And said that He was improving, Spears explained. Ten weeks after Garnetts death, the coroner ruled it a homicide. 6 Keep in mind that breast milk and formula also contain sodium. Hypernatremia Hypernatremia, also spelled hypernatraemia, is a high concentration of sodium in the blood. The objective of this article is to review the relevant literature and offer a therapeutic algorithm for the management of pediatric patients presenting with salt toxicity. Kakoo Brioso E, Moscoso J, Vieira F, Salazar A, Tuna M. Cureus. Absolutely healthy boy, he replied. I feel like if we would have saw the signs, we could have helped Lacey and helped Garnett, Shawna Lynch said. Nutr Clin Pract. She met my son Cameron and she became like a good friend, Burnham said. Distinguishing between salt poisoning and hypernatraemic - The BMJ Is Salt Safe For Babies? A Tragic Death In South Carolina Is A Reminder I didnt say that someone was setting me up. If left undetected or unresolved, persistently high salt levels may elevate his risk of developing breathing difficulties, brain swelling, kidney damage or heart failure. Non-accidental salt poisoning is a common type of chronic poisoning administered to children by caretakers. Two cases studies illustrate recommended techniques to enhance history By not imposing the maximum sentence, Im combining punishment with something that you really did not exhibit towards your son, namely, mercy., I sit here in prison innocent, Spears told Roberts. Theyre our future. And the proof is that when I took him to the hospital that night had there been high levels of sodium in that feeding bag that I had fed my son out of immediately before he went to the hospital, he would have had high levels of sodium and he didnt, Spears replied. 2011;8(6):349-355. doi:10.1038/nrgastro.2011.83, Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. And it just seemed strange that when we walked in, there were four or five medicines in a kitchenette table behind a can of salt, said Det. [16]. When I first met Lacey she was very shy -- but was real good with kids, Lynch said. On social media there was post after post, recalling traveling to Blakes memorial service, as well as holidays missed. One thing not brought up: Munchausen by proxy. Please enable it to take advantage of the complete set of features! Lacey was the opposite. The doctor came in to evaluate Garnett. the differential diagnosis includes hypernatremic dehydration, But that trust turned to trepidation, when, Burnham says, she heard some unusual stories, which made her question Laceys honesty. In the absence of appropriate medical care, such complications may be fatal. Although brain injury in salt common electrolyte disturbance, most often caused by volume And those words never heard during trial were now spoken by the judge. Overton, who has long maintained her innocence, spent seven years in prison for the young childs death. No Thats all I knew, she Spears replied. . Copyright 2023 Leaf Group Ltd., all rights reserved. Parenting is one of the most complex and challenging jobs you'll face in your lifetime -- but also the most rewarding. Her lawyers remain steadfast in their belief Spears could never harm Garnett -- or any child. Theres a lot more that went on than people understand. I did not murder my son. Published: Because that poor innocent child didnt deserve this.. breath/min, and temperature of 36.7C. Journal of Clinical Toxicology received 2505 citations as per Google Scholar report. With history, physical Instead, Martines, of Spartanburg, S.C., turned to a simple condiment found in almost any dining room: salt. Copyright: 2020 Alqahtani B, et al. He just went around opening everyones hearts, Plauche continued. Your child may also appear unusually restless, lethargic or confused. BMJ Open. Decatur, Alabama, Lacey Spears hometown, was the place she first showed an interest in children -- working as a babysitter, and later, at day care. For infants 6 months and younger, the recommended amount of sodium per day is 110 milligrams and, for babies 7 to 12 months of age, it increases to 370 milligrams. Overview Symptoms Treatment Prevention The symptoms of poisoning depend on the substance and the amount you take in. Basic signs may be mistaken as common respiratory ailments such as flu. FOIA Garnett was presenting with the exact same symptoms that he presented with when he was 9 to 10 weeks old and we found out he had high sodium, said Spears. Severe hypernatremia in a hospitalized child: Munchausen by proxy You got Laceys baby. And I look at her and Im like What? Lacey Spears, convicted of murder in son's salt poisoning death, tells "48 Hours" "I didn't kill him" - CBS News Watch CBS News 48 Hours A Mother Accused By Troy Roberts September 17, 2016 /. Didnt you tell people that the biological father was Blake? Roberts asked Spears. Radiology In Ped Emerg Med, Vol 3, Case 14 I thought about them. I got the first call That there was a sick child in the Maria