The mother of a highly ranked U.S. gymnast said her daughter is in a coma not because of a spinal injury suffered at a meet in Japan, but because of irresponsibility on the part of a Tokyo hospital, which she said caused an accidental asphyxiation.
Otilia Gomez said her daughter, Julissa, the country's 13th-ranked gymnast, went into a coma 15 days after first entering Tokyo University Hospital to be treated for a broken neck. Julissa, 15, suffered the neck injury while performing a routine practice vault at the World Sports Fair gymnastics meet. Doctors in Japan, Mrs. Gomez said, had diagnosed Julissa as being paralyzed from the neck down.
Mrs. Gomez said that her daughter, awaiting transport to the United States, went into a coma after suffering asphyxiation when an oxygen hose slipped off the tracheotomy tube lodged in Julissa's neck. An alarm did not sound to alert the nursing staff.
Mrs. Gomez said she has taken no legal action.
"She did not exactly go into a coma because of the accident (vaulting injury)," Mrs. Gomez said from Methodist Hospital in Houston, where Julissa was transferred by U.S. military transport two days after becoming comatose last month.
"She was hospitalized for 13 days, then had a tracheotomy. The day after the tracheotomy, the oxygen tube from the respirator accidentally snapped off, and the machine's alarm was not on, and so the nurse was unaware that it had happened."
Mrs. Gomez said Julissa suffered asphyxiation, went into cardiac arrest, then fell into a coma from which she has not regained consciousness.
Julissa had been given oxygen since the vaulting accident because she could not breathe on her own. Before the tracheotomy, an oxygen tube was placed down her throat. She could move her lips but could not talk.
"We (Otilia Gomez and Julissa's father, Ramiro) were horrified and we asked the doctor (Dr. Koji Mii) why the alarm was not set," Gomez said. "He said, (through an interpreter), because, 'We feel,' although I do not remember if he said we or I or they, 'that if the alarm is set, the nurses will rely on the alarms and not check the patients.' He said they check the patients every 30 minutes.
"I have since learned it is not uncommon to have the oxygen hose snap, but it is irresponsibility on the part of the hospital. It is an accident that could and should have been prevented."
Gomez said she does not know how long Julissa was without oxygen.
Reached in Tokyo, Dr. Mii, an assistant professor at Tokyo University Hospital who treated Julissa, said he has a second explanation for Julissa's comatose condition, an explanation the Gomezes said they had not heard before Saturday night.
"The disconnection of the oxygen tube, it did happen, but when it happened, and why and how it happened, is not sure," said Mii, who speaks English.
"Julissa's pulse rate became low and decreased on the heart scope monitor, to about 8 or 9 beats per minute. At the time, she was asleep and the lamp was turned back, (the room was) not completely dark, (but) the connected part of oxygen tube was not real seen. . . . At the time, it was very dark and her room is not separated--there are other patients in the same room."
Dr. Mii said that a nurse checking Julissa found her pulse to be normal at 10:30 p.m. and 10:35 p.m. He said he checked Gomez at 10:45, and her condition was unchanged.
"About 10:50, this time is not exact, I again found her normal," he said. "Then, I returned to my room (at the hospital) . . . I was called to Julissa's bedside at two or three minutes after 11 p.m. Within 10 minutes, she was revived.
"When the nurse found extreme decreased pulse rate, she cried out in a big voice, and someone turned the lamp on and she found the disconnection of the tube."
Mii said he does not know what happened first, the oxygen disconnection or the decrease in pulse rate, but that Julissa's pulse rate had fluctuated from 38 beats per minute to 70 b.p.m. during her hospitalization.
Her normal pulse rate would be 70 b.p.m., but when Mii arrived at her bedside at the time of the accident her pulse was only 8 or 9 b.p.m. He said when he checked her at 10:50 p.m., her pulse was 58 or 59 b.p.m.
"It is a fact that the disconnection happened," Dr. Mii said. "So, we thought the decrease of pulse rate was due to oxygen disconnection--we thought it was the main cause.
"But now, I am not absolutely sure if disconnection is the main cause of the decrease of heart rate, because mild decrease of pulse rate happened many times to Julissa (during her hospitalization).
"Another possible cause is an (oblong) medulla dysfunction . . . caused by a decrease in pulse rate." (The oblong medulla contains nerve centers that control breathing and circulation.)
Dr. Mii, who used an interpreter to discuss Julissa's case with the Gomezes, said it is the hospital's usual procedure to set the alarm, and that he believes his original explanation was not properly explained by the interpreter.