Two-year-old Malachi Hackworth never shies from the spotlight. The Jacksonville toddler is the first to grab the microphone to sing with the choir at his grandfather’s church, and he loves banging on the drum set he got for Christmas. Like most tots, Malachi is full of energy and is constantly running around.
So it’s not surprising that Malachi, like every little kid, has taken a tumble or two in his life. But the fall he took on Dec. 14, 2020, wasn’t like the others.
“Initially I just thought he had fallen and bumped his head,” said Kristin Hackworth, Malachi’s mother. “Never did I think it would be so serious.”
Crisis on the court
Malachi, Kristin, and Malachi’s father, Derrick Mincey, had planned to spend the afternoon at a nearby park. Kristin and Derrick walked, pushing Malachi in a stroller. The family headed straight to the basketball court when they arrived.
The three started playing, with Malachi using his own child-sized basketball. Derrick went up for a jump shot just as Malachi suddenly darted behind him. As Derrick landed, he accidentally knocked the little boy to the ground.
“Malachi started crying and we immediately just tried console him and help him calm down,” Kristin remembered.
A tumble becomes a trauma
The family decided to head home right away.
“Malachi was in his stroller, and when we got about halfway home, he reached up, signaling he wanted Derrick to hold him,” Kristin said. “He put his head down on my husband’s shoulder, like he was getting sleepy, which made me nervous because I know you’re not supposed to let a baby sleep after bumping his head. His eyes were open, but they were just kind of blankly staring ahead. And then he started to throw up, and I knew something wasn’t right.”
Not wanting to waste a minute, the family hopped straight into the car when they got home and drove to find emergency help. Kristin was behind the wheel while her husband rode in the back with Malachi.
“I could hear Derrick and he was almost in tears, saying, ‘Malachi, wake up!’ And my husband isn’t an emotional person. So to hear that made me even more scared,” Kristin said.
Terrified and frantic, Kristin pulled into the first medical facility she could find, an urgent care clinic. When the staff saw Malachi needed immediate care to save his life, they called 911 to transport Malachi to Wolfson Children’s Hospital of Jacksonville’s Pediatric Trauma Center.
A team to treat Malachi
Because of its designation as the area’s only state-designated Pediatric Trauma Center, Wolfson Children’s Hospital had a multidisciplinary team of physician and clinical specialists ready and waiting for Malachi when he arrived. The Trauma Team includes a pediatric emergency medicine physician, pediatric surgeon, pediatric anesthesiologist, pediatric critical care physician and pediatric neurosurgeon, in addition to pediatric emergency nurses. Other specialists are on-call around-the-clock and able to arrive at a moment’s notice.
One of the physicians in the hospital that evening was Robert Letton, Jr., MD, board-certified pediatric surgeon and surgeon-in-chief at Wolfson Children’s Hospital and chair of the department of Surgery at Nemours Children’s Specialty Care, Jacksonville. Dr. Letton and his team put Malachi on a ventilator to help with breathing to ensure the toddler’s brain continued to receive oxygen, and quickly brought him to a CT scan to check for brain and skull injuries. He also alerted the pediatric neurosurgeon on-call of Malachi’s case.
“Luckily, the CT scan showed he didn’t have a brain bleed or skull fracture, which was good news,” Dr. Letton said. “With traumatic head injuries, though, the biggest concern is a buildup of carbon dioxide in the bloodstream, which occurs when a child stops breathing but the heart continues beating. This can affect blood flow to the brain and can cause death when left untreated. That’s why it was so important to make sure he got on the ventilator, so he continued breathing.”
In critical condition, Malachi was transferred from the Trauma Center to the Pediatric Intensive Care Unit (PICU) and the care of Thomas Nakagawa, MD, a pediatric critical care specialist and medical director of the PICU, and professor in the department of Pediatrics with the UF College of Medicine – Jacksonville.
“In the PICU, Malachi required very close monitoring and ongoing care because his condition could deteriorate at any time,” said Dr. Nakagawa. “We kept him on the ventilator, continued to provide medications to treat the suspected trauma-induced seizure Malachi had while in the Emergency Department, and continually monitored the electrical activity of his brain using electroencephalogram (EEG) to make sure there was no abnormal brain activity that could further worsen his injury.”
Head injuries, Dr. Nakagawa said, are the most common cause of disability and death in children. The highly trained PICU team – which includes physician specialists, nurses, respiratory therapists and other medical professionals – are experts in treating the most complex injuries and critical illnesses in children of all ages.
Thankfully, in Malachi’s case, his parents acted quickly and got him to life-saving care before this accident turned into tragedy.
“If his parents hadn’t recognized that this was a true emergency, he may have fallen asleep, stopped breathing and never woken up,” Dr. Letton said.
“They did everything right.”
Malachi spent one night in the PICU. During that time, his condition improved and he was able to breathe without the ventilator. Malachi was then transferred to Wolfson Children’s Neuroscience Unit and was able to go home two days after his fall.
“He’s back to his normal, busy self,” Kristin said. “It’s a miracle.”
Moved by the way the team at Wolfson Children’s treated not only Malachi, but also herself and her husband, Kristin sent flowers and a card to the hospital to show their gratitude to the team.
“I wish there was more I could do to thank them, but there is nothing that would equal what they gave back to us,” she said. “The doctors and nurses who treated Malachi were doing God’s work. They did everything right.”
When Kristin, Derrick and Malachi set out for the park on that December afternoon, they never predicted the day would end in the hospital. And while their paths were yet to cross, the team who saved Malachi was ready for him before he ever stepped onto the basketball court.
“While most families fortunately will never require our services, it’s reassuring to know we are here to take care of any child should a life-threatening event occur that requires specialized care,” said Dr. Nakagawa. “We love kids, we care for kids, and we do it well!”
Minutes matter in a life-threatening emergency. Wolfson Children’s Hospital has pediatric specialists ready around-the-clock to treat the most serious injuries. For more information on Wolfson Children’s Emergency and Trauma services, visit wolfsonchildrens.com/emergency.