Treating toddler shot on Lake Shore Drive: Doctors detail care & work needed to help 21-month-old survive

Medical Watch

CHICAGO — It’s a horrific injury. When Kayden Swann was shot on April 6, a 21-month-old caught in the crossfire, an entire medical team mounted a herculean effort to save his life. And at the center of his care was a physician inspired by a violent loss of his own.  It was an event that ultimately brought him to Kayden’s bedside. 

The story begins on Chicago’s Lake Shore Drive, where on a sunny spring afternoon road rage ended with shots fired and a bullet ripped through Kayden’s head.

Dr Marcelo Malakooti works in the pediatric intensive care unit at Lurie Children’s.

“It seems the bullet went through the right temple,” he said. “And so that goes throughout the entire cortex of the brain and out the other side.” 

It’s an area that controls movement and vision. 

“When he came in there was a lot of blood and he really wasn’t doing much,” Malakooti said. “And that was a bad sign for us.” 

Kayden was rushed to the hospital by a good Samaritan. He was ultimately brought to a trauma room at Lurie Children’s equipped to care for the most critical patients. 

“It’s very much controlled chaos,” Dr Yiannis Katsogridakis said.

WGN Medical Watch has captured the same scene in the past. Teams three-lines deep gather, some at the bedside, a secondary unit at the perimeter and another just outside the door watching from a birdseye-view monitor — all focused on the baby in the bed.

“There’s about 20 to 30 people mobilized,” Katsogridakis said.

When asked about the odds of saving a child with Kayden’s injuries, Malakooti said,  “When you are in the moment you don’t think odds. We don’t have the luxury of thinking of odds.”

Malakooti didn’t plan on working in a pediatric hospital. But ironically, it was another act of violence that changed the course of his career. In 2007, his cousin was killed during the Virginia Tech mass shooting. 

“I was on my way to take care of adults for the rest of my life and when this happened it was just a reminder how innocent children are,” he said.  “And none ask for this to happen. And how they are put in harm’s way. And so I committed to dedicating my life to try and reverse that as much as possible.” 

From Trauma A, Kayden was brought to the pediatric intensive care unit.

“What we found when we did the scans is that his entire brain was very swollen from the injury,” Malakooti said.

Neurosurgeons placed a shunt or drain to ease the mounting pressure in Kayden’s head. The toddler was placed in a medically-induced coma and a ventilator took over his breathing, all so his brain could rest. At the same time, his tiny heart was under enormous stress. 

“We had to put his heart into overdrive, into super drive, and give him extra fuel to pump what his brain needed,” Malakooti said. “Several sensors on his body to measure his heart rate and blood pressure and several large catheters.”

Day and night, hour by hour, Kayden was monitored.

“He required a nurse that would be with him and just him the entire time, as well as a team of doctors, nurses and respiratory therapists,” Malakooti said. “We don’t hold anything back.”

As a team of 50 worked on Kayden upstairs, downstairs, Malakooti provided frequent updates to the media on the toddler’s progress.

“He had a few close calls and he had a few scary setbacks where we thought maybe we won’t be able to reverse and protect the brain,” he said. “Here is this horrible story with this innocent kid. We really wanted him to beat the odds. …The first three days are really important and that is the time you go full force forward. … As we started to lighten some of his coma medications, we wanted to see what he could do on his own. Can he move his fingers? Can he move his toes? Is he starting to move his body? If they can breathe on their own. We’re also wondering will they be able to walk, feed themselves, interact with the outside world?”

He’s certainly beaten the odds. Just a few days after we got him out of his coma, he was a vigorous little guy and trying to pull out his things. That’s really good news for the family, really good news for us. It is a miracle.

Lives can be changed overnight when things like this happen. I think the word that comes to mind is reckless because there obviously is not foresight in these peoples’ minds that will use firearms in a dangerous way, and if they had the foresight and could be in the room with us and be at the child’s side for weeks on end, I wonder if it would impact them differently.

Dr Marcelo Malakooti

Remarkably, Kayden is expected to be released from the hospital in the coming weeks and will then go to a rehabilitation facility where therapists will help him regain as much function as possible. It’s not yet known what type of deficits he’ll face during a long road ahead, but Malakooti is hopeful he’ll have a meaningful recovery.

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