Farreris Children Hospital and they wanted to start an investigation, said retired Westchester County Det. osmolality was 390 mOsmole/kg. It is a dangerous imbalance What were looking for in inconsistencies in whats being reported and what is seen clinically., Elevated sodium was a factor in this case, Roberts noted. But again, there are some cases in the literature where even low amounts of sodium consumption have resulted in really bad outcomes., It causes an imbalance of the electrolytes in her body, and then what happens is that fluid can shift, he added. While there, Spears babysat, cleaned houses, and received some public assistance. serum sodium concentration may prevent irreversible neurological She would occasionally come back to Alabama to visit. There was no history of diarrhea or vomiting. Received: 09-Oct-2020 Published 2018 May 10. doi:10.1136/bmjopen-2017-021066, Chuong KH, Haw J, Stintzi A, Mack DR, ODoherty KC. For example, people that take too much sodium, they can haveswelling of their brain, they can develop seizures, they can have arrhythmia of the heart., Dont put your hands on my flight attendant, heroic pilot yells before tackling passenger, Arizona couple accused of abandoning son for Pokmon Go, No kid deserves that: Police say barefoot child was forced outside on 110-degree day as punishment, Views from The Posts Editorial Board on current events, Police: Mom poisoned her baby with teaspoon of salt to get husband back into her life, Chinas iron fist reaches across the globe, NATOs annual summit could define a decade of Western security, A delayed dip in the Anacostia will be a big victory for clean rivers. Every doctor who testified agreed that that cannot -- cannot -- happen naturally, Murphy said in court. sodium level slowly over 84 hours, as its toxicity happened over a period of 2 months. The https:// ensures that you are connecting to the salt was given over a period of two months and no neurological Lead poisoning symptoms in adults. The symptoms associated I also could never begin to thank those who supported us, prayed and prayed for us, and walked with us along the entire way, Overton said. Some lady from her church comes up and was like, Oh, thats Cameron. You are required to also presume her innocence until they meet their burden, Riebling continued in court. That argument was refuted by the prosecution when Lacey Spears trial began in February of 2015, with her family, traveling from out of state, there to support her. The danger of poisoning is that the salt delays the fluid in the body, as a result of which the water-salt balance is violated, normal biochemical indices are violated. Before depletion. In the United States, recommendations for the same age group average 800 mg of sodium per day. She would not say yes, she would not say no, he explained. This article was published more than6 years ago. Spears case: What happened in the hospital bathroom? She asked me to go to her apartment and take the feeding bag off the stand and dispose of it, said Plauche. The responsible thing to do as attorneys is to have your client submit to mental examination and she did. Im surprised that my son is brain dead. They call code blue because hes not breathing.. The thought of this being a death by a loving mother was difficult to swallow. At 9 months old, Garnett had surgery again--this time to insert a feeding tube, commonly referred to as a G-tube, where nutrients go directly into an opening in the abdomen, either through a hanging bag or a bottle or through a syringe. 2014;2014:524383. doi:10.1155/2014/524383, Devanarayana NM, Rajindrajith S. Irritable bowel syndrome in children: Current knowledge, challenges and opportunities. It is a dangerous imbalance capable of causing significant neurological injury; quick recognition of salt toxicity is crucial to allow treatment before permanent brain injury occurs. Munchausen by proxy was on my mind from day one.. develop acute kidney injury and oliguria; in such patients, dialysis They obtained subpoenas for his health records and started interviewing doctors. doi:10.1055/s-0032-1301759, Paul, S.P., Barnard, P., Bigwood, C.Challenges in management of irritable bowel syndrome in children. doi: 10.7759/cureus.33045. I dont know whats happening, Spears said. of salt toxicity and aggressive resuscitative measures are critical in the treatment of this lethal poisoning. High levels of sodium can be deadly, potentially causing seizures and swelling in the brain. Hypernatremia is a Dry mouth. we could able to exclude by consequent analysis of both plasma and She is also qualified to receive insurance and education benefits. I was in a very emotional state and just any request she would have asked me to do, anything, I would have done it because I was in such sympathy over the situation that she was losing her child.. "After further review of all the evidence and meeting with her defense attorneys and everyone involved, my office decided that we're going to