A 20-year-old Baltimore police cadet's interest in a possible genetic defect in his family history has led to the discovery that the death of his three-day old brother at Johns Hopkins Hospital 21 years ago was not due to a liver problem but to "an accidental cause."
The death certificate for DuWayne E. Russell, issued recently by the state medical examiner's office at the request of Cadet Eric L. Russell, revealed that a transfusion of hemolyzed or bad blood into the baby's bloodstream caused an immediate respiratory arrest.
Resuscitation efforts failed and the baby died on Jan. 28, 1970.
The family said the death certificate was the first time they had been aware of the cause of the baby's death.
Vera and Ellwood Lonnie Russell Jr. were young parents then -- she was only 17 -- and the grief-stricken couple never felt they needed a death certificate.
For more than two decades, they had believed what Vera Russell says she was told by hospital physicians -- that their baby's death was unpreventable and caused by liver failure.
Now, Eric Russell's findings are the basis for a $5 million medical malpractice suit, filed Monday in Baltimore Circuit Court, against Johns Hopkins Hospital and Dr. Ralph A. Gruppo, the attending physician, who now lives in Cincinnati.
The Russells, city residents, allege they were victims of "willful and deliberate fraud and misrepresentation" by Hopkins health care workers, who "willfully and deliberately lied" to them about the circumstances surrounding their son's illness and death.
And, because the alleged fraud and negligence was not known until May 1991, the suit -- which deals with an incident that happened 21 years ago -- is not bound by the three-year cutoff normally imposed on litigation under the Maryland statute of limitations.
"The right to proceed with the court action is the same as if the incident had happened yesterday," said Marvin Ellin, the attorney who is representing the Russells. "Under the circumstances, the state law has been suspended."
Also, the Maryland law, which invoked a $350,000 cap on pain and suffering in medical malpractice cases several years ago, does not apply in this case, Ellin said.
"The law for the cap applies to all negligence which occurred on or after July 1, 1986," the attorney said. "This took place in 1970 and you can't have retroactive laws."
Two months ago, Eric Russell tried to obtain copies of his dead brother's records from the Hopkins' Medical Records Department. He said he was told the records "were lost." He then learned from the medical examiner's office that an autopsy had been performed.
Continuing efforts to obtain Baby Boy Russell's records from Hopkins -- most recently on Monday, -- have been unsuccessful, Ellin said.
The hospital has no explanation for the disappearance and/or loss of the baby's records, the suit says. It asserts they were "willfully and deliberately destroyed" to further deprive the Russells of their "right-of-action for the negligence" of doctors and nurses at the hospital.
Paul Rosenberg, an attorney for the hospital, said yesterday, "It is possible that after all these years the records have been lost." He refused to comment on the suit, saying he had not seen a copy and was not familiar with its contents.
Vera Russell was hospitalized for the delivery of her first baby Jan. 25, 1970. She had had an uncomplicated pregnancy and had been assured by Hopkins obstetricians she would have an uneventful delivery.
DuWayne Russell was born at 8:15 a.m. that day, weighing in at 6 pounds and 1 ounce, according to the suit. He was rated a 9 one minute after birth on the Apgar score and a 10 three minutes later.
The Apgar score bears the name of Dr. Virginia Apgar, a pediatric anesthesiologist, who devised the scoring system to rate newborns. Two points are allowed for each of five categories. Ten is a perfect score, eight to 10 is considered excellent.
Vera Russell had been told her son was healthy and she could look forward to leaving the hospital in the next "two days." However, the baby developed jaundice, a common post-birth complication that shows up as a yellowing in the eyes and the skin.
The suit contends that, contrary to accepted standards of care, the health care workers failed to initiate prompt therapy for the benign condition, which is caused by an elevated bilirubin -- a part of the red blood cells.
Three days after birth, the elevated bilirubin had risen to 22, a dangerously high level that required an exchange blood transfusion, the suit alleges. This involves removal of the baby's blood and the infusion of donor blood with a normal component of red blood cells.
Again, the suit alleges that contrary to accepted standards of care, the health care workers "negligently infused hemolyzed blood into the baby's vascular system" which led to death.
In hemolyzed blood, there is a breakdown of the oxygen-carrying component of living red blood cells. This destruction releases a chemical, potassium, into the bloodstream. Normally, potassium is not harmful within the viable red blood cell, but when high levels of potassium get into the vascular system, it affects heart activity and can be fatal.