Seven-year-old Betty was the light of her family’s life. “Betty was life, and she was happiness. We used to call her ‘Wonder Betty’ because even though she was autistic, she was making amazing progress,” said her father Jeremy Wattenbarger during a Patients at Risk podcast recording. “We were starting to see things in her that we were told were never to be expected. She was becoming verbal. She started riding her bicycle and running and interacting with other children.”
When Betty suddenly developed a fever, Jeremy called her pediatrician who was unavailable but suggested that Betty be evaluated at a local pediatric urgent care. That seemed reasonable to Jeremy, who assumed that an urgent care would be like an emergency department. “In fact, this one advertised that they had the same capabilities as an emergency room and everything they needed to diagnose and take care of her,” he said.
Photos taken of Betty in the urgent care waiting room showed a child that appeared quite unwell. Her expression is listless, her eyes sunken, and her lips dry, cracked, and tinged blue.12 Indeed, measurements of Betty’s vital signs showed concern that she wasn’t getting enough oxygen, with a pulse oximetry reading between 88–94% (normal over 95%).
Jeremy said that he and his wife assumed that the clinician in the white coat who came to evaluate Betty was a physician. They were wrong. In fact, there was no physician on-site at the urgent care that day. Instead, Betty was treated by pediatric nurse practitioner Madeline Broemson, who diagnosed the child with influenza, a viral infection, and discharged her home. Jeremy remembered, “She told us that Betty just had the flu; that her lungs were clear, and everything was fine.”
But Betty was not fine. She slept throughout the day, and the next morning, Betty would not wake up.