Double Trauma: Mismanaged Health Care in the Parent Foster System

By Linda Badawo

Imagine your worst nightmare as a parent...

D'Ashon was born three months early, weighed just over one pound and tested positive for several drugs, including cocaine and marijuana, which most likely contributed to his premature birth. Shortly after birth, he had difficulty breathing which led to a tracheostomy with a tube pla

• Language: English
• Publisher: DOUBLE TRAUMA BOOKS
• Release date: Dec 27, 2020
• ISBN: 9781734639001

Linda Badawo

Linda Badawo is a nurse in Texas and the author of Double Trauma: Mismanaged Health Care in the Parent Foster System. Linda is from Mogho Gokhana, Nigeria. Because of the generosity of the American people, she was able to Immigrate to the United States and start life all over again at age 19. After completing her nursing education and training, she worked non-stop for two years and purchased her first home in Texas with the goal of fostering medically dependent children. This was her way of giving back to the country that had believed in her. In 2013, she started fostering children with complex medical needs, and adopted two medically dependent children as her own. She tells their story in her new book. Linda is convinced that a managed health care system that has failed millions of vulnerable citizens over the years can be reformed, and the humanitarian crisis she has personally witnessed can be overcome. Our children deserve better and citizens deserve prompt health care coverage. Health care is our right and we're all entitled to it. She is a founder of Texans Lil Fragile Voices, a nonprofit with a global mission to relieve the plight of impoverished children, mandate health care for all, provide tools to end poverty, enhance the laws that govern the foster care system and provide adequate and timely health care for medically dependent children around the world. To learn more about Linda and Double Trauma, please visit www.doubletraumabooks.

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Preface

As a child growing up, I knew that something was different about me. I grew up in a strict Christian home. My dad was a social worker in one of the motherless homes in Port Harcourt, Nigeria, and my mother was a homemaker. I was so drawn to little kids, sharing and sneaking food out of the house to give to the poor kids in my neighborhood, which got me in trouble. I grew up in a little community town called Bori, Rivers State, Nigeria, where everybody knows everyone.

My faith and values to God were set forth from early in my childhood: I knew that I am only a human who is meant to be here temporarily. This way of thinking makes me appreciate life and the people I come in contact with on a daily basis because we never know what will happen the next day. I know we all pray for long life and prosperity, but we should also know and realize that God is not human and he doesn’t and will never think the way we do. We all ask for favors from God and only hope that we can find favor in the sight of God.

When I was ten years old, on an early morning, on my way to school I witnessed a terrible scene; a crying baby was being fed on by vultures. Perhaps the birth mother discarded the baby on the street near the dumpsters near the school. I am not sure, but the baby was still alive, and the birds were feeding off him. You could still tell it was a boy. Try to imagine the pain of this infant. I tried to get the birds off the baby but obviously there was nothing I could do because of my age. But I remembered saying to myself, Oh God, please make me help children like this when I grow up, so they won’t have to suffer.

At what point did the mother of this little child left to die on the garbage dump become more human than the infant?

At what point did the treating physician become more human than the patient who had been treated?

At what point did the lawmakers become more human than those abiding by the law?

At what point did the king become more human than the servants?

At what point did the children in the foster care system become less human than the authorities looking after them?

At what point does the president of a given country become more human than the citizens?

At what point does the preacher become more human than the audience?

At what point does the judge become more human than those being judged?

Life and death are in the hands of God. If for any reason someone is more human than the other, it is in God’s position to say. In any country, society, community, town, or village there have to be checks and balances. We are placed in the position that we are now in for only one reason: to serve the people best. When this fails for any reason, we become toxins to ourselves.

When I was fifteen years old, there was the Andoni and Ogoni crisis where people were slaughtered and murdered like animals in the street. All our family prayers at that time were for a turnaround again for peace. During this time, we moved to our village in Mogho Gokhana. Soon, I was elected as a Sunday school teacher of the youth boys in Assemblies of God church Mogho Gokhana, Nigeria.

I realized that God is always actively at work around me and has saved me through many challenges in life. God has proven to me more than once that he’s not only my creator but my sustainer, comforter, teacher, counselor, guide, strength, protector, provider, and much more. Most of the time I do things out of the ordinary; I tend to care more about people and their feelings than mine. I think that’s why I am still here and blessed.

My passion to foster and adopt children started in Millwood Hospital, in Arlington, Texas, in 2007. I was working in this psychiatric hospital as a tech in the children department. The majority of the children admitted in this facility were foster children, from ages five and up. I began to wonder why they were all foster children. I concluded that no one wants to provide the basic needs for these children, which begins with real love. Instead, many of these children will be prescribed high doses of brain-altering medications and most of them will sleep all day, gradually deteriorating and eventually not be able to function well in society.

Although I wasn’t ready at that time to start fostering, I took the required classes with Child Protective Services (CPS). I decided to wait until I had something tangible to offer the kids in my care, and that included furthering my education and moving to a house. In 2009, I started school and became a licensed vocational nurse in 2011. After working for two years, I was able to make a down payment on my first home in Mesquite, Texas. That’s when I started fostering and I now have adopted two medically dependent children, fulfilling my long-desired dreams.

