Physicians from three area hospitals collaborate to rescue sick infants during hazardous weather

There's never an ideal time for a medical emergency but Feb. 2 of this year was especially treacherous as a fearsome winter storm paralyzed much of Iowa. Clouds blotted the sky and the heavy accumulations of snow were preceded by sleet and freezing rain, leaving dark patches of visible roadway coated with ice.

On Feb. 1, as the storm closed in, physicians at Mercy Medical Center in Clinton had readmitted tiny John Wernick, an infant born there on Dec. 22, about 10 weeks early. Because he was so premature, John had been transferred to University of Iowa Children's Hospital at University of Iowa Hospitals and Clinics, whose Neonatal Intensive Care Unit is well-equipped to handle critically ill newborns.

"John had respiratory problems and had to be put on a ventilator," said Edward Bell, M.D., director of neonatology at University of Iowa Children's Hospital. "He recovered and seemed to be doing fine, so he went home on Jan. 25."

Once home, John's condition deteriorated within a few days, which led to the trip back to Mercy in Clinton. "John was coughing, sneezing, not waking up, not eating…he wasn't himself," said his mother, Heather Darsidan, 27. Physicians later determined that he had contracted respiratory syncytial virus (RSV), a dangerous infection in infants and young children.

Neeru Aggarwal, M.D., John's primary care pediatrician at Mercy, telephoned the Neonatal Intensive Care Unit during the day on Feb. 2 and discussed the case with UI neonatology fellow Lori Katz, M.D. They determined that John should be readmitted to University of Iowa Children's Hospital, but by then the weather prevented UI Hospitals and Clinic's AirCare helicopter or ambulance from attempting the 87-mile journey.

The phone consultations between Aggarwal, Katz, and then Bell lasted into the evening. As night fell, Katz suggested checking the infant's blood carbon dioxide levels. That's when they realized the extent of his illness: John's level was 165 (normal is 40), meaning he was not exchanging air well at all. "John was in severe respiratory failure," Aggarwal said. "He needed to be transferred to University of Iowa Children's Hospital for highly specialized care."

Meanwhile, Bell was aware that one of Aggarwal's colleagues at Mercy, Preeti Bhatia, M.D., had contacted Richard Flaksman, M.D., medical director of neonatology at

Genesis Medical Center in Davenport, in hopes of transferring another newborn premature infant. With the phone conversations growing more urgent and the UI transport team still unable to safely reach Clinton, Bell realized Genesis was both infants' best hope. He called Flaksman and asked if he could send a team to Mercy ahead of the UI team, as Davenport is closer to Clinton.

Neonatologists usually don't accompany a patient transport, but the extraordinary circumstances required Flaksman's presence. "By that time, we were worried about the baby (John) who might need a ventilator immediately," Flaksman said.

The late-night drive from Davenport to Clinton took a half-hour longer than usual, but the team arrived safely. Flaksman quickly stabilized John, establishing an airway and putting him on a mechanical ventilator. "John was tiring out and likely would have died that day without the medical help provided by Dr. Flaksman," Bell said.

The UI team arrived soon afterwards and transported John back to Iowa City before dawn on Feb. 3, where he remained until being discharged March 4 (during a heavy rainstorm, naturally). The other infant, who was less ill and did not require the Level III neonatal care provided at University of Iowa Children's Hospital, returned to Davenport with Flaksman's team.

With today's advanced technology, Bell said, it's rarely necessary for three hospitals to have to coordinate so closely to reach sick patients--weather or mechanical problems cause such instances perhaps once every several years. "It was fantastic the way they came together to save my son," Darsidan said.

Life is back to normal for Heather Darsidan and her infant son, John Wernick, who survived a dangerous viral illness that required emergency care during a severe winter storm. Other family members include Brandon Buickman (left), Austin Wernick, Norman Wernick, and McKenzley Morris.

Edward Bell, M.D. (Children's Hospital of Iowa)

Neeru Aggarwal, M.D. (Mercy Medical Center, Clinton)

Richard Flaksman, M.D. (Genesis Medical Center, Davenport)