By BRAD RICH

Tideland News Writer

The parents of an Emerald Isle teenager who died June 29 after a skateboarding accident near his home have filed a legal complaint against Carteret General Hospital.

The suit, which does not name any individuals as defendants, was filed Monday in Carteret County Superior Court by attorneys R. Bailey Melvin of Greenville and John T. Briggs of The Kellum Law Firm in New Bern, on behalf of David and Kimberly Hughes, parents of Drew Hughes, who was 13 when he died after being removed from life support at Vidant Medical Center in Greenville.

It alleges the hospital and/or it employees: “failed to keep Drew Hughes properly sedated and restrained; failed to properly re-intubate Andrew Davis Hughes during the transport; failed to perform standard objective tests to verify proper placement of the endotracheal tube; failed to recognize clear signs and symptoms of an esophageal intubation and respond to those signs; attempted to falsify the medical records to cover up their negligence; failed to use their best judgment in the treatment of Drew Hughes; failed to use reasonable care and diligence in the treatment of Drew Hughes and in the application of their knowledge and skill to the care of Drew Hughes; failed to possess the required skill and learning to treat Drew Hughes; failed to practice within the standard of care for respiratory therapists, nurses and/or paramedics in the same or similar communities; and were negligent in such other respects as may be shown at trial.”

The complaint also states that “The actions of employees of defendant Carteret General and officers, directors and managers of Carteret General were grossly negligent and/or were done with reckless disregard for the rights and safety of others such that the cap on non-economic damages does not apply to this case; the acts and omissions of employees and/or agents of defendant Carteret General, who were acting in the course and scope of their employment and agency at the time of the negligent acts, as alleged herein, are imputed to defendant Carteret General; and the aforesaid acts and conduct of the defendant was a proximate cause of the death of Andrew Davis Hughes.”

According to the complaint, “On June 28, 2013, Drew Hughes fell and hit his head while riding a skateboard. He was transported by ambulance to the emergency room of defendant Carteret General Hospital. A CT of the head was normal but doctors suspected a possible basilar skull fracture, therefore, the decision was made to transport him to Vidant Medical Center in Greenville, NC. Because of weather conditions, he was transported by ground ambulance.

“Drew was intubated and placed on an ambulance. The ambulance left Carteret General at approximately 11:10 p.m. with EMTs Laura Lewis and Sherrie Taylor, respiratory therapist Angela Kerntke and registered nurse Shannon Cox on board. Ms. Kerntke had been licensed for less than a year at this time and was not properly trained or adequately experienced in intubating a patient outside of a hospital setting.

“The ambulance stopped outside of Newport, North Carolina to pick up paramedic Mike Murphy. Mr. Murphy took over as driver with Laura Lewis taking over patient care. Ms. Taylor departed the ambulance. At approximately 11:15 p.m., shortly after the exchange of crewmembers, Drew awoke and pulled out his intubation tube. The crew had failed to recognize the signs Drew was waking up and had failed to properly sedate him. They also failed to properly restrain Drew, which would have kept him from pulling the ET tube out.

“Mike Murphy pulled the ambulance off the road and, according to the ambulance report, all four crew members worked to suction and re-intubate Drew with Angela Kerntke being primarily responsible for the attempted re-intubation,” the complaint continues. “Drew was given paralytics and sedatives, which meant he could not breathe on his own. He was completely dependent on the oxygen from the endotracheal tube. Drew was intubated into his esophagus rather than his trachea and was not receiving oxygen and could no longer breathe on his own. At the time of the re-intubation, Drew’s parents were parked in their car immediately behind the ambulance.

“After the attempted re-intubation, the ambulance continued enroute to Vidant Medical Center,” the complaint continued. “The crew never used objective testing, such as colormetric testing or capnography, to verify that the endotracheal tube was in his lungs and not his esophagus.

“Almost as soon as the attempted re-intubation was done, Drew’s heart rate began to drop and they could not find a pulse. According to the ambulance records, at approximately 11:25 p.m., Andrew’s heart rate is in the 30s and he has no pulse. CPR was started and epinephrine was given.

