Parents Sue Hospital, Claiming Its Delay in Treating Daughter's Strep Resulted in Amputation

A long ER wait allegedly led to partial loss of limbs for infant with strep.

Feb. 16, 2011— -- Parents of 2-year old Malyia Jeffers are suing a Sacramento hospital after alleged ER negligence resulted in the amputation of their daughter's hands and feet.

Malyia's parents brought her to Methodist Hospital in Sacramento because their daughter had a high temperature, but despite their child's increasing weakness and persistent fever stemming from an advanced strep infection, they say Malyia did not receive treatment for five hours, Sacramento ABC affiliate KXTV reports.

"At this point she couldn't walk," the girl's father, Ryan Jeffers, told KXTV. "I was carrying her around for another hour and a half. They tell us we're next, so we're figuring we're next. Still hours went by, so I really told them that ... you have to see her now. Her fever's gone up, hasn't gone down from the Motrin or Tylenol."

Once seen by medical staff, Malyia's condition required that she be flown to Stanford University Hospital, where she was diagnosed with septic shock. The shock resulted in the loss of her feet, her left hand and part of her right hand.

In rare, more aggressive types of strep, the streptococcus bacteria that causes the illness can move from the throat to the bloodstream and the resulting sepsis can lead to the loss of extremities, says Dr. Ari Brown, a pediatrician in Austin, Texas, and co-author of "Baby 411."

"When the bacterial infection goes through the bloodstream, you have sepsis and a problem with your blood clotting ability. As a result, [the infection] cuts off the blood flow to the extremities and those areas die," Brown says.

The family has filed a medical malpractice suit against the hospital and five emergency room employees, suing for compensation for their daughter's past, present and future medical bills, according to court documents.

In response to the lawsuit, the hospital released a statement saying: "At Methodist Hospital, patient care and safety is our priority. We were sorry to hear about the eventual outcome for Malyia and our thoughts and prayers are with her and her family. We are unable to comment on matters of pending litigation."

When Strep Goes Awry

In most cases, strep results in fever and infections of the skin or throat, in what's typically called "strep throat." Patients usually recover after a dose of antibiotics. According to the Centers for Disease Control and Prevention, there are several million cases of this less-serious strain of strep reported each year. There is a more invasive group A strain of strep, however, and this afflicts about 9,000 to 11,500 people each year, resulting in about 1,000 to 1,800 deaths annually.

"Group A strep is very, very common," says Dr. Lucy Pontrelli , director of pediatric infectious disease at Maimonides Hospital in Brooklyn, N.Y. "The problem is that people become very afraid" when they hear the stories of the more aggressive strains of strep, "but most infections are benign and treatable."

In those cases when strep is invasive, however, the infection can progress rapidly, even in healthy patients, Pontrelli says. An 11-year-old boy showed up with invasive strep A last Friday at Maimonides, Pontrelli says, and had to be put into intensive care. Once stabilized, the boy was transferred to another hospital for surgery to remove the large blood clot.

So how do you know when a strep infection requires medical attention beyond antibiotics?

Brown says that a child with bad strep is going to have a persistent high fever and be "extremely lethargic and not responsive," and might have skin that is very tender to the touch and a redness that quickly spreads.

"They look very sick," she says, "though it's hard to describe exactly why. This is what triage in an ER is all about -- telling the difference between a really sick kid and one who is OK. Also, the condition may change during the wait, so re-evaluation is really important."

After her amputations in November, Malyia is still recovering in a hospital in Palo Alto.