When Hennepin County (Minn.) Medical Center EMS received a dispatch for a 6-year-old girl injured at the Minneapolis Golf Club kiddie pool on June 29, they never imagined the horrific injury they would find on arrival. What they found as they began their assessment of Abigail Taylor was an evisceration of her lower intestine, which was sucked out of a 2-inch laceration in her rectum when she sat on an uncovered suction drain in the golf club's wading pool.
According to Scott Taylor, Abigail's father, his daughter got out of the pool after sustaining the injury and fell over. "She more or less blacked out, she passed out, fell face-first onto the pool decking," he told the Associated Press. The family thought it was a seizure.1 EMS was then requested.
"She loves to swim," says her father. Even though she's only 6 years old, Abigail has already competed in local swim meets. Her passion for swimming is why her family didn't think twice when she began playing in their golf club's kiddie pool.1
Taylor said a search of the pool filter turned up several feet of Abigail's intestine.2 The family's lawyer, Bob Bennett, told the Minneapolis Star Tribune that doctors had to remove the remaining part of her intestines, and she s expected to be hospitalized for two weeks as a result of the bizarre incident.2,3
In most public pools the drain cover is screwed in and can't be removed. According to the Consumer Product Safety Commission, the pressure on some pool drains can be as strong as 300 pounds per square inch.1 This kind of pressure can suck in hair or body parts, or trap swimmers underwater and cause them to drown, even if someone is trying to pull a victim away from the drain.
"This could literally be happening if you're holding your child's hand," said Bennett. "These filtration systems are meant to be covered and secure. You don't think the filtration system will literally tear your organs from your body, and it's not a risk your child would understand."4
Bennett said the golf club's swimming pool drain hole was improperly uncovered.4 However, the club's general manager told the St. Paul Pioneer Press he didn't think anything was wrong with the pool. He referred questions to the attorney for the club's insurance company, who declined to comment.
Hennepin County Medical Center EMS paramedics treated and transported Abigail to Children's Hospital in Minneapolis, where sheremains in serious condition and faces a series of surgeries. Doctors removed what was left of her small intestine this past Saturday.
Scott Taylor says his daughter will have to be fed intravenously for the rest of her life and receive all of the nutrients usually obtained from the intestine via IV fluids. She also will have to use a colostomy bag. Bennett reports doctors may insert a port, or connecting site, for a feeding tube.2 Taylor says that, if she ever eats again, she may only get 10% of her nutrition from food.2
"It never even crosses anybody's mind that potential at the bottom of that pool is enough force to literally disembowel a child, an adult," said Taylor. "We view it as a miracle that she's still with us."1
On Wednesday, July 5, she stunned her father by asking, "Am I going to be on the news?" When her parents asked why she was inquiring, Abigail said, "Because I want to make sure this doesn't happen to anyone else."1
Since 1990, 170 people, mostly children, have been caught in drains and 27 of them have died. At least three other children have suffered injuries similar to Abigail's since 1990.3 A similar case in North Carolina became one of the biggest legal victories of presidential candidate John Edwards when, in 1997, a young girl he represented who had been disemboweled by a defective swimming pool drain received a $25 million settlement.2 Note: See the special statistics section at the end of this article.
A 2005 report by the Consumer Product Safety Commission warned that if a child sits on an uncovered pool drain, the suction can rupture the rectum and "eviscerate [disembowel] the child" in seconds. But pool officials in Minneapolis, St. Paul, Anoka County and elsewhere say that most modern wading pools have been designed to prevent children from getting stuck in drains.2
Bette Fenton, YMCA spokeswoman for the Minneapolis and St. Paul area, told the Minneapolis Star Tribune that all of their new pools have multiple drains. Fenton says "We were aware of this situation for a number of years that the drains can be a problem. So the potential for it to be a problem is significantly minimized."
Some pools have a safety vacuum cutoff which shuts down if someone is trapped. In St. Paul, Bob Bierscheid, the city's Parks and Recreation director says the drain covers at the two public swimming pools (Highland Aquatic Center and Como Park) are screwed down and, if a drain cover somehow twists free, the entire pool system would shut down.
The Minneapolis Parks Board, which operates 61 wading pools, sent out a systemwide e-mail telling staffers that city pools don't have "high pressure/suction that would result in this type of injury." They were urged to share that information with the public.2
Legislation that would require pools and hot tubs to have multiple drains to ease the suction is pending in several states. On July 6, two members of Minnesota's congressional delegation, Rep. Jim Ramstad and Sen. Amy Klobuchar, called for the passage of a federal pool safety law to prevent such accidents in the future. Klobuchar said, " t's every parent's worst nightmare. Your child is playing in a pool and suddenly your life is changed forever."3
Virginia "Graeme" Baker, the 7-year-old granddaughter of former Secretary of State James Baker, was killed five years ago when she got stuck in the drain of a hot tub and drowned.
Ever since Graeme was killed her mother, Nancy Baker, has lobbied for new pool-safety laws to prevent such tragedies. Testifying before Congress, Baker said she thought Graeme had gotten out of the hot tub and gone into their house. But then her 11-year-old daughter came running to her "with terror, horror, in her eyes."
When she rushed to the hot tub, Nancy Baker told the congressional committee that she saw "nothing but dark and bubbling water"3 She pulled on her daughter with all her strength, but could not pull her up because of the hundred of pounds of suction force. Paramedics finally freed young Graeme but she could not be resuscitated.
She says Abigail's traumatic injury may capture the attention of Congress this summer. Baker, who works with Washington-D.C.-based Safe Kids Worldwide, says "[Abigail's] story is going to have a huge impact."
The federal Pool and Safety Act passed the Senate but died in the House in the final minutes of 2006. EMS, fire and police agencies would do well to join forces to lobby state and federal legislators to pass this legislation, requiring periodic pool inspections to ensure all drains are properly secured, electrical sources are properly grounded, and an emergency shut-off switch is prominently located and identified near all pools.
In the interim, emergency service agencies should ask public and private pool owners to submit to voluntary inspections to ensure injuries or deaths do not occur from these preventable causes.
JEMS Medical Editor, Ed Dickinson, MD, NREMT-P, FACEP, and Benjamin Braslow, MD, authored an outstanding continuing education article in January 2006 JEMS, entitled "Acute Abdominal Eviscerations." This article outlines assessment and management procedures for eviscerations that you can review and share with your crews.
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WCCO-TV: "Minn. Pool Drain Injury Prompts Safety Legislation." http://wcco.com/topstories/local_story_192185434.html
Lerner M, Lonetree A: Thursday: Newer pools minimize risk of drain accidents, officials say. Star Tribune. http://www.startribune.com/462/story/1287208.html
Minneapolis Star Tribune: "Senators introduce pool safety legislation." July 11. www.startribune.com/587/story/1297429.html
WAPT.com: "Wading pool drain sucks out girl's organ." www.wapt.com/news/13626279/detail.html
MSNBC: "Pool drain rips out part of girl's intestinal tract." www.msnbc.msn.com/id/19619471
CDC: "Water-Related Injuries: Fact Sheet." www.cdc.gov/ncipc/factsheets/drown.htm
Pool Alarms.com: "Statistics on Pool Drowning of Children and Adults in the United States." http://www.poolalarms.com/pool_drowning_statistics.htm
Safe Kids USA: Injury Facts: Drowning http://www.usa.safekids.org/tier3_cd.cfm?folder_id=540&content_item_id=1032