Parents for Safe Child Care
Ronan

Ronan Wilson

Child dies from E. coli complications

Others sickened at day care center

By Tom Vogt
Columbian Staff Reporter
Originally published April 9, 2010 at 12:22 p.m., updated April 9, 2010 at 11:45 p.m.

A young Vancouver-area boy has died as the result of an E. coli outbreak that hospitalized three other children.

Those three children are now out of the hospital, said Dr. Alan Melnick, Clark County health officer, on Friday afternoon.

Officials did not release any additional personal information about any of the four children.

However, the children did attend the same Vancouver day care provider, and seven other people who attended the site or worked there have tested positive for the bacteria.

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1 child dead, 3 sickened by Clark Co. E. coli

Friday, April 9, 2010

VANCOUVER, Wash. (AP) -- The Clark County, Wash., health officer says one child has died and three others fell ill after a recent outbreak of E. coli O157:H7 at a Vancouver-area day care center.

Four children were hospitalized; Melnick says the other three have been released.

Melnick says the first child was hospitalized on March 19 and three others soon after.

The licensed day care center has been closed temporarily. Health officials say they don't know the precise source of the outbreak but said it did not appear related to food, water or another single source.

Investigators tested 22 children and four adults. They say they found six people carrying the E. coli bacteria in their blood but not showing symptoms.

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Child dies after E. coli outbreak at Vancouver day care

by David Krough
KGW – Portland, Oregon

Posted on April 9, 2010 at 12:23 PM
Updated Monday, Apr 12 at 11:17 AM

VANCOUVER, Wash. -- A Clark County day care was closed after an outbreak of E. coli infections that led to the death of one child and hospitalized three others.

Clark County health officer Dr. Alan Melnick said the first child got sick on March 19 and three other cases followed. The Fletch day care center was closed pending the follow up testing of all 22 attendees and four staff members.

Melnick said the source was thought to be a person-to-person transmission.
"We are deeply saddened by the tragic death of this child," Melnick said. "Our hearts go out to the child's family during this very difficult time."

More: Statement from Fletch Family Daycare

The outbreak began in mid March, when several children at the day care began reporting gastrointestinal symptoms.
The strain was identified as E. coli O157:H7. Transmission can happen if infected people do not wash their hands after using the toilet or diapering children.

Elizabeth Winter with the Washington state Department of Early Learning said Larry and Dianne Fletch have been operating this child care center out of their home since 1990 and have had no valid complaints against their license.

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Public health doc on day care e. coli

April 9, 2010 at 7:52 PM

Updated Friday, Apr 9 at 11:11 PM


Wayne Havrelly talks with Dr. Alan Melnick, MD, MPH, about the e. coli outbreak in Vancouver that killed one child and hospitalized three others.

Day care in fatal E. coli case still closed

Health officials continue to test facility's workers

By Tom Vogt

Columbian Staff Reporter
Tuesday, April 13, 2010

The Vancouver day care center associated with a fatal outbreak of E. coli 0157 will remain closed while people who work there continue to undergo testing, county health officials said Monday.

Dr. Alan Melnick, county health officer, said Fletch Family Daycare will remain closed until staff members who have tested positive for E. coli or displayed symptoms have two negative E. coli tests separated by 24 hours.
Clark County Public Health may allow the center to reopen next Monday or sooner, pending the outcome of test results, according to a news release.

One young boy who attended the child care center died as a result of an E. coli infection. Three other children were hospitalized with the infection, but have since been released.

Seven other people tested positive for E. coli 0157 without showing symptoms of illness.

On behalf of his family's day care center, Larry Fletch e-mailed a message to local media outlets describing the complexities of the tragedy. They include episodes of what appeared to be a norolike virus — often termed "stomach flu" — among the families of several day care children.

In trying to reconstruct the progression and transmission of the outbreak, the health department couldn't tell whether those families had experienced E. coli 0157 or the norolike virus, Fletch said.

Three of their four providers tested negative for any E. coli, and two of them handled dozens of dirty diapers throughout the episode without becoming infected, he wrote.

