Dr. Bex
speaker
498 appearances
7 recordings
1 series
first heard Nov 2024
last heard Jun 2025
Dr. Bex’s voice in public audio — every appearance, attributed to the second.
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And I think children's hospitals, we, I mean, this is not an irregular occurrence, but it has happened. And I think that's why we have all the teams that we do. You know, our job is with the child. That's the patient at our hospital.
And so, you know, offering all the kinds of support, being present, you know, doing, explaining to the child in child languages, kind of what, you know, what's happening as we're able to. And then also HHSA is somehow communicating with the child when they're in the hospital as well. And
like you said i don't there's no perfect way to do this i don't think there is but we also know that the time of you know separation or when this is playing out is also a high risk time for children i'm not saying you know in this case in particular but in any case you know tempers emotions fear right are all at their highest so we also have to understand that that's a time where we do have to protect the child because there is still a risk um
Okay, so the next day, so now we're on March 8th, is the hearing before the judge where the parents are present. And what we know about it from the court documents is that the parents are going to be allowed one visit per week for one hour, and it's going to be a supervised visit.
One of the things they do say in the document is that they were told they're not to talk about her medical condition, her symptoms, how she's feeling about things. And you and I both know that this is part of kind of the OPSEC guidelines for what should be done in these cases if it gets to the separation point. So do you maybe want to explain that a little bit?
i think at this point the concern and the reasonable suspicion and what was found by the judge was that there were concerns specifically of this type of abuse so again whether you whether the parents or whoever believes that or not to be true at this point that is what the court had before them and so following this pathway is what is recommended but remember that if it is in fact found that there was abuse happening
each of these times that that is kind of replaying itself can be very traumatic to that child, or even, you know, set them back if there was, say there was starting to be recovery scene that could lead to another setback.
During this time, I just want to point this out because, again, once we get into the court process, this is going to come up again because it is one of the claims that is filed as to unwarranted medical procedures that were allegedly performed on Madison while she was at Rady's and while this shelter order or this detention order was in place.
And this we are relying solely on what was said in the court documents, which is that it seems there were specifics of what the court said the hospital could do and stuff that needed to be told to the parents before it was done. And then things that maybe specifically would need consent because the parents that's important to point out.
parents are still the medical decision makers in these cases so even though they may not be allowed to be present they are still the ones who would say sign consent forms and if not then it would go to it would have to actually go to a court order so i think a lot of things comes up come up in terms of what constitutes kind of
a normal medical procedure versus what is something that constitutes needing that extra guidance or extra consent from a parent. And this kind of actually made me think a little bit, to be honest, because there are times that a parent isn't directly at bedside. And if you're kind of following along with what the plan was, a lab test could be drawn while the mom isn't there.
You know, an X-ray could be ordered and done without the parent there. And it's kind of what is that limit? A lot of things may warrant or may kind of as a physician, you feel like you should be notifying someone versus the act of consent. And I think that is an important point. And again, as we've said a couple of times, it's very state specific.
It may be in the hospital bylaws as to what procedures require consent. But I think there's some gray areas and that's one of the ones that comes up in this case is this swallow study. And just for those who are following along, I wanna explain to you what it is and maybe we'll hear from you guys what kind of what you think. But the idea is she was describing or Madison was not eating by mouth.
not very clear exactly what symptoms she was describing but the test that was ordered is what's called a swallow study and a swallow study is you go down to the radiology suite there's usually a speech therapist or an occupational therapist and you drink liquids eat foods that are tagged with a certain dye d-y-e dye so that um you can watch it go down and the idea is you want to make sure the swallow mechanism is intact that they're able to pass it from their mouth to their esophagus and then that it passes down through to the stomach
And there are pieces of this. Again, it's not just a routine abdominal x-ray, but there is no anesthesia involved, no sedation involved, side effect risk, no pain. I mean, again, if she's having pain when swallowing, sure, but then the study would end. You know, it's not necessarily you wouldn't push through significant symptoms, I don't think, at least in my experience.
But the idea is she was swallowing contrast and that there were pictures being taken. So I'd be interested, I think, to hear what people think or maybe since you're not in this field, what you think about that. But the point is, it depends really what the hospital, I think what their policy is and then what the court orders said and how those two things play into each other.
um it sounds like there was another a number of other procedures yeah yeah yeah and i mean again this kind of reading this did make me think a little bit more about about the things we do and kind of what standard of care what falls under that you know general medical consent that the parents sign at the beginning
And a lot of times in pediatrics, to be honest, parents are present or a family member is there just because of the nature of a child being in the hospital, but there are times they can't be. And so just really thinking that out, I think, especially when I'm talking to residents in the future, kind of about notifying and keeping parents in the loop.
And I think there are parents that can't be at the bedside for other reasons, you know, work, other children, life, things that they can't necessarily be there and that we're sure we're kind of giving them the same, you know, involvement in the care as if they were within reason too.
um okay so yeah so take us back take us back to the timeline okay so um this is the window of time where we really lose eyes on madison if you want to say it that way or that there's not a lot in the court documents probably because this is the parents that we're talking about now and they're filing with the courts and they weren't at the bedside right so i think there is some um some information we don't have during this time but just so we know she is
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