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Sarah Friend - Goodbye


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Lisa Salberg Find out more about Lisa Salberg
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  • Sarah Friend - Goodbye

    **warning - this article may be difficult for some to read it is very emotional and if you are having a bad day you may wish to read this some other time**

    To Sarahs Family:
    Your daughter was very loved and that is clear to the entire world. She was lucky to have you and you were luck to have had her in your life.
    Peace, Lisa

    Saying goodbye;
    Friends and family show their love for a girl claimed by a heart flaw

    BYLINE: LEILA FADEL; Star-Telegram Staff Writer

    NORTH RICHLAND HILLS--When Laura Friend's first daughter was
    born, a rush of love filled her. She would protect Sarah, always.

    She remembers fending off the reaching hands of a relative who
    tried to hold her baby. A year later, when Laura left Sarah Friend
    with a day care provider, she felt nauseated at the thought of
    being without her.

    At Sarah's fourth-grade talent show, she remembers tearing up
    with pride and embarrassment when her little girl stood on stage,
    dressed as Rose from the movie Titanic, and sang My Heart Will Go

    But it's the missing memory that consumes her: the details of
    what happened July 14, the day 12-year-old Sarah died at the NRH20
    water park. Since then, Laura has spent almost every day making
    phone calls to people who were with Sarah that day. She has studied
    reports to piece together the moment she couldn't protect her

    When Laura awakens, the first thing on her mind is the image of
    her daughter on a stretcher: "Sarah fell at the water park. ... I
    wasn't there."

    Day is a blur

    Sarah woke early that morning for her last day of junior
    lifeguard training at NRH2O. She turned on MTV in her mother's
    bedroom and sang along with a Hoobastank song as she coaxed her mom
    out of bed.

    Downstairs, she ate half a peanut butter sandwich. She never ate
    cereal; she hated milk. At about 8 a.m. she headed to the water
    park with her friend Lexi.

    She promised to wear sunscreen.

    "What time should I come home?"

    "I'll call you," Laura told her.

    Inside Sarah's heart lurked an undetected condition,
    hypertrophic cardiomyopathy. Her heart was thick, and it beat so
    fast when she ran and swam at the park that the blood flow was
    fatally disrupted.

    At 10:49 a.m. Laura got a call on her cellphone.

    "It's Lexi. Something terrible has happened. Sarah collapsed."

    Laura grabbed her other daughter, 10-year-old Katherine, and
    Katherine's friend, turned on her car's hazard lights and sped to
    the park. She called her husband, Luther.

    The rest of the day is a blur. Laura doesn't remember talking to
    people on her cellphone. She doesn't remember the crowd that
    watched as paramedics tried to revive Sarah. She doesn't remember
    the IV. She doesn't remember the moans coming from her own mouth or
    screaming, "What's happening to her?"

    All she saw was Sarah, on the first platform of steps leading to
    a seven-story water coaster, her stomach swollen in her black
    bikini, her neck limp, her eyes cold and unblinking. All Laura
    could think was, "I wasn't there when she fell."

    A woman kneeling over Sarah cried.

    "Why is she crying?" Laura asked a staff member at NRH2O. But
    she knew.

    Her daughter wasn't going to make it.

    She prayed for a miracle, and she called others to pray with
    her. Laura touched Sarah's forehead as she was taken to the
    ambulance on a stretcher. She hugged her, oblivious to the tubes
    and to the paramedics pounding on Sarah's chest.

    She climbed into the front of the ambulance and tried to look
    back at her daughter. "Don't look in the back, ma'am," the
    paramedics said.

    Her husband waited at North Hills Hospital. They yelled
    encouragement to Sarah as doctors used defibrillators to try to
    revive her. It was a tug of war with God, Laura said.

    "Hang in there, Sarah."

    "We love you, baby."

    The shocks made Sarah's 130-pound body jump off the bed. One,
    two, three times.

    "Stop, I can't take it anymore," Laura said.

    The physicians said there was nothing else they could do. At
    12:14 p.m., Sarah was pronounced dead.

    Luther and Laura held her and cried.

    Rethinking details

    Every morning now, Luther and Laura wake up together and cry.
    Luther writes his feelings in a notebook, but Laura talks about
    Sarah to keep her memory alive.

    She pores over every detail of that day and thinks, "What if?"

    What if someone had reached Sarah with defibrillators within six

    What if there had been a line at the Green Extreme water coaster
    that day and Sarah hadn't run up the steps so quickly?

