201808.09

Doctors discharge teen after reattaching arm severed in Laguna Beach accident

by jeff in News

A 15-year old boy whose arm was reattached after it was crushed by a boulder at Emerald Bay in Laguna Beach is going home after spending three weeks recovering at UCI Medical Center in Anaheim.

Doctors discharged the patient on Thursday, Aug. 9 following seven hours of initial surgery, a total of seven operations and intense physical therapy. A collection of specialists reattached bone, blood vessels and nerves, coordinating to repair the boy’s right arm.

An x-ray shows the damaged right arm of a teenage patient during a press conference at UCI Medical Center in Orange on Thursday, August 9, 2018. The UCI Health trauma team talked about their successful treatment of the teenage patient transported on July 18 after sustaining severe injuries to his right arm in Laguna Beach. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
Plastic surgeon Wendy Ng, Trauma Services Chief Michael Lekawa, and Trauma surgeon Sebastian Schubl, from left, listen as Orthopedic surgeon James Learned, at right, shows an x-ray showing the damaged right arm of a teenage patient during a press conference at UCI Medical Center in Orange on Thursday, August 9, 2018. The UCI Health trauma team talked about their successful treatment of the teenage patient transported on July 18 after sustaining severe injuries to his right arm in Laguna Beach. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
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Trauma surgeon Sebastian Schubl, center, speaks during a press conference regarding the successful treatment of a teenage patient at UCI Medical Center in Orange on Thursday, August 9, 2018. Team members included plastic surgeon Wendy Ng, trauma services chief Michael Lekawa, orthopedic surgeon James Learned, anesthesiologist Katherine McCartney and resident physician Staci Sakai, from left. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
An x-ray shows the damaged right arm of a teenage patient during a press conference at UCI Medical Center in Orange on Thursday, August 9, 2018. The UCI Health trauma team talked about their successful treatment of the teenage patient transported on July 18 after sustaining severe injuries to his right arm in Laguna Beach. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
Anesthesiologist Katherine McCartney, in blue, speaks to the media as plastic surgeon Wendy Ng, trauma surgeon Sebastian Schubl, trauma services chief Michael Lekawa and orthopedic surgeon James Learned, from left, listen during a press conference at UCI Medical Center in Orange on Thursday, August 9, 2018. The UCI Health trauma team talked about their successful treatment of a teenage patient transported on July 18 after sustaining severe injuries to his right arm in Laguna Beach. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
Trauma surgeon Sebastian Schubl, center, speaks during a press conference regarding the successful treatment of a teenage patient at UCI Medical Center in Orange on Thursday, August 9, 2018. Team members included plastic surgeon Wendy Ng, trauma services chief Michael Lekawa, orthopedic surgeon James Learned, anesthesiologist Katherine McCartney and resident physician Staci Sakai, from left. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
Plastic surgeon Wendy Ng, Trauma Services Chief Michael Lekawa, and Trauma surgeon Sebastian Schubl, from left, listen as Orthopedic surgeon James Learned, at right, shows an x-ray showing the damaged right arm of a teenage patient during a press conference at UCI Medical Center in Orange on Thursday, August 9, 2018. The UCI Health trauma team talked about their successful treatment of the teenage patient transported on July 18 after sustaining severe injuries to his right arm in Laguna Beach. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
Orthopedic surgeon James Learned, at right, talks to the media in front of plastic surgeon Wendy Ng, trauma surgeon Sebastian Schubl, and trauma services chief Michael Lekawa during a press conference at UCI Medical Center in Orange on Thursday, August 9, 2018. The UCI Health trauma team talked about their successful treatment of a teenage patient transported on July 18 after sustaining severe injuries to his right arm in Laguna Beach. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
Plastic surgeon Wendy Ng, speaks during a press conference regarding the successful treatment of a teenage patient at UCI Medical Center in Orange on Thursday, August 9, 2018. Team members included trauma surgeon Sebastian Schubl, trauma services chief Michael Lekawa, orthopedic surgeon James Learned, anesthesiologist Katherine McCartney and resident physician Staci Sakai, from left. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)
Trauma services chief Michael Lekawa speaks during a press conference regarding the successful treatment of a teenage patient at UCI Medical Center in Orange on Thursday, August 9, 2018. Plastic surgeon Wendy Ng stands behind. They were able to reattach his right arm after more than seven hours in the operating room that day. The team reattached nerves, rebuilt muscle and blood vessels and stabilized the damaged bone. Since then, the patient has undergone six additional operations. (Photo by Kevin Sullivan, Orange County Register/SCNG)

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“Rarely do you have or need eight different surgeons from eight different specialties working in the same OR,” said the surgery team’s anesthesiologist, Dr. Katherine McCartney, during a press conference announcing his release on Thursday.

The team’s lead surgeon, Dr. Sebastian Schubl, said this was one of the worst trauma cases he had ever seen.

When he arrived at UCI Medical Center on July 18, the patient’s arm was almost completely severed just above the elbow. Making matters more complicated, the injury’s proximity to a major joint meant surgeons had to implant additional support in order for the boy to regain the use of his limb, according to the team’s orthopedic surgeon, Dr. James Learned.

Thankfully, not all of the three major nerves in the teen’s arm were cut. The patient does have some scarring at the site of the injury, but the arm has been reattached in the appropriate orientation and location, and Schubl said he was confident the patient would recover the function of his hands.

“A lot of people can’t have their limbs salvaged, so this was fortunate,” said Schubl. “It was a good save.”

The recently released patient had been out on a stroll with a friend at Emerald Bay on July 18 when a boulder about the size of an ice chest fell onto him, according to Orange County Fire Authority Captain Tony Bommarito. As he fell backward, his leg became lodged in the rocky path they were walking along. He was pinned down for at least 45 minutes before being airlifted to UCI Medical.

Fire crews used inflatable extrication bags capable of lifting up to 15,000 pounds to partially remove the boulder. From there, 8 first-responders worked together to lift the boulder off of the boy by hand. They then applied a tourniquet device to prevent blood loss, likely saving his life, according to Schubl.

“When he first came in, there were a few moments when we were concerned,” said Schubl. “But after that, it was only a question of whether or not we could save the limb.”

As the only level one trauma facility in Orange County, UCI Medical Center was the only hospital in the area capable of treating the 15-year-old in time to preserve the use of his arm and his quality of life, according to the Center’s Chief of Trauma Services, Dr. Michael Lekawa.

The patient declined to be identified, and doctor’s refrained from discussing his future prognosis, citing his family’s desire to retain their privacy.