May marked the 23rd anniversary of the tragic passing of Nicholas Rosecrans, a San Diego toddler who wandered out of his daycare facility and drowned in the ungated pool of a neighboring house. In his honor EMS World, the RedFlash Group, and the California Paramedic Foundation created the Nicholas Rosecrans Award, to be given annually to individuals and organizations that make significant impact in preventing injury and illness.
In this interview Jason Smith, who directs the foundation’s prevention efforts, speaks with Nicholas’ mother, Lynn Artz. The 2019 Nicholas Rosecrans Award will be given on October 14 at EMS World Expo in New Orleans.
Jason Smith: I’d like to start with some background on Nicholas. I understand you were very proactive with his safety. Can you provide some context to the accident?
Lynn Artz: Yes. I took Nicholas’ safety very seriously. When he was younger, I had a dream of him drowning. Upon waking I went to check on him and found him sleeping peacefully. It was quite scary even though it wasn’t real. We had a pool at the home, and I had it fenced in the day before Nicholas began walking.
That must have been very scary.
Yes, it was! As a working mom, I placed him in daycare. I had picked a lovely daycare. A woman had started it at her home. They were incredibly responsive and had a good curriculum for the kids. They even baked their own bread. Nicholas was actually their first attendee, and he loved it there. Her home-schooled daughters treated him like a little brother. He was so loved. I couldn’t have asked for a better place.
The family that owned and ran the daycare had just moved into the home a few months before Nicholas started there. The home had a hot tub in the backyard, and I discussed my concerns with the owner. They were great and removed the entry stairs, covered the tub, and fenced it in. I felt very comfortable with their quick attention to the safety of their children.
Can you tell me about the morning of May 8, 1996?
On May 8 I took Nicholas to daycare. I gave him a big kiss and left him playing with a ball and stick. At about 10 a.m., I received a call at work from the daycare staff. They told me, “Nicholas is alive, the paramedics are with him. He fell into a pool.”
My immediate thought was, What pool?! I had never seen a pool on the premises. Well, it turned out the home for sale next door had the pool. There was no fence around it. The home didn’t have a permit to have a pool built there in the first place.
I later learned the details of what happened. Nicholas had been under the supervision of a young man while he and four other boys played in a grassy field with lots of trees. They called it “the orchard,” and Nicholas loved to play there. I recall the owner telling me about it and simply thought she had hired staff and was expanding. I was happy for her. By any account a 5-to-1 ratio at a daycare is pretty good.
Well, one of the boys was able to get out by pushing a gate open. As he ran off in one direction, a second boy ran in the opposite direction. The gentleman took off after them. By the time he had gathered the two boys and returned to the orchard, Nicholas had also run off. By the time they figured out he was not just hiding among the trees and began looking for him, he had already fallen in the pool.
One of the owner’s daughters provided CPR while they called 9-1-1. The paramedics arrived and took over CPR. They were able to get his heart started and stabilize him enough to transport him to the hospital. That was when they called me. My office manager drove me first to the daycare, where I screamed Nicholas’ name as I ran up the driveway. An officer met me before I reached him and told me he was to be transported to the hospital. I was allowed to come close enough to see the paramedics treating him on the porch. I grabbed his sopping-wet shoes and clutched them to my chest all the way to the children’s hospital to await the helicopter. The smell of chlorine still takes me back to that awful day.
Can you talk a little bit about the following hours and the tough decision your family faced?
Nicholas was placed on life support at the hospital. They medicated him so he would tolerate the breathing equipment while they performed tests to evaluate his brain function. After testing throughout the day, they came to us with the terrible results: Nicholas truly had no brain function. All that remained was the very primitive drive to breathe. They gave us the choice of keeping him on life support, with no likely change, or withdrawing care. We made the choice to withdraw care.
At about 10 p.m., when his sedation medication had worn off, he was removed from life support. I had the staff bring in a rocking chair, and Nicholas was put in my arms. I rocked him, kissed him, and sang an Irish lullaby. His gurgling, labored breathing soon stopped. I sat and held him for a long time.
That is incredibly moving. I’m so sorry for your loss. And you reached out to the paramedics who responded to the incident, correct?
That’s right. I had this strong, strong feeling that I needed to thank the first responders and paramedics who came to the daycare. This feeling continued for a month, so I found out who’d been working that day at the San Miguel station. I wrote them all individual letters and thanked them for the extra time they had given me with Nicholas.
How did this tragedy transition to the incredible prevention work you’ve helped support?
After the event I was hopeful something positive could come from it. I had truly done everything I could to prevent this kind of tragedy, but it still occurred. I wanted to help prevent this from happening to others.
