“Our team is committed to making Winthrop one of the best and safest places for children,” said Warren Rosenfeld, MD, Chairman of Pediatrics at The Children’s Medical Center at Winthrop.

For more information about the wealth of pediatric care services that are available at Winthrop, call 1-866-WINTHROP or visit www.winthrop.org.

Winthrop’s Pediatric Strike Out Sepsis Team Co-Chairs

Lyn Quintos-Alagheband, MD
Physician Quality Officer for The Children’s Medical Center

Sandee Zaera, RN
Nursing Educator Pediatric

Lee Moldowsky, RN
Nursing Quality Improvement

Raquel Israel
Family Liaison

Joe Stambouly, MD
Chief, PICU

Leonard Krilov, MD
Chief, Pediatric Infectious Disease

Datev Pidedjian, MD
Pediatric ED

Aaron Tzvi, MD
Pediatric ED

Robert Asselta, RN
Nursing Educator, ED

Greta Holmgren, RN
Nursing Lead, ED

Arsenia Asuncion, MD
Faculty Educator

Nicole Almeida, CCLS
Child Life Specialist

Joseph Paradiso, RN
PICU Nursing

Kalgi Mody, MD
Housestaff

Goerge Dubroq, MD
Housestaff

Alena Connelly, MD
Housestaff

Barry Rosenthal, MD
Chairman of the Emergency Department

Warren Rosenfeld, MD
Chairman of Pediatrics at The Children’s Medical Center at Winthrop

Vol. 23, No. 1
Fall 2013

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