dismiss the case and include language in there that would actually indicate that she's not guilty of the charge that we charged her with, or the previous administration," Gonzalez said at the time. The consultation. I strongly believe that there was insufficient evidence to -- convict her of murder -- depraved indifference murder in this case, said Riebling. Lacey seemed very interested in what was going on in the investigation, said Det. CORPUS CHRISTI, Texas, Oct. 29, 2009 -- Hannah Overton, 32, a devout Christian and mother of five kids, is serving a life sentence in a Texas prison for killing her 4-year-old adopted son, Andrew Burd. MeSH / CBS News, Produced by Ruth Chenetz, Kathleen OConnell and Doug Longhini, [This story first aired on April 9, 2016. and anion gap 8 mmol/l (normal 8 to 16). Headache. As a result, the cells I never said that I had more than one child. Once that happens, it can cause cells within the body to begin to swell with water. The prosecution portrayed her as a mother who had lost control and tried to punish the young boy by giving him seasoning mixed in water. Like a medical report that noted Spears said she wanted to harm the child or one that Garnett suffered bleeding from the eyes and ears with no known medical explanation. 17.]. Carfi focused on what happened at the hospital. Water Intoxication in Babies: Everything You Need to Know - Parents finding and laboratory investigations patient was diagnosed as a Salt poisoning is an intoxication resulting from the excessive intake of sodium (usually as sodium chloride) in either solid form or in solution ( saline water, including brine, brackish water, or seawater ). that the lethal dose of salt ingestion in children was less than 5 Aug. 5, 2016 A tragic story from South Carolina ended in the death of a 17-month-year-old girl on Wednesday. frequently and fatal hypernatremia solely from ingestion of table where toxicity may have been, in part, related to co-ingested In a review, Coulthard and Haycock (p [157][1]) discuss how to differentiate in children between hypernatraemia due to salt poisoning and dehydration. A 6-year-old boy presented to our pediatric emergency department, One month after Lacey Spears trial began, on the third day after the case went to the jury, a verdict is reached: Guilty of depraved indifference murder of a child. That changed in January of 2014, shortly after Garnett turned 5, when she says, he came down with a fever, stomachache and headache. Hannah Overton, a south Texas mother of five whose wrongful conviction for the 2006 death of her foster son was overturned last year, is expected to receive over $500,000 in compensation from the state for the years she spent in jail. R56 DA038366/DA/NIDA NIH HHS/United States. It can be happened in all ages Shana Druckerman contributed to this report, 24/7 coverage of breaking news and live events. Each bag had the equivalent of at least 69 small salt packs. Torn blood vessels and fluid build up in the brain cause seizures and coma. Mom convicted in salt poisoning death to get nearly $600K for wrongful If youre going to do something as the prosecution alleged, thats as devious and is as sophisticated of having to connect a tube to his abdomen, to have to then pour a fluid down this tube to poison him Youre gonna do it with the door open? A massive urinary electrolytes and osmolality. Without the defense calling a single witness, counting on they did all they needed to do -- just raise reasonable doubt. ingestion of salt causes the plasma sodium concentration to elevate The initial lab work showed blood glucose 5.7 mmol/l, Serum Sodium (203 mmol/l) from referring suspect hypernatremic dehydration but careful history from parents, New insights into visceral hypersensitivity--clinical implications in IBS. Appeal Denied for Mom Convicted of Murder - ABC News last 2 months and he was insisting to do so while his parents were Methods: I took care of him. The two became close while at junior college, where Lacey took a few nursing classes, before dropping out. A general examination At the time, Overton had four children and was pregnant with a fifth, and had no prior trouble with the law. In addition, seizure prophylaxis is important Plauche told the leaders of the Fellowship what had transpired. You didnt poison your son with salt? Roberts asked Spears. teaspoons. He was not having any underlying medical condition before, except moderate language delay. Not in my wildest dreams would I ever have thought that my name wouldve been drawn out of this big hat as this make-believe father.. Youve seen that in other cases? Roberts asked. toast, crackers . Investigating the death of Garnett Spears. As the Bookshelf referred from other hospital with polyuria and polydipsia for two weeks and fatigue and inability to walk for 1 day. BUN/Creatinine Do Not Sell or Share My Personal Information. I wanted to know what was wrong, said Spears. In children, mortality in salt toxicity is high when the Lacey Spears, convicted of murder in son's salt poisoning death, tells And two days after being admitted to Childrens Hospital, Garnett is brain dead, on life support. The red flags in this case and for me in any case of medical child abuse is when the story does not fit what you see. The Overtons live in East Texas and told ABC News they have housed and supported prisoners after their release through their non-profit organization, Syndeo Ministries. I didnt ask Valerie to go to my apartment and remove anything. No, I did not. I did it to inform my family and my friends. 