I want to be remembered as a nurse who leaves a blueprint on a patient at his or her dying bed.

I want to be remembered as a king who will invite all his servants to come dine in with him at lunch.

I want to be remembered as a cashier who will tell all his or her customers I love you on a daily basis.

I want to be remembered by my foster children as a parent like no other behind closed doors.

I want to be remembered as a president who respects everyone including children of all colors and race and will put a smile on everyone’s faces that he or she comes in contact with.

So, God created man in his own image, in the image of God he created them; male and female he created them. Genesis 1:27

1

My Agony as the Parent of a Disabled Child

This book is about what happened to my adopted son, D’Ashon Badawo. I am writing this book in the name of all the children and their parents who are suffering in difficult circumstances because of the unsympathetic and profit-driven medical insurance providers who seem to choose monetary gain over life-enhancing solutions. Our afflicted children deserve better lives, ease from their distress, hope for their future, and solace for their hearts.

I know I am not alone, and that there are millions of parents who have experienced and are experiencing what my family and I have lived through and are still living through. If you are the parent of a child who is challenged physically, emotionally, or mentally, you understand my sorrow and agony. It is likely that you have been frustrated, frightened, disappointed, and angered by a medical insurance system that pretends to take care of its responsibilities but disregards its humanitarian obligations in favor of making profits for its executives and shareholders.

I have made it my mission to confront this dangerous situation that is affecting our homes, our communities, and the well-being of our nation. Medical insurance corporations justify their actions by making their bottom line their top priority. Something must be done when the choice is between proper care and profits.

As you will learn from reading this book, my son’s medical insurance provider did not make decisions in his best interest and, in doing so, he was robbed of his life’s potential. D’Ashon was a physically challenged baby who had the opportunity, according to his medical staff, to outgrow his physical disabilities and live a normal life. Instead, the insurance company responsible for his medical care made decisions that limited the degree of care D’Ashon received. This resulted in a medical emergency that left my son in a persistent vegetative state.

My son suffered severe and irreversible brain damage and must now live the rest of his life on prescriptions and life-sustaining machines. Ironically, the insurer is now providing the level of care D’Ashon’s medical team originally requested and needed, and would have been required for a much shorter period of time than what now must be provided.

There is nothing that can restore my son’s potential for a decent and productive life. The damage to his brain, to his life’s potential, and to the contributions he could have made to our family, community, and nation are now lost forever. My heart aches and I am inconsolable.

And we are not alone. According to the 2017 U.S. Census Bureau disability report, 56.7 million people in the U.S. had a disability. Eight percent of all children ages five to 15 have some type of disability, equaling a total of 4.7 million children, and 21 percent of people 15 and older have a disability, equaling 11.9 million people. https://disabilitycompendium.org.

The American Association for Justice, an association of trial attorneys promoting justice and fairness for injured persons, published a report in 2008 titled The Ten Worst Insurance Companies in America about the extreme profits these companies were earning by denying and delaying the payment of claims. As noted in the association’s report, insurance companies make more money by simply paying out less.

This tragedy affects millions of people, which is why everyone must advocate for much-needed reforms in government and corporate insurance companies’ policies and practices. When a child’s medical benefits are denied because the company makes a decision to preserve its profits instead of providing medically recommended services to that child, there is clearly something terribly wrong with our system. Our children pay the price of corporate profit...and this has to stop now.

According to a brief published by the Henry J. Kaiser Family Foundation in February 2019 titled Claims, Denials and Appeals in ACA Marketplace Plans, ...19% of in-network claims were denied by issuers in 2017... In addition, AARP noted in 2009 that 200 million (health care) claims are rejected every year.

While not every medical insurance claim requires automatic approval, of course, there is substantial indication that insurance companies choose to cut their costs by denying medical treatments in order to provide value to their shareholders, rather than provide medical services that could otherwise result in more compassionate and benevolent outcomes.

I recognize that it may be difficult to imagine the pain felt by a parent who has a physically, emotionally, or mentally challenged child. Let me assure you that the pain is excruciating. While our culture says there is no tragedy worse than a parent burying a child, imagine sustaining the life of a challenged child who is dependent on you during his or her childhood, adolescence, and possibly for his or her entire life. Not only is the heartache to the parent immense, the enormous funds and resources needed to sustain the child’s life for an undetermined length of time is almost immeasurable.

The managed care system is simply not meeting the needs of its patients, which should not surprise anyone. Therefore, immediate changes to the medical insurance system must be made to save lives and enhance the lives of all those affected, including the children, their parents, and their caregivers. We have it in our power to make the urgent government policy changes that should be put in place as quickly as possible.

It is too late for my son. D’Ashon will be bedridden for as long as his body’s relative health can be sustained. But I know that my son’s situation could have been averted, and therefore I know I must be an advocate for all the children in similar circumstances. What happened to my son will happen again and again to hundreds of thousands or millions of other sons and daughters unless we put an end to the focus on profits over patients. It is for the sake of these children that I ask you to join me in reforming the health insurance system in this country.

