Surgery to Reattach Child’s Severed Arm Fails

Doctors at a Northridge hospital worked more than eight hours Friday to reattach the severed right arm of a 2-year-old girl who was struck by a train near San Luis Obispo, but the surgery was unsuccessful, hospital officials said.

The girl, Madalain Hernandez of Paso Robles, remained at Northridge Hospital Medical Center on Friday, where she was listed in stable condition. The toddler, who also suffered a broken right leg and forehead cuts in the accident, is expected to remain hospitalized for about a week, doctors said.

Madalain’s 2-year-old playmate, Jose L. Contreras, died at the scene. Her 3-year-old brother, who was playing with them at the time, was not injured.

The children were without any adult supervision at the time, police said. Butch Cantalupo, community service officer for the Paso Robles Police Department, said police are investigating to determine whether child neglect charges should be filed against the girl’s mother or aunt, who was supposed to be watching the children.

Police would not release the names of the mother or aunt.

Dr. George W. Balfour, a specialist in microsurgery who is director of the Northridge hospital’s replantation department, said the surgery failed both because of the way the girl’s arm was severed and the time it took to bring her to the hospital.

Most severed limbs that are successfully reattached were cut cleanly, not pulled or ripped as was the child’s arm, Balfour explained.

Also, Balfour said, muscles die in about six hours, and at least that much time passed before surgery could begin.

The toddler underwent more than six hours of surgery--ending at 3 a.m.--during which surgeons reattached the limb but were unable to restore complete blood circulation. She was returned to the operating room about 10:45 a.m. for a two-hour second procedure, but doctors concluded that the arm was not responding, and amputated the limb.

The toddler had been airlifted to Northridge Hospital about 7:30 p.m. Thursday from Paso Robles because of the hospital’s state-of-the-art pediatric intensive-care unit, and Balfour’s reputation as a top specialist in upper extremity replantations, hospital spokeswoman Deborah Moore said.

Cantalupo said the incident began about 3:20 p.m. with the three children playing on railroad tracks in Paso Robles, about 35 miles north of San Luis Obispo.

He said the engineer of a Southern Pacific freight train saw the children as he rounded a bend and immediately activated the train’s siren, horn and emergency brakes but was unable to stop the train before it struck the two children.

Madalain was rushed to a hospital in Templeton, about seven miles outside Paso Robles, then airlifted by helicopter to Northridge.