Boy Dies During Nap, Possibly From Secondary Drowning
June 5, 2008 by Kristina Chew, PhD
Filed under Health
10-year-old Johnny Jackson died last week while taking a nap in his house from “asphyxiation due to drowning”—-according to today’s ABC News, Johnny may have died from secondary drowning. Johnny, who had attention deficit disorder and autism, had been playing in the neighborhood pool for about 45 minutes. He was wearing flotation devices on his arms and was being monitored by his mother, Cassandra Jackson, and other adults. She noted that he was “taking a little bit of water in and coughing and then calming down” but that everything seemed fine. But then:
But less than two hours after getting out of the pool, Johnny had defecated in his pants twice and was complaining of being tired.
After being bathed and dressing himself, Johnny walked to his bed unaided, leading his mother to believe that he was simply tired from playing in the water.
But shortly after leaving him to nap, Jackson discovered her son unconscious and his face covered in a foam-like substance.
“My friend went back into the room where Johnny was sleeping and noticed what appeared to be cotton balls stuffed in his nose,” Jackson said of what turned out to be the foam from his nose and mouth. “She asked if I put them there and I said no — I went in and saw him and screamed for help.
“I rolled him over and his body was very limp and I realized he’d soiled himself again and was very purplish-blue looking,” said Jackson, who then called 9-1-1. “His tongue was really swollen, too.”
Johnny suffered from cardiac arrest on the way to the hospital, his mother said, and was pronounced dead upon arrival.
Berkeley County Coroner Glenn Rhoad examined Johnny’s body after the incident and told ABCNEWS.com that the preliminary autopsy showed the cause of death was asphyxiation due to drowning. Rhoad added that the boy had a lot of water in his lungs.
The ABC News story notes that, in secondary drowning, a secondary injury is caused to the lung when only a small amount of water—-only four ounces or about six teaspoons—-gets into the lungs.
My son’s a good swimmer but I never sit around and read magazines when we’re at the pool; while I don’t always get in the water anymore, I’m always watching him and following him around. Many years ago, an autism consultant told us about a family whose son was also a great swimmer. They had a pool in their backyard and one day—with both parents eating breakfast beside the pool—-their son drowned. The consultant emphasized that “this kid was a fabulous swimmer,” and that you never can be too careful in the water. Never.
I think I’ll be contacting my YMCA to ask about instructing their lifeguards in assisting autistic and special needs kids in the pool. Spending time in the water is so important for my son and we’ve got too take every precaution.
What a tragedy. Another thing, in addition to the water-safety aspect (and I applaud you for taking this information to the YMCA) is that some autistic children have hypotonia (low tone) and/or poor oral muscle function. My daughter has both–she has a history of “silent aspiration” which means fluids were entering her lungs without any choking (or any other obvious signs of distress). She still chokes and has swallowing issues. So, it is very feasible for an autistic child to be in the water and seem okay, or recover from choking, and then later suffer the effects like this child did. How very sad. Thanks for writing on this.
Oh this is so sad and heartbreaking. We never did get around to the swim lessons for Nick before summer camp, but still have two weeks before Matt gets out of school so maybe I will read this to Nick to see what he thinks. Matt and Nick used to be in the pool at the Hospital when they were 3-5 years of age with the OT and SLP. They both liked it at that time.
With this last rent increase and wanting to move I keep passing over places with a pool as an option and will not consider a place that has one. Not worth it. Good luck with the Y. There are some helpful comments at the article posting too.
I can imagine the child may have also had a difficult time verbalizing any unusual discomfort or symptoms. Especially if his symptoms were vague, which could have saved his life if he could have explained he was feeling that poor.
Such a tragic story.
That’s worrying, I am that stage in my swimming now where I do find myself taking in water if my head goes down at the same time as I am breathing in, maybe that is why I felt a bit groggy after my last session on Tuesday.
Charlie loves to sink down under the water and float slowly back up—thanks for what everyone has noted. The point in the article about a child getting out of the water and being sleepy is staying in my head—-if this had happened with Charlie, I would be inclined to think it is due to being tired after swimming. (He is usually rather energetic after swimming—wakes him up.)
larry, careful in the water…..
I thought I’d heard of everything dangerous about pools (I have a pool) but never heard of “secondary drowning”. Thanks for posting this story. I have a 2 yr old that is fearless and just jumps in by himself before going into a dog paddle. (not swimming yet however) He always drinks a lot of water. Since we don’t use chlorine or chemicals in our pool (use ozone to keep it clean), I thought that was okay. Now I’m starting to think we’re lucky this hasn’t happened to him. I’ll now have to research the best way to deal with water in the lungs.
Small factual error in the ABC article. 4 oz. is half a cup or 24 tsps., not 3 tsps. Regardless, for the margin of safety, I’d err on the side of 3 tsps., because the significance is the physiologic response to inhaling the liquid, rather than the volume of the water. People have died of secondary drowning from aspirating vomit. From what I understand, the advice to get professional medical assistance immediately is the best; it’s not trivial to get the water out of the lungs or to intervene against pulmonary edema, etc.
I am sure that there are many people worried about this and what to do. ABC really needs to do a follow up as a public service.
S.L. brought up a good point about hypotonia.
Poor boy. I am so sorry.
My apologies–6 tsps. (still not 4 oz.). That’s about 2 tablespoons for reference.
this is terrifying and desperately sad.
fluffy loves the water and is an excellent swimmer but i’m like you, kristina, never far, always watchful, right there in the water with him. the days of reading a magazine while my son swims on his own are far far off.
Well I think that this is probably a case where a sence of proportion is needed, whilst drowning is common, I am willing to speculate this particular turn of events with apparantly asymptomatic pulmonary oedema is rare.
I think the reaction is not an automatic and inevitable consequence of inhaling foreign substances as many of us would not be here now if it were, having swallowed things “the wrong way”
I am guessing that this only occurs if the unfortunate victim has been unable to expel the liquid through the usual reflexes and that like many other extreme medical reactions is chance, if you are unlucky and susceptible.
Also in most cases there would be signs of respiratory distress apparant.
My mums death certificate gave cause of death as the result of COPD, she died from pneumonia on top of her Asthma. Effectively what happens there is that you drown in your own effusions, but to watch someone undergoing that, you can see that something is very wrong.
It all makes me consider just how reckless that teacher was so many years ago who forced my head under the water, when I refused to hold it under the water when learning to swim, never mind the consequences it had of giving me a lifelong fear of the water that I only overcame enough to learn to swim this year.
“Also in most cases there would be signs of respiratory distress apparant.”
L-Rex,
You’re right about this being a relatively rare event, but I think the point of the story is that there was some missed signs or that the signs displayed atypically. So we shouldn’t necessarily panic, but it does throw up a red flag to be alert, esp. if someone does not have the skills to alert someone explicitly that s/he doesn’t feel right–that’s it more than a little something down the wrong pipe.
Well yes there are always atypical expressions of serious traumata. Heart attack is another as it does not always appear classically in elderly people for instance.
In fact I was only in the emergency the other week with the suspicion of an atypical heart attack presentation which they initially took quite seriously (enough to scare the pants of me) but when the Dr asked about other medical problems and I mentioned trapped nerves he said “out of here”
That is the problem you never know, and if you err on the side of caution you get a reputation as a hypochondriac
What a devastating story. I am so sorry for this family. A child drowned at our local YMCA a few months ago. It does not take much water. You can not be too careful.
thank you for posting this, I will need to be more careful with my nonverbal, fishy, water swallowing son, even if this is a very rare occurence.
A Florida man has been charged with contributing to the drowning of Johnny Jackson, according to today’s Myrtle Beach Online: