Weeks after a mother in Lincoln, Neb., started telling doctors that her 8-month-old child was suffering unexplained bouts of vomiting, the case was referred to experts at Mayo Clinic.
The woman took the child to Rochester, where after repeated vomiting episodes the infant's urine was tested. Mayo physicians say they found evidence that the child had been given syrup of ipecac, which is commonly used to induce vomiting and can lead to heart failure in infants.
Details of the alleged child endangerment emerged in a criminal complaint filed Monday in Olmsted County District Court against 31-year-old Sara Ann Carstens. A summons has been issued, with Carstens' first court appearance scheduled for May 5. A physician allegedly told Nebraska law enforcement that he suspected the case was a possible instance of Munchausen syndrome by proxy , a condition in which caregivers seek attention or sympathy by acting as if people they are caring for are ill when they are not.
According to the complaint, the infant had extensive medical evaluations in Nebraska after Carstens started reporting vomiting episodes in January 2010. Carstens allegedly told doctors that the child was vomiting every three to five days, usually 10 times over a four-hour period.
The child always improved immediately after hospitalization.
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Repeated use of syrup of ipecac for infants can lead to esophagitis, aspiration pneumonia, and cardiac failure, a Mayo Clinic doctor noted in a letter cited in the complaint. Repeated ipecac administration places infants "at serious risk for lethal consequences," the complaint says.
The child was removed from Carstens' care in April of 2010. The infant was placed in foster care and has not had any hospitalizations or vomiting episodes since, according to the complaint.
Carstens has been charged with two felonies, third-degree assault and child endangerment. Both counts carry a maximum sentence of five years in prison and a $10,000 fine.
