"I am not an idiot."

By Annie Reed, Suburban Life Publications, Tue Jul 07, 2009, 06:04 PM

Swine flu precaution comes with hefty price tag for Pleasantdale family

When swine flu fever first hit the United States at the end of April, panic about a potential pandemic left many schools agonizing over how to respond.

For one family at Pleasantdale Elementary in Willow Springs, the school’s decision to err on the side of caution has resulted in more than $2,000 of medical bills for a swine flu test the family claims was unnecessary.

Now, the Pleasantdale School District 107 Board of Education must decide if the district will reimburse the family for any of the $2,031 influenza A (swine flu) testing, which the superintendent required against the opinion of the family’s doctor.

Flu back and forth
On April 15, kindergartner Lizzie Campos and her family traveled to Mexico to visit family. Lizzie did not attend school because of illness on the four days preceding the trip, according to school records.

Before making the trip, Lizzie was seen April 12 by Dr. Luis Osorio, a physician at the Family Medical Dental Center in Berwyn. Medical Assistant Luce Martinez said Lizzie was treated for dyspepsia, a gastrointestinal ailment akin to indigestion, according to medical information given to Suburban Life with the family’s permission.

When the family got back from Mexico a week later, the school requested that Lizzie’s mother, Ana, bring a doctor’s note stating Lizzie could attend school. Lizzie saw the doctor, and he wrote the note April 23.

Three days after she returned to school, however, the school nurse called Campos asking if Lizzie had been tested for swine flu. She had not been, Campos said, because the doctor had said Lizzie was healthy.

Within the hour, the school called Campos again to say she needed to pick up her daughter from the nurse’s office because Lizzie had flu-like symptoms.

In a letter signed by school nurse Lisa Penrod and Principal Matt Vandercar, Lizzie had been “complaining of a headache, stomach ache and a cough,” with a temperature of 99.6 degrees.

According to the nurse’s log provided to Campos by the school, Lizzie had also visited the nurse’s office the first day she returned from her trip and “complained of a stomach ache.” Her temperature was recorded as 99.6 in the log. She also visited the nurse on the 29th to use her inhaler before PE class.

Campos disputes the school’s diagnosis. She said that when she arrived, Lizzie was not displaying those symptoms, but District 107 Superintendent Mark Fredisdorf said he did not want to take any chances.

He said Lizzie would not be allowed back in school until she was tested for swine flu.

Wary of risks
At the time, in light of the potential pandemic status of Influenza A-H1N1, the Illinois Department of Health was issuing daily news briefs with guidance for the public.

Fredisdorf said he made his decision to require Lizzie be tested based on a release from April 27: “For people who have flu-like symptoms and have traveled to areas where swine flu has been confirmed, they should seek medical attention.”

By April 30 news sources were reporting more than 100 swine-flu-related-deaths in Mexico, where the virus first broke out.

“With the information we had at the time, we decided the testing was necessary,” Fredisdorf said. “It was the height of the swine flu alarm, and we had over 400 students in that school who would be at potential risk. That’s a chance we couldn’t take.”

Testing for swine flu requires a doctor’s order, so Campos took Lizzie to the family physician. However, when she got there, the medical assistant questioned the order.

Martinez, who said Lizzie was asymptomatic for the flu, called the school.

“The school insisted she be tested for swine flu even though I called and spoke to the nurse,” Martinez said. “In the doctor’s professional opinion, there was no need for it.”

Campos’ doctor finally wrote the prescription for the test. Martinez said she told Penrod that the family’s health insurance probably would not cover the procedure.

Penrod did not return requests for comment.

Costly caution
Lizzie’s swine flu test, performed at Advocate Christ Medical Center in Oak Lawn, came back negative later that day. Campos was sent a bill May 31 for $2,031, the cost of the test, and was informed that her insurance would not cover the test.

“Charges are not covered with given diagnosis,” the insurance claim read.

Campos, who is a licensed practical nurse at Advocate Christ Medical Center, believes the School District should cover the charges because the test was ordered by the school against her doctor’s medical opinion and because she disputes that Lizzie was sick.

“We would not consider paying for it,” Fredisdorf said. “There are a multitude of vaccinations and other related medical things students need, and that’s just something a parent is responsible for.”

The question of Lizzie’s disputed flu-like symptoms is complicated by her school medical records. In her 130 days present, she visited the nurse’s office 34 times, often complaining of stomach aches and chapped lips, according to the nurse log. Nine times the log says Lizzie had a temperature between 99.5 and 99.9, but she was not sent home. She also was absent 17 days for illnesses or medical appointments.