Several months after Nicholas’ drowning, I happened to be the program chair for my sorority alumnae group. We had been looking for programming for our regular meetings. Someone suggested I speak with Roxanne Hoffman about presenting at a meeting. She was head of the Safe Kids Coalition in San Diego. The person had heard her presentations were fantastic, and so I asked her to attend our September meeting.
At the meeting Roxanne and I were chatting, and she said, “So I guess you know Paul Maxwell.” I replied, “No, I don’t. Who is he?” Roxanne told me Paul was one of the paramedics who’d responded to Nicholas’ drowning, and he’d been carrying around the letter I’d written to him.
She told me he’d actually responded to dozens of drownings that spring. He had contacted her asking for help. He was tired of responding to child drownings and wanted it to stop. Paul had started gathering statistics and data from his EMS system, data that was not previously available to the Safe Kids Coalition, to support legislation around pool safety.
That’s incredible. Were the efforts to change the pool-safety laws successful?
Yes. Laws were created that forced new homes to have safety features like fences. Unfortunately, they grandfathered pools built prior to the law, but it was a great success moving forward.
Tell me about EPIC Medics.
Well, a few months after the legislation effort, I was contacted by Paul. He wanted to let me know he’d found several other paramedics who were interested in working on child injury prevention. Together they had started the group Paramedics Eliminating Preventable Injury in Children, or EPIC Medics. They were going to create prevention programming around the pediatric injury statistics they’d gathered.
Do you feel paramedics and first responders help injury and illness programming be more effective?
Absolutely. They present a powerful image. These providers are authority figures the public knows are responding to these incidents firsthand. It works to convey the importance of these issues. When it comes to prevention these providers know, more than anybody, what types of incidents cause injury and illness in their communities. They show up and treat these problems.
It’s similar to how a firefighter shows up to a fire, then studies how it happened, then works to prevent that from happening in the future. Paramedics and EMTs are no different. They know what caused the injury or accident. Who better to work on prevention of those things?
Can you tell me how the Nicholas Rosecrans Award got started and your involvement with it?
It was Mother’s Day 2002. I had moved from San Diego County to Indianapolis. I received a call from Josh Krimston, a paramedic and founder of EPIC Medics. He told me they were creating an award to give to paramedics and firefighters who worked in injury prevention but were rarely recognized for their actions. He told me they wanted to name it after Nicholas. I was totally on board.
The first award was given that year, and the winner was quite fittingly a fire chief in Alaska who had created a life vest water safety program called Kids Don’t Float. I believe the program continues to this day. Incredibly, the chief was discouraged by critics who did not think the program would be successful and thought life vests would just be stolen. Well, it turned out the community actually donated life vests, and he successfully reduced drowning incidents by 60%. I thought it was a wonderful program to kick off the award.
The award has been given out each year since. Each year I attend the ceremony so I can physically hand the award to the winners. The act of giving the award is so meaningful to me. I am honored and grateful to be given that opportunity to recognize those individuals.
What does all of this prevention programming, from the Safe Kids Coalition to EPIC Medics and the Nicholas Rosecrans Award, mean to you?
The story of my son has had such an impact. I know my son, at 2 years old, has saved lives. And that means a lot to me. I had one mother tell me she’d been reading one of our articles. She came across the words There is no splash, which prompted her to check on her own child. She actually found him under water but immediately pulled him out, and he was fine! Nicholas’ story saved that life.
It makes me feel like his life and death had purpose. It wasn’t just a random tragedy. There was a reason. It meant something. It means my son didn’t die for nothing. There has been a positive change in his honor.
Do you have any advice for first responders interested in prevention?
Analyze your community. What types of incidents are you called to most? What types of things do you see on your incidents that you believe can be changed?
The list of previous award winners is a great place to look for solutions. The Nicholas Rosecrans Award has recognized programs working on everything from pediatric drowning to senior falls and teenage driver safety to drug abuser rehabilitation. Those winners will gladly share their knowledge and information with those looking to start something similar. In fact, it is one of the criteria of the award to share your program with others who wish to replicate your program in their community.
It’s also important to understand that you will face challenges. There are difficulties, such as convincing provider agencies to participate in programming. It takes motivated first responders and a community approach, but it is achievable!
Jason Smith leads the California Paramedic Foundation’s prevention programming. He is an experienced paramedic serving the rural communities of eastern San Diego County. His career has involved positions in both the prehospital and hospital realms. He also field-trains new paramedics and precepts paramedic students. Jason is heavily involved in the quality assurance aspects of his service.