At the Right Place at the Right Time

How the Hartford Hospital trauma team saved three lives

Jill Weitknecht is lucky to be alive. A mother of three girls, she knows that every day is a gift – and she is thankful to the teams at Hartford Hospital that came together and saved her life on a fateful day in May 2013.

She had just put her two young girls to sleep for the night when she got a call from a local emergency department. Her husband, Jesse Weitknecht, had been in a terrible car accident. He was seriously injured and his brother had been killed. Jesse was taken to Hartford Hospital, and Jill – seven months pregnant with their third child – went with him. It was a decision that would later save Jill and her daughter. Concerned about her husband, Jill had no way of knowing that she herself was about to face a rare medical crisis – one that few people survive.

In the emergency department of Hartford Hospital, Jill didn’t leave her husband’s side. Friends came to comfort the couple, and as Jill went to thank them, she collapsed.

“I had an excruciating pain in my left abdomen,” she remem- bers, and then, almost everything went black. Overcome by nausea, chills and light-headedness, she curled into a fetal position on the floor.

Jillian and husband Jesse Weitknecht with their daughters.

Jillian and husband Jesse Weitknecht with their daughters.

Jill’s blood pressure was plummeting. The baby’s heart rate was dropping. Preliminary ultrasounds showed there was internal bleeding, but where was it coming from? Doctors suspected a complication from the pregnancy – possibly a ruptured uterus. Jill was rushed to the Caesarian section operating room on the labor and delivery unit.

In just minutes, teams of specialists converged on the room. Dr. Rosemary Quinlan, the in-house attending obste- trician that night, arrived and called in fellow obstetrician Dr. Frederick Rau. “Her blood pressure was low. She was losing a lot of blood and that meant the baby’s blood pressure was low. We had to deliver the baby,” says Rau.

“When we opened the abdomen, it was full of blood,” Quinlan says. “It was very abnormal. We knew something was very, very wrong.” Quinlan quickly delivered Jill’s baby girl and passed her to the waiting Connecticut Children’s Medical Center team. The tiny, premature infant wasn’t breathing. Her color was poor, her pulse weak. The team began chest pumps and a blood transfusion.

“There were angels with us that day,” Jill says now. “The doctors were able to save her.” Suddenly, there were two patients upstairs. And a third – Jesse, in the emergency department. As the neonatal intensive care unit (NICU) team was saving the baby’s life, the other teams fought to save Jill’s.

“Hartford Hospital has layers of specialists who are available to manage very difficult circumstances,” says Rau. “And they came through that day.” Others who sped to Jill’s side included the anesthesiology team, surgery residents, on-call general surgeon Dr. Chike Chukwumah, vascular surgeons Drs. James Gallagher and James Gallagher III, and NICU specialists.

Jill’s vital signs, and her baby’s, worsened. She was losing blood as quickly as the teams were replacing it. And the mystery remained – where was the blood coming from?

“It appeared to be the kind of injury you see when you have a true trauma, a high-velocity penetrating injury. Almost like a gunshot wound,” remembers Dr. Chike Chukwumah.

“This is what a Level 1 Trauma Center is all about. When someone is decompensating rapidly, they won’t survive unless you have multiple teams working in a synchronized fashion. There are not a lot of Level 1-designated trauma centers and that’s why.”

Doctors worked quickly and systematically searched Jill’s body, examining every organ until they found the source of the bleeding – her spleen. The diagnosis would save her life. Jill’s splenic artery had an aneurysm, a malforma- tion that ruptured. The rupture caused a massive internal hemorrhage. The surgical team worked with intensity and precision, removing the spleen and repairing the damaged blood vessels. After the bleeding subsided, Jill was transferred to the care of specialists in Hartford Hospital’s intensive care unit. She would spend 10 days in the hospital. But she – and her daughter, Jessie Ann, would survive.

A ruptured splenic artery aneurysm in pregnancy is a “very high-mortality, high-morbidity illness,” says Chukwumah. “It is typically fatal.” The national statistics are frightening. Most infants, 97 percent, do not survive a mother’s splenic aneurysm rupture. And fewer than 30 percent of mothers survive. Chukwumah says Jesse’s car accident could be considered a “blessing in disguise,” because it meant that Jill’s rupture occurred at Hartford Hospital, the region’s only adult Level I Trauma Center.

Doctors say a story like this illustrates the strengths of Hartford Hospital. “It was the middle of the night. To have the resources available at that time of night requires a large, tertiary care teaching hospital, and Hartford Hospital was really the perfect place for those teams to come together,” Rau said. “Jill was lucky to be at a hospital like Hartford that could provide those services on an immediate basis.”

Despite the devastating loss of his brother, Jesse feels blessed. His injuries have healed. Jill is a healthy, active mother of three little girls. Jessie Ann is walking, talking and thriving. Still, Jill says life has changed. She is more thankful, more appreciative of the little moments, moments she might have missed were it not for Hartford Hospital.

“I’m told I’m a miracle,” Jill says. “I think my doctors are miracles and her doctors are miracles. Because, without them, I wouldn’t be sitting here, and she wouldn’t be sitting here … By the hand of God, I was in the right place at the right time.”