“According to the records a shock is given with a defibrillator at 11:38 p.m.,” the complaint alleges. “CPR was continued. Drew’s heart rate was in the 40s. More epinephrine was given. During this time, the emergency room physician at Carteret General was called to get permission to give Amiodarone. The emergency room physician told the crew to recheck the tube and suction because the arrest may be respiratory related. The crew again failed to verify the tube placement.”

According to the complaint, “The ambulance was diverted to CarolinaEast in New Bern because Drew’s condition was deteriorating. They arrived at Carolina East at 11:43 p.m. according to the ambulance records. Drew had no pulse on arrival. Once at CarolinaEast, the emergency room physician documented that Drew’s color was cyanotic, there was no fogging of the ET tube and Drew had rumbling sounds in his stomach. All of these are classic signs of an esophageal intubation.

“A respiratory therapist at CarolinaEast immediately extubated and re-intubated Drew on the first attempt,” the complaint continues. “Within a few minutes his blood oxygen saturation level returned to 100 percent and his vitals improved.

“However, blood gases were obtained which showed a ph. of 6.88, which is consistent with massive hypoxic brain damage from a lack of oxygen during the ambulance transport. Drew remained at Carolina East until approximately 1 a.m. at which time he was transferred by ambulance to Vidant Medical Center. The ambulance crew failed to notify the doctors at Vidant of the esophageal intubation and the period of time that Drew was without oxygen.

“Upon arrival at Vidant it was determined that Drew had no brain activity,” the complaint states. “Upon further testing it was determined that he met the criteria for brain death. Life support was withdrawn and Drew passed away.”

The complaint states that, “plaintiffs David B. Hughes, Sr. and Kimberly D. Hughes are entitled to recover compensatory damages for medical expenses, and other expenses, incurred in the treatment of the minor plaintiff Andrew Davis Hughes up until the time of his death in an amount in excess of $10,000.00; are entitled to recover damages for infliction of severe emotional distress in an amount in excess of $10,000.00; and are entitled, on behalf of the Estate of Andrew Davis Hughes, to recover damages in excess of $10,000.00.

The Hughes family and their attorneys declined to comment on the suit.

Michelle Lee, community relations director for the hospital, said Tuesday that the hospital “extends its deepest sympathies to the Hughes family,” and noted that the Hughes family “is very close to our family here at Carteret General.” However, she added, “On the advice of counsel, we cannot comment” on the complaint or the allegations in it.

David Hughes works in information services in the hospital.

(34) comments

CNolan

You failed to relay in your article that Vidant Health was contacted in regards to and aircraft and they were unable to fly due to weather, as the same went for the medivac from New Hanover. And no they did not just simply throw Mr Hughes in the back of a ambulance and head up the road. Yes the pt should have been properly packaged and sedated prior to transport, I read they had a respiratory therapist as well a registered nurse on board that ambulance, so why is everyone pointing the finger at the EMT? And what about the charge nurse and attending physician arranging the transfer? Did they not make sure that the patient was stable for transport prior to just throwing him in the back of the truck with those so-called inept emts, I am pretty sure CGH has an operating room and ways to make sure a pt is stable before they just go and throw a child in the back of a truck and head 2 hours down the road. I was a patient there during the first part of the summer and the nurses there was running the feet off of those emts, I over heard one patient enquire about why they needed an IV placed in the waiting room had her response was "I am the NURSE, and I said so that's why!"

ginny

all emts and respiratory therapist should know the fundamentals of pediatric advanced life support that a sudden deterioration after intubation, tube displacement is a first consideration, what a tragedy!!

Amazedandastounded

What a horrible situation. I feel for the family of this young boy!!!

Samanthangm

Carteret General should have never sent an inexperienced Respiratory Therapist on a transport. Usually, you have to be extensively trained before going on transports. The paramedic could incubate as well. I find it hard to believe that no one on that ambulance had sense enough to figure out the tube was in the esophagus. Horrible situation. All involved deserve to be sued.

