The struggling newborn

TGH lost $305,000 saving Katlynn Hart's life, even after Medicaid kicked in. Last year, the neonatal ICU unit lost $4.1-million.

By DAVID KARP

© St. Petersburg Times, published April 9, 2000

After a week at the hospital, they were alone. Robin Hart, 20, and her 24-year-old fiance, Bill Mesmer, were scared. They had spent a week at Tampa General Hospital watching their newborn girl cling to life.

The 8-pound, 9-ounce Katlynn had been in the neonatal intensive care unit at TGH, attached to every medical device imaginable. A metal box with a circular pump breathed for her. A blue tube the diameter of a nickel carried oxygen to her lungs.

[Times photo: Fraser Hale] Katlynn Hart blows bubbles as part of her therapy at Pediatric Therapy Services in Lakeland. As a newborn, she spent months in TGH's neonatal intensive care unit.

Now, Ms. Hart was at her mother's home in the Polk County town of Auburndale, 45 miles away, sitting on the edge of the bed, holding Bill and crying. They had to decide whether to unhook Katlynn from the complicated machine with the complex name -- the extracorporeal membrane oxygenation, or ECMO -- that kept her alive.

Babies can stay only so long on ECMO, a heart-lung bypass machine that allowed Katlynn's organs to recover from infection. After a week to 10 days, damaging side effects set in. Katlynn had been on the machine for seven days with no improvement.

The phone rang: The hospital wanted to know what to do. Keep her on the ECMO, Ms. Hart said.

After another week on the machine and three more months in TGH's neonatal unit, Katlynn went home. Today, the 21/2-year-old mashes Play-Doh, takes apart a Mr. Potato Head, and jumps in her playpen like any other child.

The ECMO, however, is one of several money-losing services that could be cut if TGH doesn't get a multimillion-dollar public bailout.

TGH has one of five ECMO units in Florida, the only one in the Tampa Bay area. Starting such a program costs $250,000 for equipment, not including maintenance and lab tests.

The bigger cost is in the specially trained nurses. A baby on ECMO requires two specially trained nurses 24 hours a day. The cost to the hospital averages about $7,000 a day, said Dr. Bob Nelson, director of TGH's neonatal unit.

"That is quite a bargain for having a healthy child versus a dead child," said Dr. Robert Bartlett, one of the developers of the ECMO procedure.

Last year, the neonatal ICU lost $4.1-million.

The hospital lost $305,000 saving Katlynn's life, even after Medicaid covered part of the cost, Ms. Hart said.

"I have never received a bill," Ms. Hart said. "I have never looked at one."

She couldn't have afforded it anyway.

At the time, she worked for a child care center in Auburndale but didn't have health insurance. Her boyfriend had insurance, but they weren't married so the policy did not cover her. Now, she raises Katlynn at their mobile home in Polk City and works nights at Wal-Mart.

After saving Katlynn, TGH then helped Ms. Hart get funding for two years of therapy. Another ECMO parent made a blanket for her, and nurses put little ribbons in Katlynn's hair.

"They didn't only work with her," Ms. Hart said, "they showed her that they loved her."

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