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Vancouver child's illness spirals into deadly grip of E. coli

Published: Saturday, April 24, 2010, 10:35 PM     Updated: Saturday, April 24, 2010, 11:00 PM

The Oregonian

by Kary Muldoon

Bonnie Wilson took her sick 4-year-old, Ronan, to the pediatrician on Monday, March 29. She says she told the doctor that another child in Ronan's day care had been hospitalized with the potentially deadly bacteria E. coli O157:H7. But Ronan's symptoms didn't fit that diagnosis.

The doctor suspected the sandy-haired, hazel-eyed boy had the flu and sent Wilson home with instructions to keep a close eye on him.

Ronan improved briefly, but that Thursday he was back at Evergreen Pediatric Clinic in Vancouver, dehydrated, constipated and so weak he needed help sitting up. The clinic sent him to Southwest Washington Medical Center for tests, and just as he arrived, his symptoms took a horrifying turn -- one that, in the end, changed the lives of everyone who knew Ronan Allen "Ro-Ro" Wilson.

Timeline

Early March: Some children at Fletch Family Daycare in Vancouver have mild gastrointestinal symptoms but continue to attend day care, according to the Clark County Health Department. Illness caused by the E. coli O157:H7 bacterial strain can start as mild diarrhea that a week or so later turns bloody, a symptom the bacteria are causing illness.

Mid-March: The outbreak begins when at least one child's symptoms worsen. Several of those enrolled in the day care report gastrointestinal symptoms to their parents and doctors, according to a Health Department investigation.

March 19: The department learns of the first case of E. coli O157:H7.

March 26: The department learns of a second case. Officials inspect the day care center but don't find anything alarming in the facility's hygiene practices. That Friday and over the weekend, health officials call parents of all the day care's children to inform them of the outbreak and to interview them about their children's health.

March 28: One mother tells health officials that her child has symptoms indicative of E. coli, presumably the day care's third case.

March 29: Bonnie Wilson of Vancouver takes her 4-year-old, Ronan, to Evergreen Pediatric Clinic. Doctors, Wilson says, suspect influenza because, though Ronan has been vomiting, he doesn't have the diarrhea characteristic of E. coli O157:H7.

March 30: Ronan seems better in the morning, but by evening, he again feels ill. The Health Department orders testing of stool samples from all 22 children enrolled in the day care and from its staff of four. Some comply within one day but at least one sample isn't provided until April 6. Transporting samples, growing the cultures in the lab and getting results takes a few days.

April 1: Ronan is worse. He goes to the pediatric clinic, then to Southwest Washington Medical Center, where doctors suspect he has appendicitis and septic shock. At the hospital, he vomits and has his first bout of bloody diarrhea. Doctors rush him to Doernbecher Children's Hospital in Portland, and Washington health officials learn of his case. His diagnosis isn't confirmed, but officials presume E. coli O157:H7 made him sick. His is case No. 4.

April 2: Results aren't final, but because of the cultures' appearance, officials presume that seven individuals, not including the four children hospitalized, carry the bacteria. Later, officials get presumptive positives on three more cases. All together, 13 people are found to carry E. coli O157:H7. Fletch Family Daycare closes voluntarily, and later that day the Clark County Health Department orders that it not reopen until each child and staff member tests negative for the bacteria twice; tests must be at least 24 hours apart.

April 8: Ronan Wilson dies.

April 23: Dr. Alan Melnick, health officer for Clark and three other Southwest Washington counties, tells The Oregonian his department has concluded its investigation. The day care's staff members all test healthy, Melnick says, but five children still have not been cleared to return to day care. The center remains closed.

Information: Ronan Wilson's Facebook page

On Saturday, a week after their boy's funeral, Bonnie and Anthony Wilson told their story. They want others to know the loving, curious, ambitious child they lost and to learn from their experience. They don't want another family to ever endure what they did.

Photographs show Ronan laughing, running, climbing and wrestling with his brother, Gavin, 7. By age 4, the younger of the Wilson boys had so much energy he'd awaken in his favorite mismatched pajamas and race to his parents' room at 3 a.m., ready to play.

But his life didn't begin so vigorously.

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E. coli victim imparted big lessons in his short life

Ronan Wilson’s parents recall his fearlessness

By Stephanie Rice
Columbian staff writer

Sunday, April 25, 2010

Ronan Wilson loved trains, dinosaurs and monkeys.

Ronan Allen Wilson was born 12 weeks early, via emergency C-section at Providence St. Vincent Medical Center in Portland. He was born Nov. 20, 2005. He weighed 1 pound, 15 ounces.

It was a week before his parents, Bonnie and Anthony Wilson of Hazel Dell, were allowed to hold him, and 84 days before he was allowed to leave the hospital's neonatal intensive care unit.

Ronan came into the world too early. He left in the same manner.

He died 9:45 p.m. April 8 at Doernbecher Children's Hospital in Portland. This time, his parents were touching him. Unable to look at Ronan's sweet face, which was swollen and attached to tubes, Bonnie said she put her head on Ronan's chest, listening after the ventilator was turned off as her son's heartbeat faded. Anthony held one of Ronan's hands, his head on Ronan's arm. A pastor from Brush Prairie Baptist Church said prayers.  

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Parents of 4-year-old E. coli victim speak out

by Associated Press kgw.com

Posted on April 26, 2010 at 6:49 AM

VANCOUVER, Wash. (AP) -- Ronan Wilson came into the world too soon, born 12 weeks early. He left in the same way, too soon.

Wilson, 4, died April 8 at Doernbecher Children's Hospital in Portland. Wilson's death came after his body was overtaken by E. coli O157:H7 bacteria, which he contracted at his child care center.

In an interview with The Columbian, his parents, Bonnie and Anthony Wilson, said they've received a huge outpouring of support from the community. But the family also wishes the Clark County Health Department would have made a public announcement sooner so doctors and parents would have been more vigilant.

The first child at the center tested positive March 19. When Bonnie first took Ronan to see a doctor March 29, even though she mentioned a child had E. coli, the doctor assumed Ronan had the flu.

"We don't want this to happen to anyone else," Bonnie said. "My goal is to tell Ronan's story and make it known that he mattered."

Clark County health officer Dr. Alan Melnick said he didn't shut down Fletch Family Daycare until April 2 out of concern that other parents who used the facility could take their children to different day cares and risk exposing others.

Melnick's decision to close the facility came after tests showed seven more children and staff with no symptoms tested positive for the E. coli strain. 

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Memorial for 4-year-old e.coli victim

by Amanda Burden

kgw.com

Posted on May 8, 2010 at 5:43 PM Updated Monday, May 10 at 8:21 AM

VANCOUVER -- A four-year-old boy was remembered Saturday, after losing a heartbreaking battle with e.coli. 

Ronan Wilson started feeling sick on March 26th.  There had been an outbreak of  e.coli at the Fletch Family Daycare, where Ronan frequented. 

But Ronan's pediatrician said he didn't have the classic symptoms of the deadly bacteria.  Within days, though, Ronan became violently ill.  He quickly went from a bubbly, carefree four-year-old, to barely being able to walk.

"He looked at me and said, I'm really sick," remembered Ronan's mother, Bonnie Wilson. 

Ronan's father, Anthony, said when they brought him to Doernbecher Children's Hospital, doctors confirmed, it was e.coli. "Never in our wildest dreams did we see it being as serious as it became," Anthony said. 

Ronan went on dialysis, but the bacteria attacked his colon.  Doctors performed surgery.   But they couldn't save him.  Ronan died on April 8th.  "Once he went to sleep from the anesthesia, that was it," Anthony said.  "The e.oli continued attacking his body and it moved into his brain and he never woke up from that."

"I'll miss holding him," Bonnie said.  "Him physically being here, that's what I'll miss the most."

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State revokes license of day care where boy contracted E.coli

Owners of Hazel Dell in-home center said they will appeal

By Stephanie Rice Columbian Staff Reporter

Originally published June 3, 2010 at 3:30 p.m., updated June 3, 2010 at 7:06 p.m.

The Hazel Dell in-home day care where a 4-year-old boy contracted a fatal bacterial infection in April has had its state license permanently revoked.

Dianne and Larry Fletch had operated the day care for more than 20 years. Their license was suspended in April while the state Department of Early Learning proceeded with an investigation. 

