After a fun day out seeing the lions and tigers at a safari park, Ricky Lee got home and decided to play outside in the quiet cul-de-sac in Halesowen, in the West Midlands, where he lived. As he played out on the pavement outside his house, little did he know that danger was afoot.
A van, whose driver hadn’t spotted Ricky Lee playing, reversed from a nearby drive mounting the pavement running him straight over and then driving over his small body.
Hearing a commotion outside, mum Caroline and stepdad Niki rushed outside to see their son lying flat on his back on the pavement, his face purple and in pain and distress. 20 minutes later, Ricky Lee arrived by Midlands Air Ambulance at Birmingham Children’s Hospital – a paediatric major trauma centre in the West Midlands.
Upon arrival at the Emergency Department, a CT scan confirmed a laceration to Ricky Lee’s liver and he was transferred to the Paediatric Intensive Care Unit (PICU). During an operation to repair his liver, his blood pressure dropped dangerously low and suspecting a small hole in his heart, the anaesthetist called in Cardiologist Dr Oliver Stumper.
Carrying out an echo-cardiogram - an ultrasound of the heart - Dr Stumper confirmed that the severe compression caused by the weight of the van had caused some tears in an internal wall of the heart so that the two separate chambers were connected through a new hole, measuring 10mm. An extremely rare injury in children, there have only been 68 reported cases of this in the UK between 1965 and 2011 and only three patients at Birmingham Children’s Hospital over the last 10 years.
Known as a post-traumatic Ventricular Septal Defect, the septal is the wall of tissue that divides the left and right ventricles of the heart. The largest of these tears measured 10mm and meant that the blood in the left hand side of his heart, that was supposed to be taking the oxygenated blood around the body, was instead flooding into the right side of his heart. The build up of pressure was also close to bursting the outer wall of the heart, which would have caused a huge internal bleed, killing Ricky Lee within seconds.
With 12 specialists in theatre using their expertise to decide what to do, keyhole surgery was then carried out to plug the large hole.
“I’d just finished with another patient when I was called into theatre to see Ricky Lee. His blood pressure was so low and his heart was beating so fast, I thought we were very close to losing him,” said Dr Stumper.
“I was sure the hole that the anaesthetist detected wasn’t something that Ricky Lee had been born with. He had the typical symptoms of a larger hole in his heart so I knew that he had a post-traumatic Ventricular Septal Defect. At one point there were 12 specialists in theatre making decisions as to what we needed to do, to save his life,” he added.
Using a catheter via the groin, a flexible circular shaped device made from nickel and titanium was placed carefully to plug the hole and return the blood flow back to normal. The procedure which took three hours saved Ricky Lee’s life.
That was the longest day of Caroline and Niki’s lives and they knew that after waiting hours and a visit from Dr Stumper to explain the situation, that their only son’s life had been in the balance.
Despite the success of the heart operation, specialists discovered that the accident had caused yet more damage and as the days progressed Ricky Lee began to suffer with lung blockages and kidney failure. He went into cardiac arrest three times, with doctors and nurses reviving him each time. Caroline and Niki spent every day and every night by his bedside, reading him his favourite Roald Dahl stories Matilda and Fantastic Mr Fox.
Three weeks after arriving at Birmingham Children’s Hospital and surviving three arrests, a liver operation, collapsed lungs, failing kidneys and a procedure to repair his torn heart, Ricky Lee woke up in the Paediatric Intensive Care Unit.
Speaking about that moment, mum Caroline, said: “When he woke up, Ricky Lee was just so sad and we were so worried that our lively, happy, clever little boy would never get back to the way he was.”
A few days later Ricky Lee was learning to breathe for himself again and was able to come off the ventilator. He was soon stable enough to be transferred to one of the hospital’s medical wards and was getting back on his feet, with the help of the physiotherapists.
“He was just so brave and quickly regained his confidence, he wasn’t daunted by anything,” dad Niki said.
Four months after the accident, Ricky Lee has started back at Huntingtree School in Halesowen but because he has one very small hole remaining in his heart, he can only manage two hours each day before he gets too tired. His family hopes that after his final heart operation in January, he will be back at school full time and life will be completely back to normal.
Mum Caroline said: “Ricky Lee is doing so well but because of the remaining hole in his heart, he is frightened of getting knocked so isn’t able to do very much physical activity. His last operation in January will make a huge difference.
“As parents we feel that Ricky Lee is probably the luckiest unlucky boy, and we are thankful every day that he is still with us. We can’t thank the team of nurses, doctors, surgeons, physiotherapists and ward staff enough from the cardiac, liver, emergency, intensive care, and physiotherapy departments at Birmingham Children’s Hospital, who helped to look after Ricky Lee. Between them they worked hard to fix all of his organs - including his broken heart - to get him back to the lively, happy little boy he has always been. Christmas is going to be extra special this year thanks to them.”
Consultant Paediatric Intensivist and Major Trauma Clinical Lead at Birmingham Children’s Hospital, Fiona Reynolds, said: “Young patients who have sustained such rare injuries as Ricky Lee, need extremely specialist care and his case highlights the successful multi-disciplinary approach that Major Trauma Centres provide. This ensures that our patients receive the best treatment in the most appropriate settings and by the most highly-skilled individuals.
“There were a number of teams involved including cardiology, liver, PICU, the emergency department and physiotherapy that were instrumental in saving his life and helping him to get better and we are so happy that Ricky Lee is on the road to recovery and looking forward to Christmas with his family.”
Ricky Lee who loves computer games and is a fan of West Bromwich Albion Football Club has asked for Xbox Games and an iPad for what will be a very special Christmas.