David Collins

The Kellum Law Firm has been down that road before and along with the dog, will be with you all the way. For a percentage of the take plus expenses, taxes and et al.

Didn't say if the 13 year old, who was engaged in a common but dangerous endeavor, was wearing a helmet or safety gear. If so, then bad luck. If not, the responsibility should lie with the parents.

Read the rather lengthy article and was left with the impression that everyone but the son of God will be swept up in this one. Can there be so many incompetent folks in one setting? Of course, there is always the drama factor to consider. Worked for Denny Crane. Time will tell if this venture will be time well spent.

Marcuspa

Francis, many times I woner if you have any real, no nevermind you probably would not understand.

David Collins

Just see things a little differently and am not alone in this. Far more abrasive comments were aired than mine. Compassion is the word perhaps? When one does dangerous stuff, things can and do happen. Believe MTV had a show about just that called Jac--ss. Never heard if the 13 year old was wearing safety gear or not. Interesting that no one has come forward with that info. Probably would have made a difference had he. Now we go after deep pockets rather than the cause of the tragedy. and only those that were present know the truth. This is one of those times where the rest of the story would help to shape ones opinion. Unless the hospital folds and settles, which is probably what Kellum wants, the defending attorney should dig and uncover all the facts related to this incident and especially what brought it on.

Marcuspa, I do understand, just realize that seldom do bad things happen without cause. Have had two fatal tragedies in my family and both were brought on by the decedents irresponsible actions. That is no reason to go round playing the blame game. To relive something like this is sort of morbid and will forestall any closure.
As for what went on in the wagon and hospital, no one is perfect. I am sure they did their best . Sometimes their best is just not good enough, hence the term "The Practice of Medecine" . When it is perfected that term will change and no one will die.

MARINER MOM

Francis...No he was not wearing a helmet however that is neither here nor there. The issue now is trained Medical Professionals were negligent in their jobs and a 13 year old boy paid the price for it.

Big Fat Drunk Republican

Ignore Francis.

Such a tragedy for this family. Try to stay classy Francis.

NJMEDIC

As a 20+ year medic with time in critical care transport and Medevac, what I'm reading in this article is simply negligence. There is no excuse for an unrecognized esophageal intubation. We have detectors, colorimetric devices, end tidal CO2 detection and wave form, pulse oximetry, and clinical exam to tell us all of this. This is basic strait forward airway management. If so many providers failed to recognize this and failed to correct it, then the death of a young man is on them. I was not there so I don't know what went on but there is no excuse.

David Collins

Oh, Ok. So my negligence is less of then theirs. I get it. Well, with the release of this article, to the thousands of readers, this county's jury pool has pretty much been tainted, so I would look for a change of venue. Time to judge shop and find a pool of jurors that think with their hearts instead of their heads. Actually the hospital will fold, cash will change hands and the dog will get fed.

Arthurt

Too bad they don't have helmets in skate shops!

Big Fat Drunk Republican

I don't believe Francis or Arthurt actually read the entire article.

You two do realize this poor kid suffocated right? Please stop with your comments if it's nothing but hate and uneducated respones.

inthemiddle

Whether the kid had a helmet on or not has absolutely nothing to do with the negligence shown by the medical professionals. Keep the rude comments to yourself and maybe show a little compassion for a family that has lost a child.

presidio jones

Sorry but I'm going to have to agree with big on this one. In fact yes the skate shops have helmets,I would wager that the boy had one at home. A few years back a boy fell and hit his head at the Newport food lion while boarding,no helmet ,Ican't remember the outcome. I personally saw a 14 y.o. at a ice skating rink standing still on his skates and fell hit his head on the ice and died instantly. The point is CCGH has a well deserved horrible rep for it's entire existence as does the drug pushing medical community here.Plain and simple their was probable negligence of the participants involved and someone needs to be held accountable, yes the boy should have had a helmet ,but that might not preclude a edge of concrete still striking his head .Francis and Arthurt show some grace again, don't be like the creeps on the other side.

