One week after going home one of the twins developed some apnea, a breathing problem where kids just sort of skip taking breaths. The mother brought that baby to the hospital and the baby was admitted. So far, this is not too unusual, since premature babies often need to be readmitted to the hospital after discharge. The real problem comes with the second twin. The baby was on iron drops for anemia, and there had been some problem with the bottle the iron originally came in, so someone in the home had put the iron into a regular baby bottle and put it into the refrigerator. While the mother and father were in the emergency room with the first twin, someone else in the home fed the bottle containing the iron to the second twin, apparently thinking it was juice or something. That twin developed iron poisoning and was rushed to the hospital and put on a ventilator. Her iron level in the blood was over 1,000; it's considered severe poisoning if the level is greater than 350.
When we heard about this in the NICU, we hardly knew how to react. We were frustrated with the situation, of course, and wanted to be angry at someone, but at whom should we be angry? You can't really be angry at someone for being stupid, can you? Also, it's not clear who did the damage here. Who put the iron into a baby bottle - stupid enough - and then put it into the refrigerator? Who fed it to the baby? There are several siblings of the mother in the home, and some small children as well.
Sometimes it just seems so hopeless. People are so creative in their stupidity that there is no way to anticipate and thereby prevent every possible thing that can go wrong. We can, I guess, only try to prevent kids from going to bad homes. Maybe we're a little angry at ourselves for letting these kids go to this home, but realistically Protective Services cannot and will not remove kids from this kind of home if nothing has gone wrong. We'll have to wait to see what happens now.
P.S. Check out the new pediatric grand rounds at Aetiology.