Health Center fails to diagnose serious illness

Javier Espinosa, a senior at SMU, recently came within two hours of dying. Doctors at Methodist Hospital in Dallas saved his life with an emergency liver transplant.

While Espinosa initially went to SMU's Memorial Health Center to be treated and diagnosed for his cold-like symptoms, he said the health center is not equipped with proper resources to diagnose and treat severe cases.

"The health center can't recognize and [doesn't] really know how to handle hard-core cases like mine," Espinosa said.

Espinosa said he expected the health center to offer advice and guidance when they were unable to diagnose his symptoms. However, staff at the health center said very little and did not suggest going to a hospital.

"I expected the health center to be more responsible," he said. "It was obvious my test results were off the chart and they weren't like 'Go and see a doctor in this hospital,' and they should have."

The health center had no comment regarding Espinosa's case and referred questions to SMU's Assistant Director of News & Communications, Robert Bobo.

Bobo said that Espinosa's case cannot be talked about unless he signs a contract releasing the school from HIPAA or FERPA. HIPAA is the Health Insurance Portability and Accountability Act and according to the online U.S. Department of Health and Human Services it's the "national standards to protect the privacy or personal health information." FERPA is the Family Educational Rights and Privacy Act.

However, Bobo did say that he believes the center and SMU do a great job staying involved with students who are sick.

"SMU tries to do everything possible to help its students when they're sick and in helping them to try and get better," he said. "I would say the health center does a fantastic job staying involved and seeing how students are and how their recovery is going."

While the health center may keep in contact and inquire on the status of ill SMU patients, Espinosa believes there was nothing "fantastic" in the way the health center handled his case.

Espinosa's symptoms started one Friday morning in February. The cinema-television and advertising major attended classes, but said he felt a cold coming on. Initially Espinosa shrugged off the symptoms, took some cold medicine and took it easy for the rest of the day.

"By Saturday I was still feeling pretty bad," he said. "Then I started vomiting up everything I ate."

That night Espinosa spoke with his mother, who lives in San Antonio. She said she was coming to Dallas on Monday to look after him. Meanwhile, Maribel Espinosa told her son to see a doctor at SMU's Memorial Health Center immediately.

"I went to the health center Monday morning with a sore throat, fever and vomiting." he said.

First Espinosa saw Dr. Peter Davis, who suggested taking X-rays and blood tests after noticing something might be in Espinosa's lungs. Test results did not reveal anything serious, but Davis told Espinosa it was possible he had pneumonia. Espinosa received medicine from the health center to treat pneumonia, but because he could not keep anything down, he vomited up the medication.

That night Mrs. Espinosa arrived in Dallas and decided something was wrong with her son's stomach. The next morning, on Espinosa's 22nd birthday, mother and son went to the health center again.

"The second doctor I saw was a lot more critical than the first doctor, which was good, and the first thing he said was that I needed to be hydrated," Espinosa said.

It was then, Espinosa said, that his second doctor, Dr. Cesar Torres, and his mother noticed he started turning yellow.

Espinosa took a few tests issued that day by the health center, but for HIPAA and FERPA reasons, the type of tests performed cannot be revealed. The two tests Espinosa did release, however, were the results of his mononucleosis test that showed he had tested positive and a test that indicated his bilirubin level was off the chart.

Blood test for total bilirubin, according to biochem.northwestern.edu, measure both unconjugated and conjugated bilirubin, and are performed to evaluate jaundice, anemia, various liver diseases (including hepatitis) and impaired bile excretion.

Espinosa said SMU does not have adequate machinery to determine exact levels of high bilirubin and as a result, Espinosa said the test results either had to be sent to a hospital or Espinosa could go directly to a hospital. At the time of his clinic visit, Espinosa decided to have his results sent to a hospital through SMU.

"I didn't want to go to the emergency room so I stayed with the health center and got the tests done there," Espinosa said.

Hooked up to an IV in the health center for the next few hours for dehydration, Espinosa said the nurses sang happy birthday and gave him Gatorade as a birthday present.

A few hours later Espinosa was feeling better. He no longer had a yellow tint to his complexion. He left the center and then tried eating, but again he found he was unable to keep food down. He decided to return to the health center the next day.

The next morning Espinosa and his mother went to the health center where Dr. Laura Zeballos, Espinosa's third doctor, informed him his bilirubin level was extremely high. Mrs. Espinosa then phoned a friend of hers, a doctor in San Antonio, informing him on her son's situation. Mrs. Espinosa's friend then suggested going to the hospital as the test results were so high.

For HIPAA and FERPA reasons, Dr. Zeballos' recommendation for Espinosa is not known.

"My mom's friend was like, 'these are dangerous numbers.' I think regular bilirubin levels are around two or three and my numbers were around 35 so obviously something was wrong," Espinosa said.

By the next afternoon Espinosa had checked into Methodist Hospital.

"When I walked in I thought I was going to have to get another IV but one of the first things the doctor said to me was that I had to think about a transplant or serious surgery," he said.