News Details

Hospital Corporation of America's Screening of Newborns Preventing Brain Damage Caused by Severe Jaundice

June 28, 2005

Data released today by Hospital Corporation of America (NYSE: HCA) shows that a simple, $1 test is preventing irreparable brain damage in newborns.

The test detects severe jaundice, which is easy and inexpensive to treat, but if left undetected can lead to kernicterus, a condition that leaves babies brain damaged and often physically impaired. Experts estimate that as many as 60 percent of all newborns are affected by some level of jaundice.

HCA, which has 190 hospitals, performs the test on babies born in its 124 obstetrics units before they are discharged. More than 225,000 babies are born each year in HCA's hospitals.

"The medical community continues to underestimate the severity and incidence of kernicterus," said Dr. Vinod Bhutani, a clinical professor of neonatology at the Stanford University School of Medicine who has conducted extensive research on the prevention of kernicterus. "We have seen an increase in this disorder since hospital stays for mothers and babies shortened in the early 1990's. Visually assessing newborns is not enough. All babies should be screened for severe jaundice before they go home, in order to prevent kernicterus."

A study conducted by Dr. Bhutani using data from HCA hospitals from May 1 through December 31, 2004 -- before HCA began screening babies -- documented a monthly average of 1.2 cases of babies with jaundice severe enough to put them at hazardous risk for kernicterus. There were 151,996 babies born during this period. From February 1 of this year, when HCA began screening babies born in its hospitals, through May 31, there have been no new cases. During that time, 72,870 babies were born in HCA hospitals.

"The results of the 2004 study clearly show a much higher incidence rate than the medical community previously thought," Bhutani said. "HCA's efforts this year demonstrate that screening newborns is preventing kernicterus."

"As a mother of a child with this horrifying disorder, I know firsthand the devastating effects it can cause," said Sue Sheridan, spokesperson for the advocacy, educational and support group P.I.C.K., Parents of Infants and Children with Kernicterus and co-founder of Consumers Advancing Patient Safety. "Had my son Cal been given this simple, inexpensive test shortly after he was born, today he would be a healthy boy. Every baby must be screened. I strongly encourage all hospitals to follow HCA's example."

In the last few years, the Centers for Disease Control and the Joint Commission on the Accreditation of Healthcare Organizations have issued alerts to all accredited hospitals and public health professionals in the United States saying that all healthy infants are at potential risk of kernicterus if their newborn jaundice is not monitored and not adequately treated. P.I.C.K. has urged all hospitals to screen every newborn for severe jaundice in order to prevent kernicterus. Still, the majority of U.S. hospitals do not screen all newborns for this.

"It is our view at HCA that one case of kernicterus is one case too many," said Dr. Frank Houser, senior vice president of quality and medical director for HCA. "When we began to look at this problem, it was clear that screening babies born in our hospitals to prevent kernicterus was absolutely the right thing to do. More important, this data shows that screening newborns works."

What is Kernicterus?

Kernicterus is a type of brain damage that causes cerebral palsy and hearing loss. It also causes problems with vision and teeth and sometimes can cause mental retardation. Babies' livers can have problems processing bilirubin, a waste product of old red blood cells that the body no longer needs. When too much bilirubin builds up in a new baby's body, it causes jaundice -- a condition that frequently, but not always, causes a yellowing of the skin and eyes. Jaundice is very common in newborn babies and usually goes away by itself. A little jaundice is not a problem, but a few babies have too much jaundice. If not treated, usually with phototherapy or, if severe enough, with a blood exchange transfusion, high levels of bilirubin can damage the brain. Jaundice is not always visually detectable, however a simple, inexpensive test can identify infants at risk.

Sue and Cal Sheridan's Story

Sue Sheridan's son Cal was born a healthy baby on March 23, 1995. He was first noted to be jaundiced through visual assessment at 16.5 hours old, but a bilirubin test was not done. Caregivers assured Sue and her husband that Cal's jaundice was normal, and they shouldn't worry. On day four, Cal had trouble breastfeeding and became lethargic. Sue called the newborn nursery, and they assured her there was no reason for concern. Sue immediately took Cal to the pediatrician, who also visually assessed the jaundice. A bilirubin test was not done until day five, when Cal was admitted to the pediatric unit. Cal was treated unsuccessfully with phototherapy. On day six, Cal began displaying what Sue later learned were acute symptoms of kernicterus: a high pitched cry, respiratory distress, increased tone and arching of his neck. Sue did not know at the time that her newborn son was suffering brain damage before her eyes and in her arms. Cal's brain damage was preventable, and today Sue advocates for all hospitals to screen every newborn for severe jaundice to prevent kernicterus.

About HCA

Hospital Corporation of America is the nation's leading provider of healthcare services, composed of locally managed facilities that include approximately 190 hospitals and 90 outpatient surgery centers in 23 states, England and Switzerland. More than 225,000 babies are delivered each year at HCA's 124 obstetrics units. At its founding in 1968, Nashville-based HCA was one of the nation's first hospital companies.

All references to "Company" and "HCA" as used throughout this document refer to HCA Inc. and its affiliates.

"Safe Harbor" Statement under the Private Securities Litigation Reform Act of 1995: Statements in this press release regarding HCA's business which are not historical facts are "forward-looking statements" that involve risks and uncertainties. For a discussion of such risks and uncertainties, which could cause actual results to differ from those contained in the forward-looking statements, see "Risk Factors" in the Company's Annual Report or Form 10-K for the most recently ended fiscal year.

Investors, Mark Kimbrough, +1-615-344-2688, or
Media, Jeff Prescott, +1-615-344-5708,
both of HCA