PHOENIX (3TV/CBS 5) - How did Hacienda Healthcare staff miss the 29-year-old's pregnancy if she was getting routine checks for 26 years?
[SECTION: Hacienda Healthcare pregnancy investigation]
According to court documents, the patient was diagnosed with a brain injury and had been living in a vegetative state at the facility since she was three years old.
The records show the patient received bowel treatment and care for years, and now, an inside source told us she had bowel obstruction surgery.
[ORIGINAL STORY: Woman in vegetative state gives birth at Hacienda HealthCare in Phoenix]
Valley gynecologist Dr. Greg Marchand said there's a common result from that kind of surgery.
“It is a surgery that classically can cause a lot of scar tissue,” Marchand said.
Several inside sources also told us over the past few months the patient had a "mass" on the side of her stomach.
Dr. Marchand said a pregnancy developing in that way is likely due to scar tissue.
“It could slightly change the direction of the uterus, for example if there was scar tissue on one side or the other, the uterus may tilt more in that direction,” he said.
The court paperwork also lists phenobarbital as a medication the patient was on most of her life to control her seizures.
“Phenobarbital is a barbiturate. It is not known to cause any birth defects, but it can be very sedating for the baby,” he said.
Dr. Marchand said the sedative likely led to little fetal movement while the baby was inside the womb, and it also is likely the reason the emergency call came in for a baby who was coding when he was born.
“If a baby is sedated with anything, especially a barbiturate like phenobarbital, the baby could not want to do that and be very sleepy and not be able to breathe well,” he said.
Dr. Marchand said this case now hits even closer to home. Wednesday night he got a call from Adult Protective Services to check on a woman in a vegetative state, who had been living at Hacienda.
“I was asked to come see her to see if there was any evidence of sexual abuse,” he said. “I did the necessary tests and exams and didn’t see any signs of any abuse,” he said.
As he continues to follow the case, he said while it's likely the pregnancy was on one side of her body due to her surgery, and may have looked like a "mass," there's no excuse for not knowing she was pregnant.
“I guess it could be mistaken for an abdominal tumor instead, but any tumor work-up at the beginning is going to require some kind of imaging, and that imaging is immediately going to give you the answer,” said Dr. Marchard.
How lethal is medication to the infant, that his mom was on? A child psychiatrist said the answer is in the prescribed dosage of phenobarbital, while the baby was in the womb.
Dr. Mark Wellek looked over the patient’s medical form for medications and treatments.
“Phenobarbital, 90 milligrams. Twice a day for seizures. That’s a lot of phenobarbital. That would put most people to sleep most of the time,” said Wellek.
He said this, and other listed medications the patient was on, could cause serious developmental problems in the baby from attention deficit disorder, to severe mental disabilities.
And because the baby had to be resuscitated at birth, he said the risk is even greater.
“On a scale from 0 to 100 percent, how likely do you think it’ll be that this baby has long term developmental effects?” asked reporter Briana Whitney.
“Eighty percent. That’s off the top of my head but I wouldn’t lower it below that,” Wellek said.
He said these symptoms likely won't show up until between the ages of 4 and 7, but even with the baby brought back to life, the challenges likely have only just begun.
“Huge. Not just a problem, huge. And if this baby grows up just slightly delayed, that would be a miracle,” said Wellek.