Fredisdorf confirmed he did require that Lizzie receive the test, rather than giving the Camposes the option of keeping Lizzie home from school.

“Given the potential danger, I needed unequivocal results for the well being of this girl and the entire student body,” Fredisdorf said. “This was a real and present threat.”

A spokeswoman at the Illinois Health Department said schools were especially cautioned at that time to be vigilant, and in some cases the department recommended school closures where swine flu cases were confirmed.

However, “it was never our guidance that anyone had to be tested for H1N1,” spokeswoman Kelly Jakubek said. “For schools in particular, the guidance at the very beginning was that if students had those symptoms and had traveled to those areas, they should be seen by a doctor, but it’s up to a doctor or a physician whether they’re going to administer a test.”

Fredisdorf said one other family at the school was also identified as a possible swine flu case, but the family volunteered to get the student tested.

“It wasn’t an issue,” he said.

He did not know whether that family got tested for H1N1, or just a regular flu test. Though the latter typically costs under $200, the cost of the specific test for H1N1 was $1,659 on Lizzie’s medical bill (additional rapid flu and respiratory screenings made up the remaining $400 in charges.)

Campos recently wrote a letter to the School Board requesting reimbursement for the flu-testing bills.

School Board President Leandra Sedlack said that the board has no policy regarding medical bill reimbursement but that it will discuss whether or not to give Campos a hearing at its July 15 meeting.

Regardless of whether the board decides to foot the bill, Campos already has removed Lizzie from District 107 for the coming school year.

She said Lizzie’s experiences at Pleasantdale have left her “upset beyond explanation.”

She said the school "implied that I violated the recommendation of state law and brought my child to school placing every child and faculty member at risk."

"I am not an idiot," she said. "I am a well trained health care professional and I'm very capable of recognizing any signs or symptoms of sickness in my children."

Timeline of events

April 8, 9, 13, 14 Lizzie Campos is absent from school due to illness

April 15 The Campos family travels to Mexico

April 22 The Campos family returns from Mexico

April 23
■The U.S. Centers for Disease Control and Prevention announces human cases of swine influenza have been identified in California and Texas.
■ Lizzie is examined by her family doctor and is given a doctor’s note approving her return to school April 27.

April 27
■The Illinois Department of Health urges caution, and says people with flu-like symptoms who have traveled to areas where swine flu has been confirmed should seek medical attention.
■ Lizzie returns to school.

April 29 The IDPH announces nine probable cases of H1N1 flu in Illinois.

April 30
■Lizzie is seen in the nurse’s office. The school calls Campos at work inquiring if Lizzie has been tested for swine flu since returning from Mexico. Campos said she had been seen by the doctor and given permission to return to school, but had not been tested.
■ School calls Campos to pick up Lizzie to have her tested for influenza A-H1N1 (swine flu). The school said she complained of a headache, cough and had a temperature of 99.6. Campos said when she arrived Lizzie did not appear sick.
■ Campos takes Lizzie to the family doctor. The medical assistant calls the school because she is “asymptomatic” for the flu. Superintendent says she will not be allowed back until she is tested for swine flu. Doctor Luis Osorio writes a doctor’s order authorizing the test.
■ Lizzie is tested for swine flu at Advocate Hope Children’s Hospital. The test comes back negative.

May 1 The CDC and the Illinois Department of Public Health change swine flu testing guidelines. They recommend those with mild flu symptoms be treated without testing, to focus efforts on hospitalized patients with severe illness.

May 31 The Camposes receive a $2,031 bill from Advocate Christ Medical Center for Lizzie’s H1N1 flu test on April 30.

June 16 Campos writes a letter to the Board of Education requesting the district pay for the medical bills resulting from the flu testing.

July 17 Date School Board President Leandra Sedlack said the board will discuss Campos’ request for medical reimbursement


Editor's Note:

Any school district employee knows that if they tell a parent that their child needs to see a doctor for any reason, the district is responsible for the bill. It is something you learn the FIRST day on the job. That is why teachers can NEVER recommend that a parent take their child for testing of ANY kind. So why is this case any different?

This child WAS NOT SICK! She was barred from attending school until she received this test despite a phone call from her doctor stating SHE WAS NOT SICK! She was not even given the option to stay home for a few days, SHE WAS BARRED FROM SCHOOL!

We'd like to know how many families in our district went to Mexico (Cancun, Puerto Vallarta, Cozumel, etc.) over Spring break? Were their symptomless children required to have a swine flu test before their return to school like Lizzie Campos was?

Our school board and superintendent needs to DO THE RIGHT THING by apologizing and compensating the Campos family for the medical bill that was incurred due to this unnecessary test.

And please, don't say this was another OVERSIGHT!!