Teen Dies After Hospital Mistakes Stroke for Nicotine Effects

The story was terrible: a young teenage baseball star dead from unknown causes, after being sent home by a hospital that apparently blamed the boy’s symptoms on vaping. We now know what killed Kyle Losse, and it certainly wasn’t vaping.

The incident should serve as a cautionary tale for the tobacco control and public health officials who have encouraged an environment of fear and misunderstanding to grow around vaping and nicotine. But it probably won’t change their behavior.

On Jan. 21, 2018, 14-year-old Kyle collapsed in the bathroom of his family’s home in Delta, British Columbia, a Vancouver suburb. He fell hard enough to be heard in other rooms of the house, and his father and stepmother rushed in to find him on the floor, with a vape device on the floor next to him.

“He was very disoriented. We didn’t know if he hit his head,” his stepmother Niki Losse said in a story that ran in both the Vancouver Sun and the Victoria Times-Colonist. “We don’t know if he got dizzy.”

The parents took Kyle to Delta Hospital. There the staff took blood and urine samples, and gave him fluids. His heart rate and blood pressure were low when he arrived, and when he closed his eyes his heart rate slowed even further. He said that his head hurt, and was vomiting.

But after a few hours, he had apparently improved, and though the staff hadn’t found the cause of the incident, the hospital released Kyle at 6:00 a.m. Monday. Early that afternoon, Kyle’s symptoms worsened, and he was rushed to B.C. Children’s Hospital in an ambulance, and placed on life support.

The next day he was removed from life support and died.

A CT scan at Children’s Hospital showed extensive brain damage, according to Global News. Fraser Health Authority, the organization that manages Delta Hospital — the first hospital Kyle was taken to — said that they had tested the boy’s neurological functions and ran toxicological screens, and found no concerns before they released him. But they never did a brain scan.

Questions were raised about the e-cigarette found on the floor of the bathroom. The headline in the Times-Colonist and the Sun hinted that maybe vaping or nicotine were to blame: “14-year-old Delta baseball player dies after falling while vaping nicotine.” One of the hospitals had tested the e-liquid in Kyle’s vape device. It contained nicotine.

The boy’s stepmother said that the first hospital didn’t investigate properly because they assumed the vape explained the incident. “I want Delta Hospital to acknowledge that this shouldn’t have happened,” Niki Losse told the Sun on Jan. 25. “I feel like they chalked it up to a stupid kid using an e-vape and didn’t fully look at everything that happened.”

"They made it seem like those were normal reactions to an e-vape … Especially when they released us," she told CTV News. Of course, passing out, falling, slurred speech, and hours of disorientation are not typical side effects of nicotine — except possibly from drinking large quantities of it.

By the next day, Mrs. Losse seemed inclined to blame the vape herself. “It’s just a fad, something kids are trying to do to be cool,” she told the Sun. “I told Kyle’s friends’ parents, if they have this stuff, take it outside and smash it right now.”

“There are supposed to be all these (regulations) in place to protect kids from this,” she added. “Kids have super-easy access to this stuff; it’s sold in malls and it’s branded to look really fun.”

Kyle was an athlete, a star baseball player. No one expects healthy teenagers to die suddenly. When they do, people want to know why — or at last find a convenient scapegoat.

The parents issued a public statement. “Kyle passed as a result of an undetermined head injury that possibly involved a vape,” they said. Meanwhile, the B.C. Coroners Service announced that it would investigate. They performed an autopsy over two days in late January.

Fast forward to now

Six months later analyses of the autopsy findings were completed, and the Coroners Service announced the results. Kyle Losse died of complications from a stroke. The autopsy did not show nicotine in Kyle’s system, and apparently Delta Hospital never tested his blood for nicotine.

The autopsy showed that Kyle probably had a disease called fibromuscular dysplasia (FMD), a condition that typically presents much later in life. The kind of FMD that Kyle appeared to have suffered from — focal (or intimal) FMD — only represents 10 percent of total FMD cases, but it is the most common kind found in children.

FMD causes abnormal growth within the walls of the arteries. The damaged blood vessels restrict the flow of blood, which can lead to ischemic events like the stroke Kyle had. The autopsy indicated that his arteries showed “features that would be consistent with the intimal form of FDM,” according to the medical examiner’s report, which the Losse family shared with the Delta Optimist.

“A stroke didn’t even cross my mind,” his stepmother told the paper. “It makes me question the care that we received. How could Delta Hospital release him saying he was alert and talking if he was really having a stroke? He was not alert and not talking full sentences. He needed help getting dressed and walking.”

And even if they merely suspected that he may have hit his head in the fall, wouldn’t the possibility of a severe concussion — itself a dangerous condition — call for a CT scan? Did the doctors actually dismiss this boy’s condition because he may have vaped?

We think of strokes as instant attacks, but in fact they can last for hours, or even days. If the blood flow to the brain is interrupted slightly, the symptoms may be less obvious. And strokes are often preceded by transient ischemic attacks (TIA’s), so-called “mini strokes” that often are brief and may not cause lasting damage themselves. Kyle may have had a TIA that caused his fall in the bathroom.

But if medical professionals ignore the warning signs, they might just send a 14-year-old boy home while he’s having a stroke. That’s what apparently happened to Kyle Losse. And they didn’t take the possibility of a stroke seriously because they assumed that vaping nicotine was the cause of Kyle’s symptoms.

“He was not vaping and had not been vaping at all because nothing was present in his system,” Mrs. Losse told the Optimist. “He probably had it with him because he was hiding it from us. In my mind, I feel like they [Delta Hospital] made an assumption. They assumed it was nicotine and a nicotine overdose, but they never tested for that. I just feel like running that test to ensure that was the cause would have come back negative and they could have started testing for something else.”