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Location: Cincinnati, Ohio
Date: August 13, 1992


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On August 13, 1992, Patty Richter of Cincinnati, Ohio, discovered how easily a life-threatening puncture wound to the chest can occur when a young child is left unsupervised within reach of a pair of scissors. "I was giving my 1-year-old, Ryan, a bath in the kitchen sink and talking on the telephone," Patty said, remembering.

Meanwhile, her eldest son, Mark Jr., and his girlfriend, Shanna Rathbone, were in the family room watching television. Four-year-old Alex, Patty's middle son, who had become very close to Shanna, came and asked Shanna to help him wash his hands in the bathroom by turning the taps, which were too tight for him to open. "I feel like a member of the family," Shanna said, "and I always have, from the first day I came over. That's just how the Richters are." Shanna walked Alex back to the bathroom, turned on the water for him, and left him to finish the job of washing on his own.

Lying on a shelf, under the small towel that Alex took to dry his hands, were the scissors his mother used to give family members haircuts. Minutes later, he walked into the kitchen, holding the scissors up in front of him, and told his mother, "Mommy, I hurt myself with the scissors." "I looked at his chest, and there was just a small drop of blood, so I took the washcloth and dabbed it," Patty said. "Then I screamed." Her scream brought Shanna and Mark Jr. running into the kitchen. "I looked at Alex and I saw this hole in his chest--you could see straight down into his chest. It was just like a great tunnel, going straight down," Shanna said. Patty handed the stricken child to Shanna and called 911.

Union Township dispatcher Patty Bates was on duty by herself that afternoon. "I heard a very hysterical woman saying that her son had been stabbed and that he had pulled the scissors out himself," Bates said. "I started to worry because I'd always been told that if you're stabbed with something, it's better to leave it in." Rescue units with the Union Township Fire Department were immediately dispatched to the scene.

"I need them to hurry--please tell them to hurry," the distraught mother told Bates, who gave her instructions for immediate first aid. "She told me to apply pressure to the wound," Patty said, "and I hung the phone up. He was just like a limp washrag in your hand, so I was getting more hysterical as the time went on. And then luckily, for some God-given reason, my husband came home."

"I pulled in the driveway, and Mark came up to me and told me Alex had gotten hurt," said Mark, the boys' father. "I thought, 'We'll take him to the doctor, get stitches, and that will be the end of that.' " Then he went inside and discovered, to his horror, just what the situation was. "What happened?" he asked Patty. "He fell on my hair-cutting scissors," she said, in tears. "When I pulled the rag away from Alex's chest, you could actually look inside his chest," Mark said. "He was gray. His lips were blue. The last thing he said to me was 'I'm sleepy.' And that was it."

Among those responding to the emergency call was paramedic Jeff Jackson. "About halfway there," said Jackson, "our dispatcher called us back and advised us that the child was turning blue, which immediately heightened our response. This child has been stabbed, he could be in cardiac arrest, and we're thinking the worst."

"He was getting real listless. I don't know what to do. You're holding your son and he's dying," Mark said. "There's nothing you're going to be able to do for him," Meanwhile, Patty kept talking to Alex and calling his name, hoping by some miracle that her son would start to respond. Then the anxious family heard the sound of the sirens on the rescue vehicles.

"When the father first came out of the house, I immediately recognized who he was," Jackson said. "Mark had been in the fire department with me a few years ago, and, ironically, he had left the fire department because he could not deal with injured and sick children. As soon as I looked at the child, I knew he was in a life-threatening situation. He was blue around the lips, blue around the fingertips, which immediately told me that his body was shutting down."

Paramedic Pam Kratzer asked to see the scissors. "The blood on the scissors was 2 inches up on the blades, so we knew that it had punctured at least 2 inches into his body," Kratzer said. "That means they could have not only punctured his lungs and heart, but also gone into his spine." Jackson realized that Alex needed to have surgery immediately, and asked another EMS technician to check on the availabiliy of an AirCare helicopter to transport the child. "I thought this was this child's only hope," he said.

"Okay, Dad," Kratzer told Mark, gently but insistently, "I need you to hand Alex to me." "The father did not want to release the child from his arms, and I thought, 'How can I ask this father to lay this child down, knowing that this may be the last time he can hold him?' " she said. "We need you folks to get right down there to meet us when we get there," Jackson told Alex's parents. "He's going to be fine." "They kept telling us, 'We need you to leave,' " Patty said. "And I came out of the house thinking that he was dying and they wanted us out of the way. They didn't want us to be there when he died."

Alex was taken to the nearest open field, where he was met by a University of Cincinnati Hospital AirCare helicopter. The medical team on board included flight nurse Carol Patterson-Downing. "At the time the child was in extreme shock," Patterson-Downing said. "He wasn't breathing well, and his blood pressure was very, very low. The best thing to do was to get him to the operating room at Children's Hospital."

Mark and Patty arrived at the hospital just in time to see Alex briefly before he was wheeled into the operating room. "It was only for few minutes that we got to take a look at him," Mark said. "You want to touch him, you want to talk to him, but you know you can't. I thought that probably would be the last time that I would get to see him."

Alex had been prepared for surgery as soon as he reached the hospital. The operation was performed by surgeon Victor Garcia. "Literally every second mattered," said Dr. Garcia, "because if you have uncontrolled bleeding in the chest, there is an ever-increasing likelihood that the bleeding will result in irreversible consequences that would ultimately kill the child. Once we opened the chest, we found that there was blood inside the sack around the heart. It takes only a small amount of blood in the pericardium to interfere with the ability of the heart to pump."

Dr. Garcia operated for 6 hours, repairing the ruptured pericardium. Finally, a nurse came out to the waiting room to tell the Richters that they could see their son. "They had to cut him from the top of his chest all the way down to his groin area," Patty said. "He had 45 staples down his little, tiny body. He looked pathetic. I wanted to pick him up and kiss his whole face."

"It was as if everybody felt a sigh of relief," said Shanna, who had come to the hospital with the Richters. "Even if he couldn't talk back to us, he was there, and in a couple of weeks, he was going to be fine." Eight days later, Alex was released from the hospital.

A year after Alex's accident, he was completely recovered and delighted his family with his energy and enthusiasm for life, but there were lessons they all had learned. "Now I know why when we were kids we were always tolf by grownups, 'Don't run with scissors,' " Patty said. "If I had any advice to give to people, it would be to make sure that scissors are always put away where children can't get to them." "Scissors and Dad's tools are objects that we use on an everyday basis and don't think about. We need to think of those as lethal weapons," said Jeff Jackson.

"I'm very proud of my son for coming and telling my wife that he had fallen on the scissors," said Mark. "If he hadn't come to tell her, he could have run out in the yard and died. I thought about being an EMT, but that takes a different breed of people. They saved my son's life. I think those people are great."

"You train all your life to help people," Pam Kratzer said, "and this was one instance where you really did help a child." "Everything came together," said Jeff Jackson. "It was not a one-person or a one-crew effort. All the years, and all the people we've worked on who have not survived--the bad times, the good times--this makes it all worthwhile."

"When I see him out playing, it's amazing," said Patty. "He's got a scar, but that's okay--that's a battle scar to him. He shows it to everybody." "This is where the doctor cut me," says Alex, raising his shirt. "I won't play with scissors again, because they could hurt you." "I almost lost him," said Patty. "And that's probably why he's pretty spoiled right now. I can't imagine my life without Alex--I just can't imagine it."