Michigan Boy Dies After Laser Tonsil Surgery

Mom says its still unclear why a laser procedure led to her 5-year-old's death.

May 21, 2009, 7:09 PM

May 22, 2009— -- Getting your tonsils out used to be just a rite of passage -- one that would leave memories of sore throats and extra popsicles at the end.

Routine tonsillectomies largely were abandoned after the discovery and adoption of antibiotics proved to reduce infections without surgery.

But 5-year-old Hunter Mosher's May 8 outpatient procedure to reduce his tonsils turned into a week of agony and tragedy.

"I just had a bad feeling the whole time," said Hunter's mother Erin Mosher, of Jones, Mich.

Mosher said she called the doctor on the way home shortly after laser procedure to reduce Hunter's tonsils at Watervliet Community Hospital in Watervliet, Mich.

"He's telling me he's in pain, and they're telling me, 'No, he's not.' They said, 'No ma'am, there's no pain'," said Mosher. "He's a tough little cookie. He knows when he's in pain."

The next day, Mosher took her son to a nearby emergency room at Three Rivers Hospital in Three Rivers, Mich., because he could not swallow. She said doctors gave him an IV but within five minutes blood was streaming out of his mouth, choking him.

"His carotid artery blew open and it was a race to save his life," said Mosher.

Hunter lost his heartbeat for 35 minutes. Doctors revived him and sent him to Bronson Methodist Hospital in Kalamazoo, Mich., but he fell into a coma and died a week later.

"There was nothing wrong with him before that," Mosher told a local ABC News affiliate. "The surgeon knows that there was something from his surgery that did this and killed my son."

Ray Cruse, CEO of Watervliet Community Hospital, issued a statement Thursday that read, "Everyone associated with our hospital was deeply saddened to learn about this. Our thoughts and prayers are with the family during this difficult time."

However, the hospital refused to comment on the specifics of Mosher's case, citing patient privacy.

Mosher said Hunter was an active and healthy boy who lived up to his name, following his father on every fishing and hunting trip.

"My husband has his truck and boat, and whenever he left the driveway, Hunter was in it," said Mosher. "He was his dad's little protege in that way."

A Change in How Doctors View Tonsil Surgery

Hunter had hearing problems and, according to Mosher, the tonsillotomy was done at their doctor's suggestion to possibly clear drainage in his ears.

Even so, "The days of, 'You have a child; therefore, his tonsils had to be removed,' are long gone," said Dr. David Darrow, chairman of the section on otolaryngology at the American Academy of Pediatrics.

However, Darrow and other ear, nose and throat surgeons said childhood tonsillectomies have staged a comeback, to some degree, in the last 15 years. But now, the operation is deployed to treat sleep apnea.

"Before the '90s, there were virtually no tonsillectomies anymore," said Dr. Donald Keamy, an assistant surgeon at the Massachusetts Eye and Ear Infirmary. "It has really been shown to be effective for childhood sleep apnea ... where there's a known effect on cognitive ability and association with attention deficient disorder."

He added that a tonsillectomy might cure 80 to 90 percent of childhood sleep apnea cases.

"A laser is certainly not one of the most common ways that we do tonsillectomy -- I'm a little surprised that a laser was used," said Darrow.

However, he said there have been studies showing the effectiveness of using a laser in adult patients.

The revival of tonsillectomies has spurred new innovations to make the operation less painful, including a less-invasive procedure called a tonsillotomy that removes just part of the tonsil and various ways to cut tissue -- including plasma technology, cauterization, microdebriders and lasers.

But along with the new technology comes a reminder of why people abandoned the surgery in the first place.

Despite the best medical advances, any surgery in the head and neck can carry grave risks. Dr. Nortin Hadler, author of "Worried Sick: A Prescription for Health in an Overtreated America," said when tonsillectomies were routine, the death rate was as high as 1 to 2 per 1,000 surgeries.

Pediatric surgeons who specialize in head and neck surgery say what ended Mosher's life -- a pseudo-aneurism in the carotid artery -- is a rare, but very present risk in any tonsil surgery.

"In a situation like that it wouldn't matter how a tonsil was operated on," said Keamy.

Although that particular complication is rare, Keamy said it's a good idea for any parent or patient dealing with a tonsillectomy to take risks seriously.

"The number one thing is that any blood that they see, they have to take very seriously -- even if it's a tint of blood in the salvia," said Keamy. "They can't tell if something is wrong. Only a doctor can tell."

The Mosher Family has set up the Hunter Allen Mosher Memorial Fund at Bank of America