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CARTERETISCORRUPT

Folks, slow down. This is just one side of a story, and may not be at all true. Why is everyone so fast to condemn the players in this mess? We don't know what actually happened.

This could very well be a ploy to cause removal from this county court to another venue, or some other strategic reason. I find it interesting the detail of this article, that alone raises many questions.
Only those involved know what actually happened. We must wait for the outcome of the trial, if one is held. One thing is certain: The lawyers will cash in big on this one, and the county citizens will lose, and big. Where do you think the money for big damages will come from, involving a county hospital, that is right, you and me. Litigation, it makes me sick.

CARTERETISCORRUPT

And please, no name calling. Address the issue at hand.

David Collins

Big Fat Drunk Republican, Actually I read the article, a few times and shared it with others in other areas. Always the same or similar replies. Why no helmet? In some areas that constitutes child abuse leading to death, even though a convoluted chain of unfortunate events followed. Enough is enough, the legal course is set, so away we go down life's twisted path. This too will pass.

Smokey

A cascade of errors and poor decision making let to this tragic outcome.
1. Failure to follow spinal precautions and properly secure the patient.
2. Failure to properly secure the airway.
3. Failure to adequately sedate a pediatric patient that is unable to protect his airway.
4. Failure to maintain sedation and paralysis of the patient.
5. Failure to recognize vital sign trending hallmarking esophageal intubation.
6. Failure to recognize visual vital signs such as peripheral & central cyanosis.
7. Failure to utilize proper crew resource management.
8. Failure to document.
10. Failure to follow proper patient transfer reporting guidelines and practices.

Those are just a quick top ten. Then the issues of falsification of documentation, lack of Quality Assurance/Quality Initiatives reporting and other sweep it under the rug hope it goes away ruses.
Oh and the less that six years total experience for the transport crew- it's no wonder that this tragedy took place. This reflects poorly on Carteret County medicine on all levels.

Judgedredd

A very unfortunate accident ,and whether or not he had a helmet on or the people responsible for his care were negligent does not bring the boy back. This will probably be settled out of court, but money should go to training staff and better standard of care or a helmet wearing campaign, so its less likely to happen again. Make a better future or just complain, life's to short.

Elysean

How many kids go into hospitals each day hurt in sports accidents or climbing trees or four wheeling? How many adults go in with chainsaw kickback or after a motorcycle wreck? --All activities where they may have done something reckless. Does it follow that a hospital is off the hook if the patient dies a survivable injury if hospital staff can be shown to have caused the fatal damage? --Because the patient came to the hospital wounded??? People are SUPPOSED be able to get competent medical help at a hospital! That's why it exists! Any fool can grasp the obvious that Drew would have been better protected in his fall with a helmet. His parents have advocated for helmets. But Drew's CT was NORMAL before he got in the ambulance! Then, the case indicates, Drew was SUFFOCATED. It says an ER doctor in New Bern had to pull the air tube out of Drew's belly. How would YOU like to try to breathe with all the oxygen going into your stomach??? This is a dear family. The outpouring of love for them in this community attests to who they are. Drew was a beautiful, happy, beloved child whose helpless, paralyzed struggle to breathe must have been terrifying, agonizing--and happened with licensed medical practitioners all around him. His voice begs to be heard. You smug, self-righteous blamers of the parents do not know the wrong you do. Worried about lawyers benefiting? What chance would these normal, average folks have against the resources of a hospital! Drew couldn't speak in that ambulance, but his voice begs to be heard. By all of us. His death shall not have been in vain if even one other person is spared such a horror due to this case coming to light. DO IT FOR DREW!