2017;10:231237. This is my 5-year-old son on life support.. Longdom Group SA Avenue Roger Vandendriessche, 18, 1150 Brussels, Belgium Phone: +442038085340 Email: info@longdom.org, Publication ethics & malpractice statement, Pharmacokinetics of monoclonal antibodies used for inflammatory bowel diseases in pregnant women, Single-Walled Carbon Nanotubes Induce Fibrogenic Effect by Disturbing Mitochondrial Oxidative Stress and Activating NF-B Signaling, Journal of Clinical Toxicology peer review process verified at publons, 7th International Conference on Global Toxicology and Risk Assessment. Shawna Lynch met Lacey about eight years ago at the daycare center where Spears took care of her son. Central nervous examination showed Glasgow Coma scale of 15/15, alert and active. Sodium: Too Much of a Good Thing At least 97 percent of children and adolescents take in too much sodium, which may also cause a significant increase in your child's blood pressure, according to the American Heart Association 1. water loss [2]. Hydration status was normal. Doctor Sanders never met Lacey Spears, but has reviewed information about her. It was just something that I was given and I embraced it., Garnett was becoming of age where he was gonna go to school, Lacey Spears told Roberts. Children younger than age 14 should consume no more than 6 grams of sodium daily, depending upon their age, according to health professionals with the Food Standards Agency. Budnick. level over 3 days. Over time, high blood pressure may damage your child's heart muscle and can increase his risk of developing heart disease as an adult. point out that cerebral edema may develop in response to diffuse Recurrent bouts of diarrhea may result in the loss of too much fluid from your child's body, which may cause dehydration. sharing sensitive information, make sure youre on a federal The following day, the detectives interviewed a cooperative Spears at the hospital. Salt Poisoning in a 6-year-old Child: A Case Report The National Capital Poison Center writes on itswebsite that theres no shortage of horror stories surrounding people consuming large amounts of salt, including a shipwrecked man who drank salt water and a 19-year-old who ended up in a coma two hours after drinking a quart of soy sauce. Conclusions: Hypernatremia due to sodium excess occurs less And I would agree with that, said Riebling. Sodium and Babies - Solid Starts There was no history of diarrhea or vomiting. J Clin Toxicol. Were you surprised when the police showed up? Roberts asked Spears. She and other Munchausen experts believe the syndrome is child abuse and, as such, needs to be reported. [1] Severe symptoms include confusion, muscle twitching, and bleeding in or around the brain. Garnett had severe ear infections, Spears replied. She now had second thoughts about disposing of the bag, so she brought it home. But the recovery lasted less than 24 hours. Sakai Y, Kato M, Okada T, Sagata Y, Goh R, Kohyama A, Sumitomo M. Wallace D, Lichtarowicz-Krynska E, Bockenhauer D. Arch Dis Child. He then delivered his sentence: 20 years to life. poisoning in the UK in one study was approximately 1 in She spends a considerable amount of time not searching for sodium, but searching for other possible reasons, whether it be a vitamin D deficiency, a brain tumor All sorts of stuff, Dave Sachs explained. Yes, Dr. Darenkov replied. Garnetts father was a friend of mine. Overton's original trial attorneys admitted at an appeals hearing that they had made errors. typically occurs after a single massive ingestion of salt or it can occur At least 97 percent of children and adolescents take in too much sodium, which may also cause a significant increase in your child's blood pressure, according to the American Heart Association 1. most important aspect is to actually consider this diagnosis, given its rarity and the severe medical and social consequences associated with it [1-3]. way of distinguishing the causes hypernatremia is challenging as I wanted my son to be healthy.. Coker came across a disturbing discrepancy in Laceys background: she had lied about the identity of Garnetts father. Occasionally, patients with acute salt poisoning may Overview Giardia infection is an intestinal infection marked by stomach cramps, bloating, nausea and bouts of watery diarrhea. 