    What if Laura had been there?

    She scans medical Web sites about hypertrophic cardiomyopathy.
    Sarah had none of the symptoms -- she never fainted or complained
    that her chest hurt.

    She asks Sarah's friends whether they are allowed to go to the
    water park alone. She wishes she hadn't let Sarah.

    She called the manager of emergency services at the hospital to
    talk about Sarah's death. Did she regain consciousness? She never

    In the guest book at Sarah's funeral, someone wrote, "I was
    there with you that morning at the park. I held your hand and saw
    an angel."

    She called the woman, Colleen Carri.

    Carri told her that she had held Sarah's hand after she fell.
    She said she felt peace in it, as if Sarah were watching from
    above. Carri and Laura talked for more than an hour.

    Laura asked her about the crying woman. Carri didn't know her
    name. The woman was an off-duty nurse, standing in line for the

    She called the park's emergency medical technician who worked on
    Sarah that day at NRH2O, but the park wouldn't let the technician
    talk about the events of that day, Laura said. They spoke only
    briefly; Laura wanted to ask about the nurse, the woman who cried
    for her daughter when she couldn't be there.

    "If Sarah ever needed me, it was then," Laura said.

    She asked Lexi if Sarah felt sick when they climbed the steps to
    the water coaster for a second time. She was having fun, Lexi said.
    The two girls talked about Sarah's upcoming birthday party.

    Balloons and wishes

    Laura and Sarah had already started to plan the party. Unopened
    invitations are still in the downstairs closet, and a list Sarah
    wrote on a ragged piece of notebook paper has the names of 32
    potential guests with a reminder written on top, "might not be able
    to invite everybody."

    Laura had the party on Aug. 10 to celebrate the day that her
    daughter would have become a teen-ager. There were pink balloons,
    vanilla cake and chocolate ice cream. Thirteen-year-old girls
    giggled, told secrets and chased boys.

    The cake said "Happy birthday, Sarah. We love you!" in pink
    frosting but had no candles. There was no one to blow them out.

    At the cemetery, Sarah's grave was covered with balloons, pink
    roses, carnations and white lilies.

    "You are my hero," Luther wrote on a balloon, tears streaming
    down his face. "RIP, We miss you Sarah," Lexi wrote on another.

    Then 24 balloons, covered with messages, were released.

    "Happy birthday, Sarah," the guests said as they watched the
    balloons disappear. "We miss you."

    The group left the cemetery together for cake at the house, and
    Laura watched the girls whisper to each other.

    Sarah's friends said goodbye that day. But Laura keeps her
    daughter alive. For Laura, every day is July 14, and Sarah is lying
    on the platform at the water park, waiting for her mother.

    "I don't know what else to do," Laura said. "I just have a hole
    in my heart."

    * Sarah may have been saved if an automated external
    defibrillator was used four to six minutes after her collapse

    NORTH RICHLAND HILLS--Time was the key to survival for Sarah

    The 12-year-old collapsed on the steps of a water coaster at
    NRH2O on July 14. She was declared dead more than an hour later.
    But she might have lived if she had been shocked with
    defibrillators within four to six minutes of her collapse, experts
    and studies say.

    The water park has two of the devices, which send an electric
    shock through the heart. They were stored at the opposite end of
    the 7 1/2-acre park in the first aid office and the administration
    office. Paramedics used their own defibrillators some 20 minutes
    after Sarah collapsed -- far too late to save her.

    "If there was any chance to bring her back, it would have been
    with defibrillation," said Dr. Harry Lever of the Cleveland Clinic
    Heart Center in Ohio. He is a leading expert in hypertrophic
    cardiomyopathy, the condition that led to Sarah's death.

    For each minute that passed after her collapse without
    defibrillation, Sarah lost 10 percent of her chance to survive,
    Lever said.

    An incident report obtained from the park states that a
    lifeguard at the Green Extreme was notified of Sarah's fall at
    about 10:45 a.m. She announced a medical emergency over the radio
    and cleared Sarah's airway.

    The report does not state what time the park's emergency medical
    technician, Jennifer Kettner, got to Sarah. When she arrived,
    Kettner, of North Richland Hills, asked for an oxygen tank. An
    off-duty nurse who was helping told Kettner that she could not find
    a pulse.