Darcy Taylor, licensing supervisor for the Department of Early Learning, sent Dianne Fletch a seven-page letter explaining her decision to revoke the license. The letter was dated May 21, but the state announced the revocation on Thursday after receiving confirmation the Fletches had received the letter, which had been sent by registered mail. 

According to Taylor's letter, among the factors contributing to the decision to revoke the license: the Fletches waited too long to contact the Clark County Health Department after children started becoming ill; they used diapering procedures contrary to state regulations; they did not have adequate records for one of the children at the day care center; and they had previous citations for operating overcapacity (they were licensed for 12 children).

"Your family home has had a history of not being in compliance of the minimum licensing regulations," Taylor wrote. 

Ronan died after his body was overtaken by E. coli O157:H7 bacteria. Doctors tried treating the havoc wreaked on Ronan's body by the bacteria, which affected his kidneys and colon before destroying large sections of his brain.

14 total infections

When Bonnie Wilson first took Ronan to a doctor on March 29, the doctor assumed the boy had the flu because he did not have the bloody diarrhea that's symptomatic of E.coli. By the time that symptom appeared, on April 1, Ronan was rushed to Doernbecher and put on dialysis.

Three other people from the day care were hospitalized but recovered, and an additional 10 people had positive stool cultures with mild symptoms, said Dr. Alan Melnick, Clark County's health officer.

 Melnick said it appears that the infection was spread by person-to-person contact, rather than a food source.

In the revocation letter, Taylor wrote that an infant who tested positive for E.coli had diarrhea for 10 days.

"The infant was identified as being one of the first children to exhibit symptoms of E.coli, and may have been the source of the illness being introduced to your child care home," Taylor wrote.

Taylor said that diarrhea is among symptoms that should keep children from attending day care.

In her conclusion, Taylor wrote, "Based upon these facts and circumstances, at this time, the Department cannot ensure that children in your care will be safe and secure or that you will follow the licensing requirements."

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County's E. coli response questioned

Boy's aunt feels health department should have alerted the public

By Stephanie Rice Columbian Staff Reporter

Thursday, June 24, 2010

The aunt of 4-year-old Ronan Wilson, who died April 8 after contracting E. coli at his Hazel Dell in-home day care, said Wednesday she wants to know why the Clark County Department of Health did not let the public know about the outbreak until the day after Ronan died.

Savenia Falquist also questions why the day care children and their siblings continued attending school, possibly putting other children at risk, and why the health department did not at least alert health care providers about the outbreak.

When Ronan's mother first took him to a doctor on March 29, the doctor did not think it was necessary to test for E. coli and diagnosed Ronan with the flu. Other parents of children at the day care have said they initially had difficulty getting doctors to approve a stool test, the only way to test for E. coli. 

Children who tested positive were not allowed to go to a day care until they had two negative stool samples, 24 hours apart, Melnick said Wednesday. He said older children at the center or older siblings of children at the day care were still allowed to go to school because there aren't the same concerns about transmitting the bacteria with older children. There aren't diapers being changed, for example.

"The kids are older, and their hygiene is better," Melnick said.

There's no cure for E. coli O157:H7, so doctors can only treat what it does to the body. Generally speaking, Melnick said, the course of treatment is hydration to help avoid kidney failure.

Falquist said she wants to make sure the county, when deciding on whether to send out public alerts or provider alerts, errs on the side of protecting its most vulnerable residents rather than worrying about causing panic.

"Information is what helps us advocate," she said. 

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Claim filed against county over boy's E. coli death

It alleges negligent failures by health agency related to outbreak at day care

By Marissa Harshman Columbian Staff Reporter

Thursday, June 23, 2011

The parents of 4-year-old Ronan Wilson, the Hazel Dell boy who died last year from complications of E. coli, have filed a claim against Clark County Public Health.

The county received the claim filed by the boy's parents, Anthony and Bonnie Wilson, on June 8. The Wilsons claim negligent failures by the county health department were causes of Ronan's death. The financial damages are listed in the claim as "undetermined, pending further investigation and discovery."

 Anthony and Bonnie Wilson claim the county health department was negligent and didn't "reasonably alert the medical community, the general public or the public schools of the E. coli outbreak in a timely manner."

The claim also says the county failed to prevent or control the outbreak from spreading, supervise the health and sanitation conditions of the Fletch Family Daycare, institute appropriate control measures after learning of the outbreak and close the day care center.

