Bothell family says racism at Seattle Children’s led to teen’s death

In February 2021, Sahana Ramesh, the daughter of Indian immigrants, died after months of suffering from a rare disease.

Bothell

By Alexandra Yoon-Hendricks / The Seattle Times

BOTHELL — A Bothell family is suing Seattle Children’s hospital, alleging the death of 16-year-old Sahana Ramesh was caused by racial discrimination in her health care and negligence.

In February 2021, Ramesh, the daughter of Indian immigrants, died from myocarditis — inflammation of the heart muscle that can lead to heart failure — after months of suffering from a rare disease known as Drug Reaction with Eosinophilia and Systemic Symptoms, or DRESS.

At the center of the case: Ramesh was never tested for myocarditis and never admitted to the hospital when suffering from DRESS — treatment her family says she would have received had she not been of South Asian descent.

Judge Elizabeth Berns on Thursday denied the hospital’s request to dismiss the racial discrimination claim, writing in her order that the family has “plausibly alleged harm, including dignitary harm, resulting from unlawful discrimination — not from health care.”

In a statement, a hospital spokesperson said they could not comment on Ramesh’s case.

“Our hearts go out to any family mourning the loss of a child and we take our responsibility to provide equitable, high-quality care seriously, but cannot comment on this specific case due to pending litigation,” the statement read.

In August 2020, after experiencing recurring seizures, Ramesh was prescribed lamotrigine by a Seattle Children’s hospital neurologist to treat her seizures and underlying anxiety.

By mid-November 2020, Ramesh had broken out into a painful and intense rash all over her body, with her hands, feet and face swelling. Seattle Children’s physicians diagnosed her with DRESS — a severe allergic reaction to medication that has various reported mortality rates, ranging from 3.8% to 10-20%.

After the diagnosis, doctors discharged Ramesh. Her symptoms worsened.

Over the next three months, Ramesh’s parents brought her to the emergency room repeatedly as she experienced frequent chills, a fever, extreme pain, a swelling face and an elevated heart rate. But doctors declined to admit her.

“They’re watching her symptoms worsen and they keep being sent home,” said Steve Berman, an attorney representing the family.

Blood work and lab testing “showed increasing problems with her liver and other facets of her organ functioning,” according to the complaint, but Seattle Children’s hospital physicians told Ramesh’s parents she could be safely treated at home.

Doctors did not tell Ramesh’s parents of the potentially life-threatening complications related to DRESS, the suit alleged, and cardiac-specific testing was not performed.

The family contacted the hospital via email or phone over 50 times to ask for help, Berman said, with “very little response.”

“Oftentimes they were ignored. Calls would be made and no one would respond,” Berman said. “There was once a ten-day lag, and they got an apology for being so late.”

On February 12, 2021, Ramesh collapsed and died at home in front of her family.

“They were treated differently than white people would’ve been,” Berman said. “People know when they’re discriminated against, and looking back, the Ramesh [family] know they were discriminated against.”

Ramesh’s family first filed their lawsuit against the hospital alleging negligence in October 2022.

They amended their complaint last year after their lawyers found a pattern of racial discrimination allegations at the hospital, Berman said.

In November 2020, the same month Ramesh was diagnosed with DRESS by Seattle Children’s physicians, the former medical director of the Odessa Brown Children’s Clinic at Seattle Children’s Hospital resigned.

At the time, Dr. Benjamin Danielson pointed to institutional racism and other issues that he said jeopardized the safety of patients and staff as the cause for his departure. He sued the hospital for racial discrimination and retaliation.

In 2021, in the wake of Danielson’s resignation, Seattle Children’s announced it would take steps to dismantle systemic racism within its institution to improve health equity among patients and promote diversity and inclusion among staff.

One of the physicians who treated Ramesh, Dr. Emily Hartford, published a paper in June 2022 on racial disparities in migraine treatment for children at the hospital between 2016 and 2020.

Reviewing medical records of more than 800 children, she found Asian, Black and Hispanic children, and children who received care in a language other than English, were significantly less likely than white children to receive intravenous medication for pain relief, despite reporting similar pain levels.

The court had previously granted a protective order allowing Seattle Children’s not to disclose records detailing the racial demographics of other children treated for DRESS and whether they were admitted to the hospital. Attorneys for the hospital had argued producing the records while complying with laws on health care information disclosure would be too burdensome.

With the new Thursday order allowing the discrimination claim to move forward, Berman said his legal team will again request the release of those records.

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