    Kettner asked for an automated external defibrillator. The
    report does not specify what time she asked for it, only that the
    device, which was 180 yards away, got to the scene at 10:51 a.m.,
    the same time that the paramedics arrived.

    Kettner could not be reached to comment.

    "The reality is, there has to be an assessment done," said
    Richard Torres, an assistant city manager who oversees NRH2O along
    with the city parks and recreation division. "She's up on a tower,
    and there are lines of people everywhere. This is a large park with
    thousands of people and one EMT. For all we know the EMT didn't
    even get to her for several minutes."

    Although paramedics got to the park three minutes after the 911
    call, they didn't make contact with Sarah for another three
    minutes, according to reports.

    Sarah had already been down for at least six minutes, and
    paramedics did not use defibrillation right away, said Dr. Roy
    Yamada, medical director of emergency medical services with the
    North Richland Hills Fire Department. They used cardiopulmonary
    resuscitation first to get her blood flowing, but her heart had
    completely stopped. Quivering or fibrillation of the heart must be
    present for the device to work.

    Medics gave her an IV and epinephrine to make the heart quiver,
    he said.

    The paramedics could not have known Sarah had hypertrophic
    cardiomyopathy. Epinephrine can make it worse, Lever said.

    About 21 minutes had passed before medics administered the first
    shock, according to reports from both NRH2O and paramedics.

    "If she was down next to the first aid center where they had the
    AEDs, it may have been different," Yamada said. "But in a tower
    like that where they're on the second floor and they don't have the
    equipment up there ... and then with the heart being enlarged.

    "It's unfortunate, but they tried. They worked their hearts out
    for her."

    Park staff is trained

    The off-duty nurse and water park staff administered CPR, but
    chest compressions and assisted breaths alone are not as effective
    as CPR with an AED, according to two studies published in the New
    England Journal of Medicine in August.

    One study found that 14 percent of people with cardiac arrest
    survive with only CPR by trained volunteers. But about 23 percent
    survive with early defibrillation and CPR combined.

    "It was the only chance she had," said Lisa Salberg, president
    of the Hypertrophic Cardiomyopathy Association, a nonprofit support
    and advocacy group based in New Jersey. "In all likelihood, they
    would have resuscitated her."

    The second study, conducted in Canada, shows that trained
    bystanders could increase survival rates after cardiac arrest with
    CPR and early defibrillation because paramedics often arrive too

    AEDs are now common in public places and businesses. Dallas/Fort
    Worth Airport has one at every checkpoint. American Airlines
    carries the devices on planes and trains flight attendants to use
    them. Some cities, including North Richland Hills, stock AEDs in
    all public buildings. The HeartStart Home Defibrillator is
    available with a prescription.

    Most states, including Texas, have "Good Samaritan" laws that
    protect the average person from liability if they come to the
    rescue of a person in distress with an AED.

    The NRH2O water park, unlike a passer-by, has a responsibility
    to care for anyone hurt on site, said Ellen Pryor, a tort expert
    and law professor at Southern Methodist University's Dedman Law
    School in Dallas.

    By adding AEDs to its inventory, the park has a responsibility
    to use the equipment appropriately, she said.

    "The water park is not an average person," she said. "If someone
    is drowning or hurting in your pool or on your property, you have a
    duty of care. ... The more tools you have when you're under a duty
    of care, the more you've got know about what to do with them."

    At NRH2O, the 200 members of the water park's staff are trained
    to operate AEDs and to conduct CPR, said Paulette Hartman, North
    Richland Hills city spokeswoman.

    About 50 employees, including lifeguards, and one emergency
    medical technician are at the park at all times, said NRH2O
    Operations Coordinator Frank Perez.

    The park's two AEDs are checked daily. Workers get training
    updates monthly on either AEDs, CPR or administering oxygen.
    Updates for lifeguards include aquatic training, he said.

    "We're going above and beyond by having two AEDs," he said.

    The park had tried in the past to store one of the AEDs at the
    Green Extreme tower for easier access, Perez said. But the machines
    got too hot and malfunctioned.

    Instead, one is kept in the first aid office and the other in
    the park's administration office, both at the front of the park
    near the entrance.

    Sarah's death was the first cardiac arrest in the park's 10-year
    history. The AEDs have never been used, Hartman said.

    "The staff at the water park and the paramedics did everything
    they could to save this little girl," she said.

    Odds against her

    The odds may have been against Sarah. She was on the second
    story of a seven-story water coaster. The AEDs were 180 yards away.
    And no one expected a 12-year-old girl's heart to stop.

