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Pregnant teenager died trying to get help on three trips to Texas ERs

Doctors who spoke to ProPublica and reviewed Crain’s medical information said she should have been treated at the first hospital

Graig Graziosi
Monday 04 November 2024 19:48
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A healthcare policy professor believes that strict abortion laws enacted by Republican states have made pregnant women "untouchables" — and have resulted in their deaths.

Nevaeh Crain was 18 years old when she died on October 29, 2023. She was pregnant at the time, was suffering from a fever, vomiting, weakness, and intense abdominal pain.

Within 12 hours, Crain — a Texas resident — had visited two hospital emergency rooms, and was blocked from receiving life-saving treatment both times, according to a report by ProPublica.

At her first stop doctors diagnosed her with strep throat, but did not address her abdominal pain. A doctor at a second hospital confirmed that she was suffering from sepsis, a potentially deadly reaction to infection. Doctors told her that the six-month-old fetus she was carrying had a heartbeat and dismissed Crain from the hospital.

She went a third hospital, where an obstetrician insisted on performing two ultrasounds to "confirm fetal demise," according to a nurse's note. After the ultrasounds, she was finally placed in intensive care.

It was too late; by the time she was receiving appropriate treatment, Crain's blood pressure had tanked and her lips had turned "blue and dusky," according to a nurse's account.

Her organs failed, and she died at 18.

Candace Fails, Crain's mother, told ProPublica that she cannot understand why doctor's refused to treat her daughter's situation like an emergency, but Sara Rosenbaum, a health and law police professor emerita at George Washington University has a theory.

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She was a pregnant woman in a Republican state with strict abortion laws.

“Pregnant women have become essentially untouchables,” she told ProPublica.

In Governor Greg Abbott's Texas, abortion bans threaten healthcare professionals with prison time if they perform medical interventions that end a fetal heartbeat. While the law does allow for exceptions for lie-threatening conditions, doctors told ProPublica that the murky legal waters surrounding the issue have warped the way their colleagues treat pregnant women.

For example, they say that pregnant women — like Crain — are bounced from hospital to hospital because health providers are reluctant to provide treatments that could land them in the crosshairs of a conservative prosecutor, according to doctors who spoke with the outlet.

They described treatment time wasted debating the merits of treatment and creating air-tight documentation, fearing what might happen to them if they become the subject of a criminal complaint.

That has left pregnant women unable to trust the advice they're receiving from healthcare providers.

“Am I being sent home because I really am OK? " Dr Jodi Abbott, an associate professor of obstetrics and gynecology at Boston University School of Medicine told ProPublica. "Or am I being sent home because they’re afraid that the solution to what’s going on with my pregnancy would be ending the pregnancy, and they’re not allowed to do that?”

While federal law prohibits emergency room doctors from withholding lifesaving care, Texas has fought hard to change the interpretation of its law. Greg Abbott's Texas has warned doctors that it's state law supersedes the Biden administration's guidance on the federal law.

Texas Attorney General Ken Paxton filed a lawsuit in 2022 arguing that the federal guidance "forces hospitals and doctors to commit crimes" and that it was an "attempt to use federal law to transform every emergency room in the country into a walk-in abortion clinic."

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The lawsuit was upheld as it moved through federal courts overseen by Donald Trump-nominated judges, until US District Judge James Wesley Hendrix — also a Trump appointee — sided with Paxton.

Earlier this year, the US Court of Appeals for the 5th Circuit upheld the ruling. The Biden administration has appealed the ruling to the US Supreme Court.

Violating the state law can land health providers in prison for a maximum of 99 years.

This threat of life-shattering consequences has pressured doctors into walking on egg shells and wasting precious time needed to treat a patient, critics say. Case in point: the nurse who ordered two ultrasounds to confirm "fetal demise" before Crain was moved to intensive care.

“This is how these restrictions kill women,” Dr Dara Kass, a former regional director at the Department of Health and Human Services, told the outlet. “It is never just one decision, it’s never just one doctor, it’s never just one nurse.”

Health providers at Baptist Hospitals of Southeast Texas and Christus Southeast Texas St Elizabeth, the facilities where Crain was treated, did not answer requests for comment from ProPublica.

The Independent has asked the providers for comment.

ProPublica compiled Crain's medical records and asked a collection of doctors to review the information. All of the doctors who reviewed Crain's information said she never should been allowed to leave after her first hospital visit.

"She should have never left, never left," Elise Boos, an OB-GYN in Tennessee, said after reviewing the information.

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