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Local doctor supports McDonnell's executive directive

By Kim Walter -- kwalter@nvdaily.com

Governor Bob McDonnell signed Executive Directive No. 4 last week, which will establish a workgroup to develop a plan for implementing a program to screen all newborn babies in the state for critical congenital heart disease.

In Virginia, nearly 4 out of every 1,000 newborns are diagnosed with a defect causing heart disease. Currently, 74 percent of the roughly 300 newborns are diagnosed at birth each year.

While that number may seem small, local neonatologist Teresa Clawson feels the effort is an important one.

"The frequency may be low, but the severity and associated cost is high," she said, addressing the outcome of a baby diagnosed with some kind of heart defect.

Winchester Medical Center instituted prenatal screenings last year, Clawson said, and that has certainly been helpful in catching heart defects early.

Although many newborns with critical heart defects are symptomatic and identified soon after birth, others are not diagnosed till after discharge from the hospital.

Some babies are able to grow and be born with heart lesions, because they're supported by the placenta. However, after birth, some of the lesions fail to close. Clawson said a newborn could appear perfectly healthy for several days after birth because some of the lesions take longer to close than others.

Some newborns show symptoms, like a poor pulse or their skin turning blue, while they're still in the hospital, but other take longer to completely develop the defect.

"Silent CCHD is not something you can pick up visibly," she said. "Imagine being a parent with a seemingly normal baby, leaving the hospital, and next thing you know your baby isn't breathing and you're rushing it to the ER."

While Winchester Medical center diagnoses anywhere from five to ten babies a year through prenatal screening, Clawson said there are still two or three newborns with critical congenital heart disease that aren't realized until birth.

Clawson feels the added screening will help to prevent death and irreversible long term conditions in newborns.

"With modern technology, we're not being caught by surprise as often as we used to, but unfortunately we can still miss lesions even with the best prenatal ultrasounds," she said.

The screenings will actually cost efficient as well, Clawson added, as the price per "disposable probe" is only $6.

"Now with the governor's support and it being recommended by different medical associations, it will be the insurance company's responsibility," she said. "The cost of one screening is much better than the associated cost that comes with a life time illness."

"It is certainly worth it if it means saving a life."


The legislation was passed unanimously by the Virginia House and Senate and was supported throughout the state by health care providers and patient advocacy organizations, including the ACC's Virginia Chapter and the Virginia chapters of the American Academy of Pediatrics and the American Heart Association, before it was vetoed. According to the ACC's Virginia Chapter President Rober Shor, MD, FACC, Gov. McDonnell explained that he vetoed the bill in order to avoid increasing the size of government in perpetuity. Shor expressed disappointment with McDonnell's initial decision, saying it was a missed opportunity to help protect Virginia infants and had the potential to negatively impact Virginia receiving a federal grant of $1 million that would help address this issue.

After the veto announcement, Shor stressed that an Executive Order could fulfill the same objective as the bill by creating an optimal path toward universal screening of newborns for congenital heart disease. "An Executive Order would put the congenital heart disease screening policy in place without creating any new government bodies or increasing the size of government," he said. "Additionally, the bill does not have a fiscal impact on the state’s budget."



"Silent CCHD is not something you can pick up visibly," she said. "Imagine being a parent with a seemingly normal baby, leaving the hospital, and next thing you know your baby isn't breathing and you're rushing it to the ER."

That's exactly what happened to my daughter. http://www.corasstory.org

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