Seven-year-old Aaron Pointer spoke his last words from the back of an ambulance.
"I . . . am . . . tired . . . of . . . breathing," the asthmatic boy gasped, taking breaths between each word, according to a nurse's report.
From the front seat of the ambulance, worried mother Sharese Pointer waited and waited, hoping at any minute they'd arrive at the hospital.
It would be the third hospital in 11 hours that her son was taken to after he suffered an asthma attack at home early in the morning of Sept. 13, 2010.
Aaron was moved out of the first two hospitals after his family was told he needed facilities better equipped to deal with his condition.
The minutes ticked on as the ambulance fought through rush-hour, 4 p.m. traffic and construction.
Sharese Pointer kept looking back at her son and then at the road construction ahead of her, wondering when they'd get to the hospital.
It was only later that she learned something that stunned her: The hospital where they were headed was 45 minutes away.
By the time they reached St. Joseph Medical Center in Joliet, after the roughly 30-mile drive, her son's brain was "starved for oxygen," according to a lawsuit the family has filed. Aaron later died.
The Pointer family, of Matteson, charges that their son died unnecessarily, a result, they say, of a series of errors and gross negligence by medical professionals along the way. They have filed a lawsuit in Cook County Circuit Court that seeks damages and charges his asthma was not properly treated.
The circumstances around Aaron's death raise questions about why an asthmatic pediatric patient was transferred among three hospitals in less than 12 hours, whether he was really stable when he was transported and why he was taken to a facility 45 minutes away when there were closer options that could have handled pediatric care.
Sharese Pointer said she was never told her son would be transported that distance.
"Who would send a sick child almost an hour away? That's crazy," Sharese Pointer said.
"All I knew was we needed to get him there as soon as possible and get him help. I don't understand why they didn't say something. As a parent, you know, we don't know. We go with what the doctor says. The doctor knows best. I'm just trusting that he's putting my child in good hands."
About 30 minutes into the ambulance ride, Aaron's condition worsened and the emergency technicians in the ambulance decided to insert a tube to assist in breathing. First, though, they used paralyzing drugs.
"Intubating a 7-year-old is difficult in the best of circumstances, much less in an ambulance," during a long ride, said the family's lawyer, Joseph Miroballi. "It's a disaster waiting to happen. It's a formula for death."
Those named in the lawsuit declined to comment. They include the three hospitals where Aaron visited: St. James Hospital in Olympia Fields, St. James Hospital in Chicago Heights, Provena St. Joseph Medical Center in Joliet, as well as two physicians: Ravi George and John Davis. In addition, Kurtz Ambulance Service was named. Kurtz did not respond to a request for comment.
A spokeswoman for the Illinois Department of Professional Regulation said the office could not comment on specific cases.
The Illinois Department of Public Health said the agency doesn't govern the transfer of patients.
"It's up to the physician and the family to decide if they want to transfer a patient to another hospital," said spokeswoman Melaney Arnold. "If a family says, 'no,' we want to do it here, then, yes, they can remain at their hospital. It's up to the physician and the family."
The Pointers, who have Medicaid, say they were not given a choice and were never told he would be taken so far.
"It's not supposed to be that way," Arnold said.
"No one explained anything," Sharese Pointer said, breaking into tears. "We had no clue what was happening."
Sharese Pointer said she and her husband, Adarien, still struggle to find answers to what went wrong that day.
Aaron suffered from bronchial asthma, but his family said they felt it was under control. He always carried an inhaler and used a nebulizer. He had been hospitalized in the past but bounced back quickly once he was treated, they said.
"We know the routine. We were prepared to sit in a hospital . . . once they get him to where he needs to be, we're fine," she said. "This situation went wrong, completely wrong."
The day before his health spiraled, Aaron - who loved his big brother Amari and enjoyed making up songs with his dad, watching Sponge Bob and riding his bike - was as energetic and entertaining as ever, his mother said. The family had just celebrated the father's birthday at a barbecue.
"He was running around, playing, eating everything in sight," she said.
According to the American Lung Association, the death of a child under 15 from asthma is relatively rare. In 2007, there were 6.7 million children with asthma and around half had at least one attack. There were 213 deaths that year - 48 deaths for those 5 to 9 years of age. The most recent number for hospitalizations was in 2005, and there were 145,000. That year, there were 145 deaths of children under 19 nationwide, and 44 who were 5 to 9 years of age.
"While no formal risk estimate can be determined from this, it can be reasoned that it would be very low given the magnitude of asthma prevalence and the relatively small number of deaths," said Mary Havell, manager of public relations for the American Lung Association. "In addition, it is often believed that most asthma deaths among children were uncontrolled cases. If this is the case, the risk for those who were being treated or received treatment would be even lower."
The morning after his dad's birthday, Aaron woke up with an asthma attack. His mother recognized that it seemed more severe than usual. So instead of driving 15 minutes to the hospital the family had visited in the past, the Pointers went to the closer hospital - Franciscan St. James Hospital in Olympia Fields.
At around 7 a.m., the family was told he needed to be taken to a facility better equipped for his needs.
"They didn't have the equipment that Aaron needed, so they said they had to move him," Sharese Pointer said she was told.
Aaron was again put in an ambulance, something attorneys referred to as a "destabilizing event." He was taken to Franciscan St. James Hospital in Chicago Heights.
"What is so unusual about this is, why St. James Olympia Fields to St. James Chicago Heights? They have the same facilities. There's no difference," Miroballi said. "Why didn't they transfer him to Hope Christ Hospital, it's not even 18-19 miles away."
Aaron stayed at St. James Chicago Heights for about eight hours. The Pointers were again told that their son needed to be relocated, this time to a pediatric intensive care unit.
The fact that Aaron was wheezing and struggling to breathe should have been a sign not to put him in an ambulance, Miroballi said.
"They send him even though he's not stable," he said. "Why they didn't put a doctor in that ambulance with him, or an anesthesioloist or someone who would manage his condition during that long transfer, we don't know."
"Who would send a sick child almost an hour away? That's crazy."