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Four Doctors Reprimanded In Child’s Death

May 22, 1985

TACOMA, Wash. (AP) _ Four Army doctors have been reprimanded by the commanding officer of Madigan Army Medical Center, who said errors and failure to communicate contributed to the death of a 6-year-old boy being treated for a cut lip in Madigan’s emergency room.

Brig. Gen. Darryl Powell, who said earlier he didn’t feel the punishment recommended by two hospital committees was severe enough, ordered letters of reprimand be placed in each of the four doctors’ military personnel records. He also ordered extensive training for two of the physicians.

Powell also said Tuesday he has instituted new hospital policies requiring cautious treatment of patients under age 12, including one policy prohibiting interns or residents from making final decisions on treatment of children.

Scott Johnston died of a heart attack last month after being improperly given a ″pain cocktail″ of three sedatives by an unsupervised intern, the Army has said.

A five-member Army medical team is investigating the death. Madigan and five other Army hospitals were criticized in audits last fall for a number of deficiencies, including poorly supervised emergency rooms.

Powell said the intern who treated the boy, Capt. John Bowersox, began treating patients again Monday but is under special supervision for the next 90 days. An emergency room resident involved in the incident, Maj. Dee Pettigrew, has also been put under special supervision as recommended by the hospital education committee.

″These fellows are under very tight scrutiny now in how they do things,″ said Powell, who on Tuesday also ordered Bowersox and Pettigrew to undergo an extensive one-month training period in the pharmacologic effects of sedatives and narcotics.

The two doctors also will be under close scrutiny by their attending teaching chiefs for a 90-day period, Powell ordered.

Letters of reprimand were issued for Pettigrew and Bowersox, and for Col. Frederick Burkle, attending physician in the emergency room, and Maj. Stephen Clift, a plastic surgeon.

Madigan’s credentials committee had recommended that Bowersox, Pettigrew and Clift be given letters of reprimand, but had voted against reprimanding Burkle. But Powell said Burkle had failed to instruct Pettigrew properly on the procedure for administering the sedatives to Johnston.

Powell said the most serious mistake was to give the drugs Demarol, Phenergan and Thorazine intravenously to the boy, rather than injecting them into a muscle.

He also said Bowersox, who stitched the boy’s cut lip, should have more carefully monitored Johnston’s vital signs. Had close monitoring been done, the boy could have been revived, the general said.

Under the new hospital policies for children, Powell said interns and residents will be required to consult with a fully trained staff physician on every treatment. In addition, an intern or resident will not be allowed to perform a procedure which is ″potentially dangerous″ without a staff doctor present.

The new policies also prohibit giving children Thorazine, a powerful sedative that was given to the Johnston boy, and tighten control over the use of intravenous devices.

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