Octuplet mom fears hospital may not release babies

Date: 2/26/2009
By SHAYA TAYEFE MOHAJER
Associated Press Writer

LOS ANGELES (AP) — Nadya Suleman has voiced concern that the hospital where her octuplets are being cared for may prevent her from taking them home when they're healthy enough in coming weeks.

But in reality, hospitals don't prevent healthy children from going home — child protective services do.

And that's only if a complaint has been filed. Hospital employees are mandated to report to county authorities any concerns they have about unsuitable home environments, a mother's emotional or psychological instability, or any other situation that could result in harm to a child.

According to talk show host Dr. Phil McGraw, the 33-year-old unemployed mother called him Tuesday and said hospital officials were worried that her current living arrangement wouldn't be suitable.

Stu Riskin, a spokesman for Los Angeles County Department of Children and Family Services, said the agency cannot comment specifically on Suleman's situation and could not confirm whether a case had been opened on her family.

But in the event a child welfare complaint is made for a baby ready to leave the neo-natal intensive care unit, it's followed by interviews with family and doctors and in-home visits in an effort "to leave no stone unturned so that we can make the best possible assessment," Riskin said.

If a home is determined to be unsuitable, the county first looks to relatives willing to care for the children. If none is found, a foster home is sought, Riskin said.

Suleman gave birth to the octuplets at Kaiser Permanente Bellflower Medical Center on Jan. 26, when they were nine weeks premature. She has six other children, lives in her mother's three-bedroom home in Whittier and has relied on food stamps and disability income to provide for her family.

She expects the children to come home within the next two weeks, she told McGraw in a show that aired Wednesday. Part two of the interview is scheduled to air Thursday.

Kaiser Permanente spokesman Jim Anderson refused to provide details of Suleman's case, citing privacy concerns, and further refused to elaborate on the health provider's normal procedure for discharging neo-natal infants.

But according to experts and information published on the health provider's Web site, typical protocol for babies discharged from NICU is that the hospital's hired social workers and discharge planners work with parents to coordinate the child's return to the home.

"This discharge plan has to account for the fact that these children, because they're small, they might require special consideration," said Lizelda Lopez, spokeswoman for the state's Department of Social Services, which oversees the county-run child welfare programs. "The hospital has to plan for that and has to work with Ms. Suleman."

It is normal for hospitals to provide parents of premature babies with a host of services to prepare them to care for the babies at home, according to Vicki Bermudez, a neo-natal intensive care unit nurse at the Kaiser hospital in Roseville and a California Nurses Association regulatory policy specialist.

That includes environmental assessments and parenting instruction. Home consultations or home visits from nurses are not unusual, Bermudez said.

"This whole issue has been very emotional, and there have been many judgments made by the public. But nurses and doctors aren't there to make judgments," she said. "They just want to make sure the children and family are getting the services they're entitled to and what's in the best interest of those babies."

The babies must be medically stable before they can be released, which means they should be feeding well and able to breathe on their own, though they are sometimes sent home with oxygen or monitoring equipment, said California Nurses Association co-president Geri Jenkins, also a registered nurse.

"The bottom line is they won't be sent home until the medical team is sure — and they're evaluated to make sure — they're strong enough to eat and grow and thrive," Jenkins said.

In a video posted on the celebrity news Web site RadarOnline.com on Wednesday, cameras went from room to room at Suleman's home, showing cramped quarters and clutter.

In the video, Suleman says the home is "obviously too small" but has a large backyard where the children can play. She also says she's looking for a larger home to rent.

"I want the house to be ready, so my whole head is swimming with ideas," Suleman said in the video.

She has not responded to repeated interview requests from The Associated Press. Her phone has been disconnected and though she said on "Dr. Phil" that she has a publicist, the show only identifies him as "Victor" at his request. Efforts to reach him were unsuccessful.

Copyright 2009 The Associated Press.

Medical society looking into octuplets' conception

Date: 2/10/2009

LOS ANGELES (AP) — The American Society for Reproductive Medicine says it's investigating whether fertility treatment guidelines were broken in the case of a Southern California woman who gave birth to octuplets last month.

The society said in a statement issued Monday that it asked Nadya Suleman and the doctor for more details about her latest pregnancy. Suleman's six other children were conceived through in vitro procedures.

The voluntary, nonprofit organization has guidelines for the number of embryos that should be implanted to prevent multiple births. But the group can't stop doctors from practicing.

"It seems that the guidelines may not have been followed in Ms. Suleman's case," Dr. R. Dale McClure, president of the American Society for Reproductive Medicine, said in a statement.

In an interview broadcast Monday on NBC's "Today," Suleman said she underwent in vitro fertilization at a Beverly Hills fertility clinic run by Dr. Michael Kamrava.

The birth of the octuplets has raised questions over the ethics of implanting numerous embryos in a woman who already had six children.

Without identifying the doctor, the Medical Board of California said last week it was looking into the Suleman case to see if there was a "violation of the standard of care." The board said it has not taken any disciplinary action against Kamrava in the past.

Kamrava, 57, would not comment on the issue.

In the NBC interview, Suleman did not identify her doctor by name, but said that she went to the West Coast IVF Clinic in Beverly Hills — of which Kamrava is director — and that all 14 of her children were conceived with help from the same doctor. In 2006, Los Angeles TV station KTLA ran a story on infertility that showed Kamrava treating Suleman and discussing embryo implantation.

Suleman said she had six embryos implanted for each of her pregnancies. The octuplets were a surprise result of her last set of six embryos, she said, explaining she had expected twins at most. Two of the embryos evidently divided in the womb.

Medical ethicists have criticized the implanting of so many embryos. National guidelines put the norm at two to three embryos for a woman of Suleman's age, except in extraordinary circumstances.

Kamrava's clinic performed 52 in vitro procedures in 2006, according to the most recent national report compiled by the Centers for Disease Control and Prevention. Of those, five resulted in pregnancies and two in births. One of the births were Suleman's twins.

Kamrava's pregnancy rate that year was one of the lowest in the country. Experts say many factors affect a clinic's success rate including a patient's health and types of procedures done.

The average number of embryos Kamrava transferred per procedure for women under 35 was 3.5, compared with 2.3 nationally the report said. Fertility doctors often implant more than one embryo to increase the chances that one will take hold.

Suleman's octuplets were delivered nine weeks premature but doctors have said they appear relatively healthy.

Copyright 2009 The Associated Press.