Mother's Quest

Looking into a child's death

One June morning three years ago, Rebecca Vadala, 12 1/2, woke up complaining of severe headache. Her mother was not too concerned; Becky had had headaches six months before, and the neurologist had assured her that headaches are not uncommon during puberty. But by evening the child was having convulsions and had lost consciousness temporarily. She was rushed to nearby Baptist Hospital of Miami, where a neurologist performed a lumbar puncture, inserting a needle between vertebrae in the lower back to get a sample of cerebrospinal fluid. Within an hour Becky went into cardiac and respiratory arrest. She was put on a life-support system, but soon after was declared dead.

Her mother Betty, now 39, was grief-stricken. "I asked, 'What happened?' The doctors said, 'We don't know. Things like this happen.' " The answer did not satisfy Vadala: "That child meant too much for me to just bury her and forget about her."

Determined to find an explanation for her daughter's death, Vadala, who had dropped out of school after the seventh grade and had only recently passed a high school equivalency test, began reading medical texts, looking for clues. Then, thinking she could learn even more by working at a hospital, she began a one-year course to become a licensed practical nurse. The program offered on-the-job training at Baptist Hospital; when she graduated she joined the staff. In her free time, she inquired about procedures and the doctors who had cared for Becky.

Her medical reading had led her to believe that they had not been thorough in her daughter's case. From a nursing manual, she learned that when there is evidence of severe pressure inside the skull, a lumbar puncture is usually performed only as a last-ditch diagnostic test because it can result in a portion of the brain's being pushed down into the spine, possibly causing death. According to the manual, a brain scan should be performed first.

Vadala turned the information she had collected over to attorneys, who filed a malpractice suit against Neurologists Wayne Tobin and Michael Aptman. The suit contended that Becky had shown signs of a pressure buildup and a scan was ordered only after she arrested.

Just before the case was to go to trial, an out-of-court settlement of $350,000 to the Vadalas was agreed upon. Such settlements are common in medical cases, and willingness to make them does not constitute an admission of guilt or negligence. Declares Dr. Tobin: "I did what I considered the right thing. I feel no malpractice was done." But Vadala is convinced otherwise and, at last, satisfied. She has quit her job at Baptist and is moving from Miami to central Florida. But she intends to go on working as a practical nurse.

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