Marcuspa

It seems in the opinion of some if a person does something wrong and ends up in a hospital that person should get less attention to detail that is in relation to the care they took to get them there. For goodness sake, when people go to health professionals they should expect the same care as anyone. If the article is accurate, which it is likely to be, the young man got much less than professional care. It seems the care is what killed him. The events seem to point to a series of errors in this case pointing to a lack of attention to detail among many people. Perhaps this incident will result as a learning experience that will benefit future care at the hospital.
What the family is doing here is not out of line with certainly most Americans would do with the same situation, even some of the detractors here. As stated this case will most likely not go to trial, but will be an agreement between both parties that will be acceptable to all involves.

CNolan

After reading the article once again as well as the comments I was wondering several things. Smokey sure seems to have a significant amount of knowledge about the situation. How exactly do you know how many years experience those individuals have? Being since that the only ones experience that was made mention of is the respiratory tech. I also can't help but wonder just how Ms Lewis could be named as one of the ones that initially left with the patient then several sentences later be stated as one of the EMTs that boarded the ambulance in Newport? Such comments could prove detrimental during the case. For all persons concerned. It also concerns me how lab as well as other reports are being displayed for public knowledge. What happened to the patients privacy? Why is it not being respected? Or the work history of the persons involved? Yes this is a tragedy on so many levels, I am quite sure Drews parents highly encouraged him to utilize safety equipment. However being a teenager, he felt he was mature enough to take charge of his own actions and opted not to use the proper safety measures. How about the people who made the decision to transport this young man? Did they not make sure that he was properly sedated and packaged for the trip before he even left the hospital? And wouldn't the nurse in back of the truck have the knowledge and training to make sure he was being cared for properly? I mean after all nurses are required to have considerable more intense training than EMTs? And I would think that the nurse was the one in charge after all. But when it all comes down in the end, no amount of money nor blame is going to bring that young man back to his family and friends.

CARTERETISCORRUPT

Folks can we just let this case follow the accepted route of justice? No one here knows the real truth. Most here are talking about protected HIPPA PROTECTED INFORMATION. How did anyone here get this information, much less talk about it. WE DON'T KNOW ANY OF THIS IS TRUE. The staff at Carteret General are professionals. They undergo extensive training that is endlessly ongoing, from experts in the field. They are credentialed, licensed, and competency validated. They are in the most accountable field there is. (as opposed to lawyers where there is no accountability). This article is most likely entirely false, done purposely to remove the case from local court due to contamination of the jury pool. Lets end the speculation. The public needs to stop believing everything it reads. If there is proof offered, then the public needs to see it. If this goes to trial, then the public needs to attend court and listen, to hear the truth, or the courts version of the truth. Stomach intubation, puleeeze. This is too easy to detect to be true, even by a beginner.

CARTERETISCORRUPT

And no, the nurse on board the transport is not in command of the situation, the paramedic on board is in charge. When ems arrives on scene, they would not take orders from even the on site physician, they take their orders from the physician in command of the ems. Training of emt's and nurses are vastly different, and the credentialing is quite different. A nurse to practice independently must be a nurse practitioner, and then only working under established protocol set by the sponsoring physician. Non practitioner nurses cannot step into the role of a nurse practitioner if they are not so credentialed. Physical or chemical restraint laws are very strict. Any breach of such law is serious. As such, the legal system has scared the heck out of the medical community for restraint use. Now, it wants to cut the other way. Most here have no idea of what they are talking about. Hence, everyone should back off and let the case proceed in proper forum.

CARTERETISCORRUPT

How did Brad Rich come by this protected information?

Believer

Careteretiscorrupt did you read the article? The very beginning of the article states that the complaint/suit was filed in Carteret County Superior Court. At that point the information in the complaint is public record. The complaint is based on the medical records not just made up. You evidently don't have much knowledge of how the legal system works today. You may not want to believe that this could have happened but there must have been plenty of documentation to support the filing or it never would have gotten to this point. Oh..and from what I've read, many of the comments made in this thread seem to know exactly what they are talking about. The truth will come out and hopefully this family can move on and changes that need to be made to help protect future patients will be implemented.