"Despite the knowledge of three children from the Fletch Family Daycare having contracted E. coli and the knowledge that Fletch Family Daycare was not following proper diaper disposal procedures and was not taking proper precautions against the spread of a communicable disease, the Clark County Public Health Department did not notify or otherwise alert the medical community, the general public or the public schools of this outbreak," according to the claim.

When the Wilsons took Ronan to see a doctor on March 29, 2010, the doctor had not been notified by the county of the E. coli cases, the Wilsons said in the claim.

"When the doctor was told by the parents of Ronan A. Wilson of a suspected E. coli outbreak at the Fletch Family Daycare, he disregarded the claim. He diagnosed Ronan A. Wilson with the flu," according to the claim.

A total of 23 children and four staff members were found to have either probable or confirmed cases of E. coli O157:H7. Four children, including Ronan, were hospitalized.

The county learned of the first case March 19, 2010. An initial investigation showed there were no other sick children at the day care center, county health officer Dr. Alan Melnick said last year.

A physician who treated the first child alerted the county on March 26, 2010, of a second case. The county then began interviewing parents and ordering stool samples from all day care staff and children, Melnick said.

The county ordered the day care to close April 2, 2010, after test results showed other people had E. coli, even though they weren't experiencing symptoms.

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Health department denies claim in boy's E. coli death

By Marissa Harshman Columbian Staff Reporter

Wednesday, August 10, 2011

Clark County Public Health is denying culpability in the E. coli-related death of a 4-year-old Hazel Dell boy. 

Dr. Anthony Marfin, state epidemiologist for communicable diseases, sent the Clark County commissioners a letter last fall indicating the county acted within state guidelines. 

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Lawsuit filed for Child's E.coli death at day care

Posted by Karen Koehler on August 12, 2011

The day care should have been shut down long before this tragedy.

Day cares can only stay in business if the government decides they are safe. 

Laws require day cares to use proper diapering and cleaning procedures and report outbreaks of illnesses.  Laws require public health departments to act to prevent the spread of disease.  Laws require the Department of Early Learning to revoke the license of day cares that chronically violate the laws that are meant to protect children.

The young parents who entrusted 4 year old Ronan Wilson to Fletch Family Day Care, had no idea that the County and State should have shut that facility down.  The parents had no idea of the number of health and safety violations found over and over again.  But the government knew and took no action.

Fletch Family Day Care was a public safety hazard.  It posed a threat to the health and safety of those it was supposed to care for.  Ultimately the long line of violations and failures lead to the death of Ronan from complications associated with E. Coli.  The preventable outbreak  injured a total 18 children and 3 adults at the Fletch Family Day Care.

After Ronan's death, the government decided that this last violation should be Fletch Family Day Care's final one.  It shut down the Day Care.  One child too late.

Read the lawsuit

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Parents sue government, day care over son's E. coli death

Lawsuit alleges infection could have been stopped

By Laura McVicker Columbian Staff Reporter

Originally published August 12, 2011 at 1:42 p.m., updated August 12, 2011 at 6:35 p.m.

The parents of a 4-year-old Hazel Dell boy who died from complications of E. coli have filed a lawsuit against his former day care center, Clark County and the state, alleging all were responsible for a series of missteps that led to the child's death. 

The 19-page complaint lists a series of alleged errors that started with the day care center. Since 1995, the day care was found several times to be in violation of state law for the number of children under its supervision (more than 12).

The suit also alleges the Fletches did not ensure children were properly diapered or that they were washing their hands or took precautions against communicable diseases.

"Fletch did not maintain their home and all child care equipment in a clean and sanitary condition, which contributed to the person-to-person spread of E. coli," the suit said. 

The suit alleges that the "negligent failure of the Clark County Public Health Department to reasonably alert the medical community, the general public or the public schools of the E. coli outbreak in a timely manner caused or contributed to the death of Ronan A. Wilson." 

In addition, the suit claims the state's Department of Early Learning was negligent in not considering "the previous noncompliance by the (day care) when it did inspections of the facility." The suit also alleges the state department did not close the day care in a timely manner and did not ensure the center was "safe and clean." 

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