Intermountain Health physician leads effort to transport terminal infant

When it became clear that an infant born recently at Intermountain Medical Center (IMC) in Murray, Utah was not going to survive, the parents had one request — they wanted to take the baby home to spend time with their other children.?

However, when their insurance wouldn’t cover transportation, Dr. Nicholas Carr, DO, an attending neonatologist based in the Salt Lake Valley, was determined to help the young couple accomplish their goal. His efforts drew in multiple teams, including homecare and hospice, clinical operations, life flight, and Gold Cross ambulance services.?

The baby was being treated for hypoxic-ischemic encephalopathy, a brain injury caused by lack of oxygen or blood flow. The condition caused severe seizures, and an MRI showed catastrophic bleeding. Although the baby was otherwise stable, the care team knew that recovery was unlikely and asked the parents what they would like to do.?

“The first thing they identified was that they wanted time with him as a family,” Dr. Carr said. “They wanted to bring the baby home, to spend time together and take pictures.”?

Dr. Carr reached out to the hospice team and began coordinating the multiple teams necessary to complete the transfer. The responses were quick and even included financial assistance to offset the cost.?

“Knowing that was their goal, we were able to come up with a plan that made that happen within 24 hours,” Dr. Carr said.?

Thanks in large part to several nurses who came in on their day off to facilitate, the family ultimately introduced the newborn to their other children and spent several hours together.?

“In the effort to do everything we could to support the family in their care goals, we were able to get them in a place where the infant could pass surrounded by family and lots of love,” Dr. Carr said.?

IMC’s NICU nurse manager, Alice Casper, said Dr. Carr “just wouldn’t take ‘no’ for an answer” and overcame multiple insurance-related obstacles. “He just kept finding the right people to make it happen.”?

“We couldn’t have done this without Alice, Alisha (Bowling, IMC’s clinical operations director), Lori (McBride, Life Flight’s nurse manager), and IMC being willing to ensure that there wasn’t a financial bomb that came back on the family,” Dr. Carr said. “This would have fallen apart if we didn’t have everybody lining up and making this coordinated effort to do right by the family.”?

The homecare and hospice team oversaw the necessary medications to allow the transfer, and Intermountain’s Neurology TeleHealth team took multiple calls to help manage the seizures.??

Lori McBride said that for Life Flight, “it was an easy ask,” and they were happy to be part of the family’s journey. She added that Gold Cross was very accommodating to donate the ground transportation.?

Dr. Carr said the baby’s mother is a nurse, and the father is a medical student.??

“We wanted to make sure that they received the top-notch care they provide to their own patients,” he said. “Some of the nurses involved came in on their day off to help. It shows the dedication of people going above and beyond to support the family.”?