DALLAS — For years, Makayla Thomas prayed for a baby.
“I struggled with fertility for a while,” the North Texas woman told WFAA.
In February, she and her husband Joe got their wish. “I was like, ‘Oh my gosh I’m finally pregnant!’ We’ve been together for 11 years.”
Thomas started documenting milestones on her journey to motherhood, photographing and videotaping her pregnancy tests, sonograms, hospital visits and more. But what would later happen was worse than anything she and her husband could have prepared for.
“This was not supposed to happen,” she said.
Their story starts in June when Thomas went to Texas Presbyterian Hospital in Dallas three separate times over two weeks with abdominal pain.
During her third stay on June 25, Thomas’ medical paperwork said she was diagnosed with a kidney infection. Thomas told WFAA the kidney infection was caused by a “possibly untreated UTI,” which was also documented in her paperwork.
She stayed in the hospital through the 27th under observation, medical records show.
“They discharged me, and said, ‘Just take the new antibiotics, and you’ll be fine,’” she recalled.
Two days later, Thomas woke up again in pain. This time, though, she did not go back to Presbyterian. “I had been there three times,” she said.
Frustrated that her pain still had not improved, and at 26 weeks pregnant, on June 29, Thomas instead went to a freestanding ER called Preston Hollow Emergency Room.
“I thought I’m going to go to the emergency room, and hope they can do something about this pain and kidney infection,” she said.
“Never at that moment…did I think I was going through labor.”
At the ER
Thomas’ paperwork from Preston Hollow confirms she arrived in abdominal pain and with vaginal bleeding. Thomas said she was in the room alone after being checked and screened as she waited for a doctor. Her documents say a physician was notified.
“Very scary,” she said.
Her pain got worse, she said, and she suddenly felt the urge to push. Kidney infections, according to Nationwide Children’s Hospital, can cause pre-term labor.
“I was just like ‘Oh my God! Did I push out my baby?” she recalled.
Makayla said she pushed out her baby by herself, and that her baby rolled off the bed onto the floor. She recorded what happened next in a series of cell phone videos. The first video she shared with WFAA shows Thomas’ baby on the floor.
“I’m going to have to pick up your child, okay?” a medical employee says on the video. The video shows that an employee scooped the baby off the ground.
“How many weeks do you think you are?” the employee asks her.
Thomas’s baby was born in en caul, a rare type of birth, roughly 1 in every 80,000, where a baby is delivered still inside the amniotic sac. Thomas said she filmed this intimate moment because she was stunned, unsure if what came out was even her baby.
“I was really in a state of shock,” she said.
“So that’s the baby?” Thomas is heard asking in the video.
“Yeah,” an employee replies.
“Is that the baby? Is it dead?” Thomas asks.
“It appears to be…yeah,” an employee replies.
Later in the video, an employee says, “It may have had some genetic abnormality or something, it appears so…but we’re still going to transfer you over just to get checked out and make sure everything, you know, came out.”
“It was just so nonchalant,” Thomas told WFAA. “They were examining her but not attending to her medically.”
The video ends there and Thomas says the medical workers leave again. She started recording a second video caressing her baby girl, thinking her first time holding her daughter would be her last.
“If this is the only time I'm going to see her in the flesh,” Thomas told WFAA. “I’m going to record it and make sure I have all my memories.”
A third video shows an ER employee appearing to listen for the baby’s heartbeat. The video ends when they tell her she cannot film.
“Ma’am, I’m sorry you can’t record,” a medical worker is heard saying.
“But this is my baby,” Thomas replies before the video cuts off.
Thomas picks the camera back up for a fourth video. In it, her baby has been cut out of the amniotic sac, but the video ends when she’s told again to stop recording.
In a fifth video, a medical worker is doing chest compressions on the newborn.
“He said there’s a faint heartbeat, I was like ‘Oh my God, she’s still here,’” Thomas remembered.
Thomas’ medical records say her baby was given oxygen after a heartbeat was confirmed, but that is not seen in any of the videos she took.
The director of operations for Preston Hollow Emergency Room declined to answer our questions about Makayla's care, even when we told her Makayla would give written permission to discuss her treatment.
"We follow all state regulations that every freestanding emergency room has to follow,” said Mandi Sralla, the ER’s director of operations.
Presbyterian also declined to answer questions about Thomas’ care at their hospital, citing patient privacy laws.