2014;20(22):67596773. Physicians feel they need to know for sure and they dont. Uddin earned her Master of Science in integrated biomedical sciences with an emphasis in molecular and cellular biochemistry from the University of Kentucky College of Medicine. Clin Kidney J. If convicted, she faces up to 20 years in prison. The defense, however, questions where the salt or syringe would come from. 2018;8(5):e021066. Epub 2022 Jul 2. toxicity. Spears became pregnant with Garnett in 2008, when she was 20. Consultation of nephrology and child protection services are strongly recommended in the comprehensive treatment approach. HHS Vulnerability Disclosure, Help What first caught my eye, said Det. And, says Spears, it did not find that she suffered from any mental illness. But if you suspect, report, said Dr. Mary Sanders, a clinical psychologist and associate professor at Stanford University. She and her family do so much good with nothing. In severe cases coma, brain damage, or death may occur. I took him to the pediatrician who said, You know, I cant figure out anything thats going on with him, but were gonna watch him said Spears. home with outpatient follow up appointment. Who was his biological father? Roberts asked Spears. Hypernatraemia caused by salt poisoning or dehydration must be distinguished correctly, as the two situations need different legal and medical approaches. from the cells, the brain cells pump in electrolytes and endogenous Every time she takes her son into that bathroom the door remains open, said Stephen Riebling. No eyewitness No forensic evidence And no answer to the question why, Riebling told jurors. More searches, dangers of high sodium -- signs of high sodium, Murphy said in court. An official website of the United States government. hypotonic intravenous fluids and target should reduce the sodium due to either salt excess e.g. An investigation, involving Detective Carfi and Ramapo detectives Kirk Budnick and Greg Dunn, was immediately under way. Friday night, Saturday he was fine.. grandmother, they admitted that he had poor growth since birth Journal of Gastroenterology and Hepatology. Distinguishing between salt poisoning and hypernatraemic dehydration in Five months after Garnett died, Lacey Spears was charged, and held without bail, for murder in the second degree and first-degree manslaughter. and diarrhea, presumably due to the mucosal irritation and fluid Abdominal pain. As the condition worsens a patient may have an increased heart rate, muscle spasms, or seizures. I would have nuts or fruit on the counter and he would eat, she said. I never thought he was sick or anything. Coriell MB, Gandham P, Wintergerst K, Thrasher B. World J Gastroenterol. A video EEG was set up using a special cap on his head, wired to a machine that monitors brain activity. They speculated Andrew might have had pica, an eating disorder characterized by an obsessive appetite and that Andrew accidentally poisoned himself by consuming a fatal amount of sodium. He soon stops breathing, and is intubated. But almost two days after being admitted, he took a turn for the worse - with stomach issues and pain. A statement released by family members recalled the joy the infant had brought her loved ones. Serum chemistry; serum sodium,185.4 mmol/L; I love children, Spears told 48 Hours correspondent Troy Roberts in her first interview. Lacey remained by her sons side, caring for him, taking him to the bathroom, and everything seemed normal. toxicity has been present for less than 24 hours, because brains The normal range is 140 for infants. serum sodium concentration should only be considered in acute phases of hypernatremia within a few hours from He was in and out of the hospital for the first nine weeks of his life and afterwards, she said. This is 1 in 30 563 Lothian children<17 years. Youre trying to deal with your son, and then what has happened and transpired and then youre thrown into a mix of police officer and investigators? The most important aspect is to actually consider this diagnosis, given its rarity and the severe medical and social consequences associated with it, since parents and carers suddenly become suspects to be confronted with the possibility of having . They I realized I had actually known Lacey when she was a child and remember seeing her at church on a regular basis, said Coker. UpToDate Published 2017 Jul 19. doi:10.2147/PRBM.S120817, Sagawa T, Okamura S, Kakizaki S, Zhang Y, Morita K, Mori M. Functional gastrointestinal disorders in adolescents and quality of school life. 2019;14(1):1648945. doi:10.1080/17482631.2019.1648945, Zhou Q, Verne GN. If your child is unusually thirsty or shows signs of swelling, he may be consuming too much salt. But former Nueces County District Attorney Mark Skurka charged Overton a second time for murder after her release. The Full Story Our bodies are finely-tuned machines with lots of back-up systems in place. Two days after she arrived at the hospital, the baby was unresponsive, prompting doctors to place her on life support, the station reported.