This is on the front page of the Metro section in today's Washington
Post.
http://www.washingtonpost.com/wp-srv/WPcap/1997-11/25/031r-112597-idx.html
Prescription Drug Leaves Baby Dead, Police Curious
By Sylvia Moreno
Washington Post Staff Writer
Tuesday, November 25, 1997; Page B01
The Washington Post
Police are investigating the death of an 11-day-old Fairfax boy whose
bloodstream and liver were laced with high levels of a prescription drug
his mother said she was taking to relieve pain
The child's mother, a 19-year-old Mexican immigrant who was
breast-feeding her son, told police she got the prescription medicine,
Ultram, from her mother-in-law.
But whether the case is a tragic example of a young mother unknowingly
intoxicating her baby through her breast milk, or whether it is a
suspicious death, is still under review, police said yesterday.
"What our investigation is focusing on now is exactly how the drug was
introduced into the child," said Fairfax police spokesman Warren
Carmichael. "We have not eliminated the possibility of it being directly
administered."
Asked in an interview if she gave her son the drug directly, Elvia
Garcia said, "No."
The drug, known chemically as tramadol hydrochloride, has caused
addiction and seizures in certain patients, prompting a warning last
year to doctors by the Food and Drug Administration and the
manufacturer, Ortho-McNeil Pharmaceutical.
The drug is not intended for use by anyone younger than 16 and is not
recommended for nursing mothers because its safety in infants and
newborns has not been studied, according to prescribing information
published by Ortho-McNeil.
Garcia, who has two other children, said in an interview that she began
taking one tablet of Ultram daily because the ibuprofen she was given
when she left the hospital did not ease the pain she felt in her pelvic
and hip area.
The pain "went away with that," Elvia Garcia said as she sat on her bed,
holding her smiling 1-year-old son, Jovan. But on the sixth day she said
she ingested the tablet, her baby died.
Ivan Garcia was born Oct. 29, about three weeks early but healthy and
weighing 6 pounds 11 ounces. The last time she held him alive, Garcia
said, she breast-fed him, then wrapped him up warmly for his midday nap.
The baby never awoke from his nap on Nov. 9. Garcia, who went to change
the baby's diaper two hours after she had laid him down, found him pale,
unresponsive and not breathing.
She yelled to her mother-in-law, Maria Garcia, with whom she and her
husband share a three-bedroom trailer, for help. Maria Garcia, screaming
prayers to Saint Francis to revive the infant,
ran to a neighboring trailer to call an ambulance.
The infant was rushed to Inova Mount Vernon Hospital in Alexandria,
where he was pronounced dead on arrival.
There were no "obvious suspicious circumstances," according to a Fairfax
police detective's affidavit. The medical examiner found "no trauma or
visible abnormalities" in her initial examination of the infant's body.
But what Francis Field found in the preliminary toxicology exam were
"high levels" of tramadol hydrochloride in Ivan's blood and liver
tissue, according to the affidavit.
Police are awaiting final toxicology test results, Carmichael said.
The drug was found during a search conducted last week of Garcia's home
by Fairfax detectives. The bottle, prescribed to Maria Garcia, sat in a
kitchen cupboard with a jumble of other white plastic bottles containing
pills for the elder woman's diabetes, nausea and pain.
Maria Garcia said she got tramadol to quell the pain in her right
shoulder after a fall. "But I took it, and I vomited so much that I had
to go to the hospital, where they gave me an IV," she said.
However, her husband, a construction worker, took the drug with no side
effects for pain he suffered from a fall, and an aunt who visited from
Mexico took it for pain she suffered in her knees.
Self-prescribing is a common practice among many recent Latino
immigrants who are used to obtaining medicine easily over the counter at
pharmacies, said Elmer Huerta, director of a Washington Hospital Center
cancer-screening clinic for Latinos.
"They have no concept of dosage or how many times they need to take
medications or for how many days," Huerta said.
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Kathy Koch, BSEd, IBCLC
Mom to Andrew, Abigail and Molly
LLL Leader, AAPL/OL for VA and MD/DE/DC
[log in to unmask] Great Mills, MD, USA
"Within the child lies the fate of the future." Maria Montessori
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