2

Meet D’Ashon

D’Ashon and his sister D’Asia are twins, born on May 2, 2015. They were born prematurely at twenty-five weeks, or about three months early. Extremely preterm infants are born between twenty-three and twenty-eight weeks. Babies born this prematurely usually suffer from extreme medical conditions and D’Ashon and D’Asia were both highly medically fragile.

from left is D’Asia, and D’Ashon Right

from left is D’Asia, and D’Ashon Right

D’Ashon and D’Asia were delivered at home unattended; D’Ashon, born first, was then transported to Charlton Methodist Hospital, where he was given chest compression upon arrival, intubated, stabilized, and then taken by ambulance to Medical City Dallas Hospital, a facility that provides care for babies born prematurely. D’Asia was taken to the same facility. Their mother was thirty-one years old and medical records show she had used cocaine and marijuana during her pregnancy; the father of the twins was unknown.

At birth, D’Ashon weighed less than two pounds and tested positive for drugs. His condition was extreme with bleeding in the brain, internal hemorrhaging, and a lingering lung disease. D’Asia was in an even more extreme condition. D’Ashon and D’Asia were not able to breathe or eat without assistance so they both received round-the-clock medical care. D’Ashon was later transferred to Our Children’s House in September, and his sister would remain at the Medical City Dallas Hospital for five months, until October 2015.

During this time D’Ashon was constantly connected to a mechanical ventilator to assist with his breathing. A ventilator is a machine that is placed beside a baby’s crib with a breathing tube that is inserted into the baby’s windpipe, or trachea. This means that the baby’s throat has an incision through which the breathing tube passes. The breathing tube delivers oxygen to the baby’s lungs. The amount of oxygen is regulated by the caregivers depending upon the needs of the child.

Requiring a mechanical ventilator is obviously a very serious condition because delivering oxygen under pressure can damage the baby’s lungs. As D’Ashon’s lungs were not fully developed, round-the-clock supervision was necessary to ensure that the ventilator was performing properly and D’Ashon was receiving exactly the amount of oxygen he needed.

D’Ashon had a stoma, or a surgically made hole, in the front of his neck into which the tracheostomy tube, or trach, was inserted. The trach is secured to the baby’s body with medical tape so the flow of oxygen can’t be disrupted, such as being coughed out. The trach is employed because the baby is unable to breathe through his nose or mouth.

D’Ashon required tracheal suctioning two or three times per hour. The purpose of suctioning is to remove the thick mucus and secretions that gather in the lower airways of the lungs. If not removed, the baby could contract pneumonia or suffocate by choking. Also, if the trach becomes plugged with this material, oxygen cannot be delivered to the baby’s lungs. Without oxygen, the baby’s heart and brain begin to shut down, which leads to serious incapacity and then death.

Professional care of this medical equipment by competent and trained staff is mandatory because the baby’s life is dependent on this machine functioning properly at all times. Suctioning the mucus at regular intervals is a time-consuming task and must be done with extreme care so the baby is not harmed. The attending nurse must provide his or her full attention to this activity, and as this task must be performed two or three times per hour and sometimes as often as seven times an hour, the work is both delicate and time-consuming.

There is a lengthy protocol required for suctioning the baby’s trachea: inserting another sanitized trachea tube, and cleaning the removed trachea tube, all the while ensuring that the baby continues to receive a flow of oxygen from the machine. D’Ashon was attached to the mechanical ventilator and trach for the first five months of his life, almost equivalent to the entire time he was in his mother’s womb.

In addition to the mechanical ventilator, D’Ashon was also attached to a continuous pulse oximeter machine. This machine monitored D’Ashon’s vital signs, specifically how well oxygen was traveling through his body to his arms and legs, the extremities furthest from his heart. This machine was attached to him around the clock.

Since D’Ashon was not able to eat normally. He required a gastronomy tube, also known as a G-tube. A G-tube is a tube that delivers nutrition directly to the stomach through an incision in the abdomen. This ensures that the baby receives the nutrition he or she needs. D’Ashon received nutrition every four hours during the day and continuously at night.

Because of the twins’ exposure to drugs in utero, and the mother’s inability to care for her children and no relatives available to accept legal custody, Child Protective Services (CPS) soon took custody of D’Ashon and D’Asia. CPS, which operates under the auspices of the Texas Department of Family and Protective Services (DFPS), started the necessary paperwork so the two babies could eventually be placed in the Texas foster care system.

This is when I entered these children’s lives. I am a trained pediatric nurse, licensed by Texas to perform specialized services for the care of patients of all ages. I am also licensed by the state to operate a foster care home for children needing medical attention.

A few months after they were born, I heard that CPS was considering possible placement of the twins in my home through my child placement agency, Covenant Kids Services. Covenant Kids Services works in collaboration with CPS to license foster homes, verifies adoption families, and assists in obtaining permanent placements for the children. When I saw them for the first time, I thought they were beautiful, and I felt deep compassion for D’Ashon and D’Asia, the babies I would eventually adopt as my own children.

I began visiting the twins regularly in Medical City Dallas Hospital and assisted with their daily care, becoming familiar with their needs and the routines that sustained their lives. As a pediatric nurse, I had worked with babies like D’Ashon and D’Asia for many years, so I