‘He’s like the miracle boy,’ mom says of son
Published: October 3, 2005
When Keegan Sugnet’s parents arrived at Strong Memorial Hospital late on July 3, they didn’t know whether their son was alive or dead.
The 15-year-old had every reason to be dead. He had been struck by a car going 45 miles an hour, shattering his left kidney, raising a huge bump on his head and — though his parents wouldn’t find out until the next day — cutting off his left arm.
Paul and Susan Sugnet of Penfield said that when they gave their names, the emergency room workers’ faces fell.
“They’re looking at each other,” Susan Sugnet said, the image still fresh in her memory. One said, “‘We’re going to get you the social worker.’” The social worker ushered them into “the quiet room.”
The Sugnets expected the worst.
Instead they learned that Keegan was alive, though gravely injured. The doctors weren’t available to talk because they were working on him. Soon, a trauma surgeon was able to give the Sugnets more details.
It would be an eventful night, showcasing the abilities of a team of surgeons, radiologists, nurses and technicians who specialize in fixing, or at least treating, terrible injuries. But beyond the resources of the biggest and most well-equipped trauma center in the Rochester region, Keegan had something else going for him: his youth and health.
“He’s like the miracle boy,” Susan Sugnet said. Eleven days after arriving at Strong on advanced life support, after losing more than half his blood and undergoing two surgeries, Keegan left the hospital with two arms and a good start on the road to recovery.
“You can’t ask for a better outcome,” said Dr. Mark Gestring, head of adult trauma at the Strong Regional Trauma Center.
Internal injuries
When the ambulance carrying Keegan got to the trauma center shortly before 11 p.m. on Sunday, July 3, one thing was obvious about his condition. “We knew his arm was missing. We didn’t have to have a medical degree to know that,” Gestring said. As horrible as the amputation was, Gestring said it was almost irrelevant. Keegan could live without an arm. The medical know-how came in diagnosing his life-threatening injuries and fixing them.
With a tourniquet tied firmly around Keegan’s upper left arm and Keegan sedated, the members of the medical staff ran a series of CT scans to check for internal injuries. Immediately, they realized that his lungs were functioning fine, even though they were bruised. He had a head injury, but there was no evidence of harm to his brain.
The biggest threat to both his life and arm reattachment was a bleeding kidney.
A scan showed that the right kidney was healthy and whole, but to an untrained eye the left kidney resembled a cloud in the night sky. Looking at the image weeks later, Gestring said it showed doctors that the organ was in pieces, surrounded by blood.
“A huge amount of your blood goes through your kidneys,” the doctor said, so if one is bleeding — as Keegan’s was — it’s easy to bleed to death internally.
Gestring, acting as a sort of medical choreographer, entertained arguments from several doctors on the best way to proceed. Because of the bleeding kidney, blood thinners were ruled out, since they could cause even more bleeding. Blood thinners are typically used after reattachment surgeries so that clots don’t form in the sewn-together arteries and veins.
Dr. Thomas Hansen, the orthopedic surgeon who did the reattachment, agreed to avoid blood thinners because they’re not absolutely necessary.
Dr. David Waldman, a vascular intervention radiologist, threaded a surgical instrument on the end of a wire through an artery in Keegan’s groin. When the tool reached the kidney, Waldman used the instrument to seal off the bleeding.
Within an hour of his arrival at the hospital, Keegan was deemed healthy enough for doctors to try reattaching his left arm.
Husband-wife team
The arm had been sent to surgery 45 minutes before he arrived. Dr. Anjali Singh, a pediatric orthopedic surgeon, was on duty and immediately called her husband, Hansen, who has training not only in repairing bone injuries but also in the blood vessels and other soft tissues of the arm and hand.
It’s rare for them to be on weekend duty at the same time, as Singh, 34, and Hansen, 33, have a small child. But a fluke of scheduling made them call in Hansen’s mother from Ithaca to watch their baby while they worked.
Singh had assisted her husband on other bone surgeries, but she had never before seen him perform in his area of special expertise — soft tissues — and was impressed with his work.
“I have to cut him some slack that he doesn’t do the laundry,” she said with a laugh.
The surgery took six hours and could have been stopped at any time if the internal injuries ended up being worse than the doctors had thought.
Hansen worked as quickly as possible to keep the tissues alive, looking through magnifying lenses to see his work. “You’re trying to do it fast but do it right,” he said. Some of the hollow vessels he was sewing together were as thin as strands of spaghetti.
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