    "When you hear of a 12-year-old going down, you don't think of
    cardiac arrest," Yamada said. "You think of heat exhaustion, you
    think of falling. You never think she's going to have a cardiac

    Sarah was one of about 450,000 people who die of sudden cardiac
    arrest in the United States each year. Forty-seven percent of the
    deaths occur outside a hospital, according to another study in the
    New England Journal of Medicine. Only about 5 percent of people who
    experience cardiac arrest outside a hospital survive.

    But Lever contends that defibrillation within minutes of a
    collapse could mean a normal life for a person with hypertrophic

    "This is one of those cases that makes you feel really bad," he

    When seconds count

    Sarah Friend, a 12-year-old from North Richland Hills, collapsed
    at NRH2O and died July 14. Doctors attributed her death to a
    previously undetected heart condition.

    Some medical experts say that she may have been saved if the
    staff had used automated external defibrillators, stored at the
    park, within four to six minutes of her collapse.

    About 10:45 a.m. A lifeguard at the Green Extreme at NRH2O
    learns that a girl has collapsed.

    10:48 a.m. Dispatchers notify the Fire Department.

    10:49 a.m. Laura Friend gets a call saying that her daughter has

    10:51 a.m. Paramedics arrive at the scene.

    10:54 a.m. Paramedics make contact with the girl.

    10:56 a.m. Paramedics start to monitor her heart.

    11:06 a.m. Defibrillator is used, but paramedics cannot revive

    12:14 p.m. Sarah is pronounced dead at North Hills Hospital.

    SOURCES: NRH2O incident report, North Richland Hills public
    safety reports, Friend family

    Hypertrophic cardiomyopathy

    * The disease causes the heart to thicken and can fatally
    disrupt the flow of blood.

    * The most common genetic heart disease, hypertrophic
    cardiomyopathy is underdiagnosed. It occurs in about one in 500
    people and is more common than cystic fibrosis and muscular
    dystrophy. For some people, sudden death is the first sign.

    * Symptoms include palpitations, shortness of breath, dizziness,
    passing out and chest pains. The disease is diagnosed with an
    echocardiogram, an ultrasound scan of the heart.

    ONLINE: www.4hcm.org


    SOURCES: Hypertrophic Cardiomyopathy Association, Cleveland
    Clinic Heart Center in Ohio
    Knowledge is power ... Stay informed!
    YOU can make a difference - all you have to do is try!

    Dx age 12 current age 46 and counting!
    lost: 5 family members to HCM (SCD, Stroke, CHF)
    Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
    Therapy - ICD (implanted 97, 01, 04 and 11, medication
    Currently not obstructed
    Complications - unnecessary pacemaker and stroke (unrelated to each other)

  • #2
    Re: Sarah Friend - Goodbye

    Very, Very , Sad to finally read all the details. This is a hard, hard way to learn that things need to be changed.
    Thank you Lisa for sharing this story.
    Dx @ 47 with HOCM & HF:11/00
    Guidant ICD:Mar.01, Recalled/replaced:6/05 w/ Medtronic device
    Lead failure,replaced 12/06.
    SF lead recall:07,extracted leads and new device 2012
    [email protected] Tufts, Boston:10/5/03; age 50. ( [email protected] 240 mmHg ++)
    Paroxysmal A-Fib: 06-07,2010 controlled w/sotalol dosing
    Genetic mutation 4/09, mother(d), brother, son, gene+
    Mother of 3, grandma of 3:Tim,27,Sarah,33w/6 y/o old Sophia, 5 y/o Jack, Laura 34, w/ 5 y/o old Benjamin


    • #3
      Re: Sarah Friend - Goodbye

      Oh MY

      My heart goes out to Luther and Laura and their entire family, it is surely a shame that this little 12 year old could not be helped, a 7 acre park you would think would have had more staff then it did and more AED's then they had

      Diagnosed 2003
      Myectomy 2-23-2004
      Husband: Ken
      Son: John diagnosed 2004
      Daughter: Janet (free of HCM)

      Grandchildren: Drew 15,Aaron 13,Karen 9,Connor 9


      • #4
        Re: Sarah Friend - Goodbye


        This is such a sad horrible story... and the worst part is that it is true. I send my best wishes to the Friend family and Sarah's friends. Please know that my heart truly goes out to you and that I pray that the Lord will minister to you all.



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