Max’s school made serious errors in his care stemming from their failure to properly train staff, refused to follow his physician’s orders in the event of an emergency, and refused to communicate with his parents.
Max is an 8 year old who was diagnosed with Type I diabetes when he was 3. During first grade his mom had to come into his suburban school to administer insulin on a daily basis because the school did not have a nurse for most of the school year. (A school administrator said that this was the mother’s “choice,” even though not coming in would have endangered Max’s health.) Max could not ride the bus because the school refused to train the bus driver in what to do in the event of an emergency or to let Max’s diabetes supplies (including glucagon) go with him on the bus. Before Max started second grade, the school hired a nurse. However, the school refused the nurse's request to attend a specialized diabetes training which would have covered the latest diabetes information as well as information about Max’s insulin pump and continual glucose monitoring system. The school also refused the parents’ offer to arrange for a certified diabetes educator to train school personnel.
After the nurse made several errors in Max’s care, his parents called us for help in convincing the school to implement a Section 504 Plan that would ensure Max was cared for during the school day. Besides inadequate training, other issues that had come up included the nurse requiring Max to come to the office for his BG checks resulting in him missing up to an hour of class a day, the school refusing to communicate with the parents, the school refusing to train people to provide care when the nurse was not available, the nurse scolding Max for testing his own glucose or operating his pump, the school refusing to agree to administer glucagon in the event of an emergency before calling 911, and the school failing to notify the parents when a classmate brought treats to the school for a birthday and then refusing to adjust Max’s insulin according to the parent’s direction.
After meeting and consulting with its own attorney, the school agreed that Max could test in the classroom, that they would inform the parents of treats brought to the school, and that Max could test his own levels, write the numbers down himself, and operate his pump. Click here to view the chart Max’s mother created to be filled in on a daily basis after it became apparent Max was not testing in the classroom or writing his numbers down himself.
The school refused to train volunteers to back up the school nurse and principal in case they were not available. The school took the position that there would “never be an absence of a trained person to supervise the implementation” of the 504 plan. Predictably, nearly half a dozen times in the next few month, Max was alone at the school with no one trained to take care of him. One day when his mother picked him up, his blood sugar was over 400. There had been no one at the school to administer insulin. The school indicated it thought this was a “good” blood sugar level. Other days, the school called in the morning to say that the nurse was not available and offered a non-nurse substitute. The school also made several more serious errors in Max’s care, such as giving him a bolus of rapid acting insulin when his blood sugar was below 80 without giving him glucose tabs or food and, on another occasion, sending him out to recess when his blood sugar was already low. Max became fearful of going to school and began having frequent crying bouts, saying that he was afraid he would “die at school.” He started asking his mom to call every morning before they left the house to make sure the one nurse he felt comfortable with would be at the school. The parents considered putting their house up for sale so they could get Max to a safer school. Click here to read a letter sent to the school documenting violations of the 504 Plan.
Finally, with the end of the school year fast approaching, the school agreed to provide training by a certified diabetes educator, exactly what the parents had previously offered to provide before the school year began. However, the training did not take place until almost a month later. Click here to read a letter sent to the school regarding their failure to provide the promised training in a timely manner. Unfortunately, this was a situation in which a date for the training should have been demanded, instead of relying on the school to follow through with its promise.
Now, Max is in 3rd grade in the same school district. This year, the school agreed to provide two training sessions by a certified diabetes educator before classes started: first, for all staff to learn about diabetes in general; and second, for volunteers to learn to administer insulin, supervise blood glucose checks, and administer glucagon. Several people on the staff of the school stepped forward to receive this additional training. The school has also agreed that in the event of a severe hypoglycemic emergency, they will follow his doctor’s orders and administer glucagon before calling 911. And because staff members are finally allowed to volunteer to be trained in diabetes related tasks, a health aide in Max’s class can watch him check his blood sugar so he does not have to go down to the nurse’s office.
It is clear that parents and attorneys must diligently document their concerns and the school’s promise to remedy the situation. If you are having problems with your child’s school, please contact us.