Caring for Carter

Raising awareness on fatal gastronomy tube (g-tube) complications​

In loving memory of Carter Jay William Anderson
Beloved son, brother, grandson, great-grandson, nephew, great-nephew, cousin, and friend.



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Carter didn’t pass away due to the symptoms or complications of his genetic disorder, he died because an experienced GI doctor and fellow at a well-known hospital used excessive force while dilating his g-tube tract creating a false tract. In addition, they didn’t check to see if the g-tube they replaced was back in his stomach and sent him home. Instead of nutrients going into his stomach, the false tract resulted in the pumping of over 550 cc of food and medicine into his peritoneal cavity. Please read Carter’s story below and share with those who are thinking about getting a feeding tube and caregivers, healthcare professionals, or school employees who care for someone with a g-tube. Due to Carter’s disorder, he was unable to feed himself or drink independently but he ate purees fine and drank from a bottle very well with caregiver assistance. Carter’s caregivers were able to feed him orally until the age of 9. When Carter started having difficulty drinking his bottle, a swallow study was ordered. It was found that Carter was slightly aspirating on nectar-thick consistencies. Therefore, the talk of “safer alternatives” began, including feeding tubes. On February 14th, 2018, Carter had his temporary PEG tube placed and did very well with it. Then on May 16th, 2018 Carter had his Mic-Key balloon g-tube placed. Again, the procedure went well and at this time Carter had gained 14 lbs since the initial placement of his PEG tube in February. Sometime within the late evening/early morning of May 31st, 2018 Carter’s g-tube became dislodged (came out). His mom tried to place a catheter in the tract (in order to keep the tract open until a new tube could be placed) at their home when they awoke that morning but was unsuccessful. The GI provider at a well-known hospital, then instructed them to go to the ER. In the medical report from that day, it was noted that Carter was alert, interactive, making verbal noises, was moving all extremities and vitals and physical examination were reported to be “unremarkable” in the ER. The physician assistant attempted to replace his Mic-Key tube but was unsuccessful as the tract had narrowed quite a bit due to how long it had been out. The catheter was replaced, as it is smaller than the tube (the catheter placed by the PA was in the right place as stomach contents were seen), in order to keep the stoma open and GI was consulted.

When the pediatric GI arrived, he had a Sports Medicine fellow with him. The pediatric GI provider, who has decades of experience, instructed the Sports Medicine fellow to use hegar dilators on Carter to dilate the tract to 5mm. While dilating with the hegars, she was very rough and aggressive (really pocking and jabbing). *In a Medscape article that I read, it states “Aggressive probing should be avoided, as a false tract can be created.” (Schraga, 2018) Never force the tube! The GI provider in the room, who has over 30 years of experience didn’t say a word about how aggressive she was. After the fellow was done doing this to Carter, she was instructed to put in his new 14 Fr 2.5 cm Mic-Key balloon tube at bedside in the ER. The nurse asked the GI provider and fellow if they wanted to do contrast (a way to confirm the placement of the tube into the stomach) and they said, “No”. Carter’s discomfort after the procedure was noted and he was monitored for a few moments. After a few minutes, Carter was given ibuprofen for “discomfort” and sent home. Carter was happy, smiling, cooing, and doing well up until this day. When he passed away suddenly on Friday, June 1st, 2018 (a little over 24 hours after this procedure), our family knew something wasn’t right. An autopsy was performed and it found that Carter died due to the complications from a misplaced percutaneous endoscopic gastrostomy feeding tube as the tip of the PEG tube was present within the peritoneal cavity. The GI provider who instructed the fellow that day, overseeing the whole procedure, has called Carter’s mom several times apologizing for what happened and even stated, “when we tried to dilate, we must have made a false opening.” Carter would still be here today if it wasn’t for the negligence of these healthcare providers. PLEASE, PLEASE share this story with others so that this doesn’t happen to another child. It would have only taken minutes to make sure the g-tube was back in his stomach. Carter’s last hours were more than likely filled with severe pain and discomfort as associated with the misplaced PEG tube was acute peritonitis (Due to Carter being nonverbal, he was unable to verbally state how he was feeling) and they caused our family, friends, and others who cared for Carter immense pain, grief, and a void that will last forever as a result of the decisions they made that day. It is disturbing that the provider and fellow who were responsible for the death of Carter aren’t being held accountable. It is disturbing that this is supposed to be one of the best “teaching hospitals”, yet the fellow was TAUGHT to cut corners, that using excessive force to dilate a tract is OK, and that you don’t need to confirm the placement of a tube you just replaced. Since she has no idea what she did, I pray that she never replaces a g-tube again. It is disturbing that an experienced pediatric GI provider didn’t use his years of experience and do the right thing and that he will more than likely perform this same procedure on many other sweet and innocent children.
Schraga, E.D.(2018). Gastrostomy tube replacement technique. Medscape. Retrieved from:

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Gastrostomy Tube Replacement Technique

This is the headinga

A Guide to the Management of Common Gastrostomy and Gastrojejunostomy Tube Problems

Gastrostomy Tube Complications

Malposition of percutaneous endoscopic-guided gastrostomy: Guideline and management

Management of G-tubes & buttons: Scroll to Red Flags slide for signs of Peritonitis, device in wrong place, and feeding intolerance.

This is the heading

Percutaneous Endoscopic Gastrostomy Tube Replacement Unexpected Serious Events.

(This is the link to the Wiley Online Library article abstract where you can pay a fee for either 48 hour access, read-only, or full text and PDF Download)

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Non-Communicating Children’s Pain Checklist – Revised (NCCPC-R) assessment. You can also find it by typing the name of the assessment in Google. Have those who work with and/or take care of your child look at this. If they notice anything abnormal instruct them to call you immediately; especially, after a procedure.