CARTERETISCORRUPT

One person below commented on an iv being placed in the waiting room. This situation is due to a full emergency department, with no beds available. With Obamacare, the emergency department will see even more jam ups due to many without insurance, and not being seen in doctors offices or urgent cares. This situation will get worse. Finally, if the hospital gets hit with a big monetary judgement, this will be reflected in not having expansion of the emergency department, or more staff. Folks, you cannot have it both ways. Money won't bring back the dead. But, it can be used to improve care, and the needed increase in emergency rooms. It is a long haul to new bern for an emergency, and a helicopter cannot always fly. Factor this when you want the hospital to pay. The majority of any monetary award will go to the lawyers anyway, this is a fact. Do we really need to give more money to those weasels?

Believer

Carteretiscorrupt, expanding does not equal improved patient care. The expansion of the hospital that is currently about to start really does very little to improve patient care, it just makes the outside look nicer and gives a nicer setting for the same patient care people receive now. Any expansion of the emergency department is years away. People really need to educate themselves and read the fine print. The hospital has insurance for cases like this. They can spin it any way they want but justice still needs to be done when people are reckless/negligent and a life is lost or the same mistakes will be made on others. Changes need to be made on the inside to insure that this community is receiving the best care possible. You don't need to expand to improve patient care you just need to spend the money on hiring good staff and fixing the inside. Then you can look to making the outside pretty. Carteretiscorrupt if you want to improve this hospital so much then focus on correcting the problems that led to that young man losing his life unnecessarily. Put your priorities in the right place..Patient Care comes first..

JohnDoeKnows

While this whole situation is tragic and a lot of opinions are flying around I don’t think we can overlook the elephant in the room.

Regardless of how events unfolded, he ended up in the back of CGH’s EMS unit being transported to Vidant Medical Center.

During the transport this young man awoke from sedation and displaced his endotracheal tube. Once that happened it was the responsibility of the crew to sedate, paralyze and reestablish a patent airway. I understand there was a respiratory therapist on board, a large portion of their career centers around managing the airway. The back of an EMS unit is much different than a hospital setting, the environments are completely different. If you have ever been in the room when the respiratory therapist wants to intubate several things take place. There is usually 3 of them, the bed has to be at the exact height, good lighting, perfect patient position, etc etc etc. The other thing that is unsettling is how everyone seemed to miss all of the clues. There is waveform capnography, breath sounds, condensation in the tube, decline of the patient and on and on. How could 2 paramedics, a respiratory therapist and an RN let this happen? Somehow the most basic concept of care, airway airway airway was not managed.

As for who is responsible or what monetary damages should be awarded, that will be for others to decide. I certainly don’t think to best interest of the hospital should come into play, or the taxpayers, or the possibility of less services in the future if there is a large settlement. I don’t think anyone was thinking of that when the young man was without oxygen. It would definitely send a message, it’s not ok to provide substandard care, that you are accountable!

The question is do you think this is an isolated incident, or the one that is the most publicized? Time and time again there are situations, while not as drastic as this, that happen in this county that go unchallenged. Mistakes are made, situations arise and yet no one answers for these issues. Now we sit back and ask how a tragedy like this happen, it’s very simple, a lack of accountability. Until changes are made we cannot expect a different outcome.

Big Fat Drunk Republican

Carteret Is Corrupt lives in an alternate universe, just ignore the fiction he writes.
Of course he didn't read the article, just read the headline and start typing is the MO.

Corrupt likes to stir the pot, uses outlandish claims to get a rise out of people.

Old Patriot

I think it's funny that Brad Rich put his name on this piece of work that was obviously written by an ambulance chaser. Get a haircut with your kickback money, Brad!

clammerhead

Maybe CC knows what he is talking about, and is trying to open eyes that have been welded shut by passive compliants..

Too bad some people would like to save the government the cost of a blindfold for the execution, by closing their eyes long before the trial...

Clammerhead

Believer

Get Educated...

http://roguemedic.com/2013/11/further-details-on-ambulance-mistake-killed-teen-after-skateboard-accident/

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