‘Painful to watch’
“It was painful to watch the video, I’ll be real honest,” retired obstetrician and gynecologist Melinda Morris told WFAA.
We asked her to review not only the videos Thomas took inside Preston Hollow ER, but also her hospital medical records.
“It was obvious they didn’t know what to do with this baby,” she said.
Dr. Morris said Thomas’ baby should have immediately been taken out of the amniotic sac, and should have been resuscitated and given oxygen without hesitation. It’s unclear from the medical documents and videos we have how long exactly her baby was deprived of oxygen.
Dr. Morris said brain damage “starts to occur after just four minutes.”
“When these babies are delivered en caul with that amniotic sac around them, they’re like in a dry cleaner bag. There’s no oxygen there.”
Dr. Morris said freestanding ERs often lack the equipment and trained staff to respond to obstetrical emergencies.
“These freestanding [clinics] really owe these obstetrical patients some warnings,” she said. “They should tell them upfront, there should be a sign at the desk that says, ‘If you’re an obstetrical patient, we’re not adequately equipped.’”
Thomas said Preston Hollow ER providers did eventually say they'd have to transfer her to a hospital. But only after she was already in her room, and moments before she began to deliver.
“When I was practicing, I would have ladies go to these standalones and it was very frightening,” Dr. Morris said.
“We were having to wait for an ambulance to come to pick them up and transport them over to the hospital where we were, you know, and when you're dealing with an obstetrical patient in crisis, every minute makes a difference on the outcome of the baby.”
The Texas Association of Freestanding Emergency Centers is a member-based group that promotes freestanding ERs and advocates for fair regulation of them. The executive director, Andrea Connell, told WFAA Preston Hollow is not a member, but issued this statement:
“Licensed by Texas HHS, FECs are staffed with experienced emergency medicine physicians and nurses and are equipped to handle all emergency situations, including obstetrical/gynecological. In emergent cases, the patient would be stabilized and, if necessary, transferred to a higher level of care. This would be the identical process for most rural emergency departments and many urban emergency departments who do not have an active labor and delivery service.
“FECs routinely provide appropriate, timely care for ob/gyn patients. They identify ectopic pregnancies, placenta previa, blighted ovum, and other potentially life-threatening conditions in a fraction of the time as over-crowded emergency departments. FEC's have long-standing relationships and hold well-established transfer agreements with local hospitals to ensure rapid transition to the most appropriate facility after stabilization. FECs have provided care for tens of thousands of ob/gyn emergencies since their inception.
“It is well-proven that emergencies benefit most from rapid assessment, treatment, and stabilization. For a physician to encourage potentially critically ill pregnant women to bypass the closest emergency department, such as an FEC, places her and her child at unnecessary risk in a very volatile time. We strongly disagree with this recommendation due to the risk it places on patients. As always, our industry welcomes the opportunity to engage with the ob/gyn community to discuss any and all areas to improve the quality-of-care offered to our patients.”
The Texas Health and Human Services Commission licenses and regulates freestanding emergency rooms. When asked if the department provides guidance on how they should handle obstetrical emergencies, a spokesperson only directed us to state law, which lays out a freestanding ER’s transfer policy requirements.
“The facility must provide medical treatment within its capacity that minimizes risk to the individual’s health and, in the case of a woman in labor, the health of the unborn child,” the state law says.
Heaven Grace
Thomas and her baby were eventually transported from Preston Hollow ER to Medical City Hospital, where doctors saved her baby's life. Her name is Heaven Grace.
“I thought I was saying goodbye to my first child,” Thomas told WFAA. “And now she’s alive.”
Thomas feels blessed to have her baby, but she is also afraid for her baby. While Heaven’s final prognosis is not yet clear, medical records say “a lack of oxygen” caused her coma, that she is in a “vegetative state,” and that she may never fully recover.
“We are just praying and praying and praying,” Thomas said.
Thomas said Preston Hollow’s director of operations called her in mid-July. Thomas said she was apologetic, and said they would investigate what happened to her. She also received a note in the mail, explaining how to pay her bill.
It also had a handwritten message: “We appreciate you trusting us with your care. We hope you are doing better!”
“I definitely do believe if they had started reviving her right away when they came in the room and saw, this could have been a lot different,” Thomas said.
“I feel like they failed me.”
Thomas and her husband are now trying to raise money to help with her recovery on GoFundMe. The link to that page can be found here.
Email: investigates@wfaa.com