A little boy has been in a vegetative state for six years after his brain was deprived of oxygen during a surgery his family believes was unnecessary.
Carlos Blanco, now eight, was born with subglottic stenosis, a narrow airway that can cause infants to produce a whistling sound while breathing or shortness of breath.
While many children are advised to wait and grow out of this, the Blanco family was told that their son needed an operation to widen his windpipe.
But during the surgery, Carlos, who was two at the time, suffered a cardiac arrest that cut off the blood supply to his brain.
After doctors finally managed to restart his heart, he had suffered severe brain damage — as the lack of oxygen had caused brain cells to die.
His family is now suing his doctors and the New Mexico hospital, claiming their actions robbed the boy of his young life and caused ‘significant, debilitating and permanent injuries.’
Carlos Blanco pictured before he had the surgery at two years old
Carlos is ‘just surviving’ today and only able to breathe via a machine that must be constantly monitored and cleaned.
He has his eyes open, but can’t talk, walk, eat on his own, get dressed, go to the bathroom or do anything a young boy his age normally could do.
Carlos’ case was revealed in court filings at the 1st judicial district in Santa Fe, New Mexico.
The toddler had undergone two procedures to widen his airway in April and June 2018 at Presbyterian Hospital in Albuquerque, New Mexico, which were both successful.
But after he developed a new cough, his surgeon Dr Jonathan Owens, who was based in Las Cruces, New Mexico — close to the family’s home — recommended that he have a third surgery in September that same year.
Dr Owens offered to carry out the surgery himself so the family could avoid traveling to Albuquerque, about 200 miles away, for a third time — which they agreed to.
It was during this procedure, according to court filings, that the then two-year-old suffered a cardiopulmonary arrest — or a medical emergency where the heart stops beating.
Doctors performed CPR, but Carlos’ brain was deprived of oxygen for too long, resulting in severe damage. He was diagnosed with an anoxic brain injury.
Court filings suggest the cardiac arrest was ‘mismanaged’ for 15 minutes, during which CPR was performed and medications were administered.
Brain tissue is very sensitive to an interruption in oxygen supply and brain cells begin dying within minutes of low oxygen, according to the Cleveland Clinic.
After his heart started again, doctors found Carlos could not breathe on his own and the toddler had to be put on a ventilator for 13 days.
After two weeks, doctors performed a tracheostomy, a procedure that creates an opening in the throat for a tube to be inserted to allow a person to breathe.
Carlos was discharged on October 9, 2018 to his mother Josefina Blanco, and later went home where he has been in a vegetative state ever since.
Following the surgery, Carlos – pictured above before the surgery – was left in a vegetative state
It is not expected that Carlos will recover and he now requires round-the-clock care and a machine to breathe.
Carlos’ mother is suing the hospital, Memorial Medical Center in Las Cruces, New Mexico, and Dr Owens, an otolaryngologist (also known as an ENT) who recommended and carried out the operation, for medical malpractice.
She is seeking an undisclosed sum for her son’s ‘significant, debilitating and permanent injuries’.
Attorney Adrian Vega, who is representing Carlos and Josefina, said in a statement: ‘In this case, we have a little boy in a vegetative state that requires 24/7 care.
‘[Subglottic stenosis] is an airway issue that generally, in most children, goes away once they reach toddler status so they actually age out of the condition.’
In a statement to the Las Cruces Sun-News, a spokesperson for Memorial Medical Center said: ‘As a matter of practice, MMC does not comment on active litigation and federal law prohibits us from discussing any specific patient matter.’
Memorial Medical Center and Dr Owens did not respond to DailyMail.com’s requests for comment.
Carlos, who is a twin, had a mild to moderate form of subglottic stenosis, which gave him breathing trouble but did not lead to him being regularly hospitalized, a source close to the case told DailyMail.com.
There are no formal guidelines on whether children with a mild form of the condition should have surgery, but doctors say this is often a decision between doctors and parents.
But Dr Satyanarayan Hegde, a pediatric pulmonologist at Access Pediatric in Florida — who did not view the child’s medical notes — said if a child had a mild case but was managing well he would likely opt to ‘wait and see’ rather than operate.
He told DailyMail.com: ‘If I do an investigation and find some subglottic stenosis but that the child is managing well, I might just decide to wait and see.
‘Whether to operate depends on clinical judgement and what the parents want. Some parents want surgery, but others want to avoid it.’
As children grow throughout the first six to seven years of their lives the airways widen, which can help to minimize any symptoms the condition causes.
Dr Jonathan Ida, a pediatric otolaryngologist at Northwestern University in Chicago, disagreed, however, and said he would aim to operate on most patients with subglottic stenosis.
He told DailyMail.com: ‘If I was told there was some level of subglottic stenosis, then I would want to evaluate visually via an airway endoscopy.
‘Little children are very resilient and we are often surprised by the visual obstructions that we find during examinations compared to how well they are breathing.’
Surgeries for subglottic stenosis treatment have a fatality rate below five percent, according to studies. It is not clear what proportion of child patients die if subglottic stenosis is left untreated.
According to a 2012 study in JAMA, the success rate for dilation procedures for subglottic stenosis in children — which Carlos received — is around 70 percent.
The above graphic from the Cleveland Clinic shows a normal airway (main) and then one with subglottic stenosis (inset)
Dr Ida added: ‘In general, most people who delay end up getting the intervention for subglottic stenosis.
‘In medicine, we talk about the ABCs which are the first three things needed to save a life. The first is the airway.’
He explained that surgery is often recommended because if the stenosis is left, it raises the risk of complications later in life if someone needs to be intubated for a condition such as pneumonia.
He also said it was easier to treat earlier in life when the patient was still young.
Warning signs of subglottic stenosis in babies include stridor, or a high-pitched whistling noise when a baby breathes in or out, and recurring respiratory infections.
In young children who have the condition, they may also suffer from a cough that doesn’t go away and shortness of breath.
Treatment options include an endoscopic dilation, a type of minimally invasive surgery where surgeons split the front and back of the narrowed area in the windpipe and place a tiny balloon inside to stretch it and open up a larger area.
It is common to have to do this several times with an infant because during the healing process the area may close up again.
In some cases, surgeons may perform a cricotracheal resection, or removal of the narrowed part of the airway just below the voicebox.
