No one -- not her teacher, not her mom, not the school nurse, not the paramedics -- could initially explain why Meaghan Levy, an otherwise healthy kindergartener at Frisco's Corbell Elementary, suddenly collapsed to the floor as her class walked to the library on the morning of December 12. She had no history of medical problems and no known allergies. The night before was normal -- a trip to the grocery store with her mom and siblings, a dinner of turkey tacos, a run-through of Finding Nemo before bed -- as was the morning. She was in good spirits when she was dropped off at school in her white shirt and jean jacket, and she was typically cheerful as her class set out for the library an hour-and-a-half later. When Fox 4 reported on the death the next week, they could say for certain only that Meaghan "became ill."
The actual cause of death was suggested by X-rays doctors at Children's Medical Center at Legacy as they frantically tried to save Meaghan's life, and confirmed a month later by the Collin County Medical Examiner: asphyxiation by pushpin.
For Meaghan's mother, Nicole Kennedy, and her aunt, Erika Kennedy, the past five months have eroded some of the initial shock of losing a child 11 days before her 6th birthday. But they've done little to ease their despair.
Though Frisco ISD and Frisco police have closed their respective investigations and ruled the death an accident, the Kennedy sisters have questions: Why didn't Meaghan's teacher have CPR training? Why did the oxygen bottle pumping air into her lungs while paramedics were en route malfunction, sending the school nurse to the hospital? Why were pushpins allowed within a kindergartener's reach in the first place?
In an emailed response to questions posed by Unfair Park, Frisco ISD spokeswoman Shana Wortham said no employees have been disciplined and no policy changes have been made in the wake of Meaghan's death. Teachers are still encouraged, but not required, to take CPR training as part of their professional development regimen, and no move has been made to bar pushpins from Frisco ISD kindergarten classes.
"The hearts of the staff and students at the campus and the District continue to go out to the family," Wortham wrote. "It was a tragic loss for all those who knew and loved her."
Tragic particularly because it was avoidable. Pushpin deaths seem to be relatively rare, but they're hardly unheard of. Within two months of each other in 2011, children in Louisville, Kentucky and Oceanside, California choked to death on pushpins, their plastic bases just the right size to lodge in a young child's trachea. Even when they're fully inhaled, they pose a painful challenge, the sharp point making them a nightmare to remove from the lungs.
Even after Meaghan began choking on the pushpin, there appears to be room for a quicker, more effective response. According to a Frisco PD incident report, the first indication that something was wrong came when Meaghan approached her teacher in the hallway with her hands to her throat, appearing as if she couldn't breath. (A video camera in the hallway captured Meaghan choking from afar, but does not show when or how she obtained the pushpin.)
The teacher's response was to lead the girl to the nurse's office, but Meaghan collapsed before they reached the door. Two parent volunteers happened to be standing nearby and helped carry Meaghan into the nurse's office, by which time her face was turning blue. One of the volunteers performed the Heimlich maneuver -- unsuccessfully, he told police. The nurse began CPR.
During the course of CPR, the nurse began to use one of the portable medical emergency oxygen units Frisco ISD provides at all its campuses. As she delivered the oxygen, the tank malfunctioned, spraying the nurse with a chemical -- a caustic substance similar to soda ash -- and sending her to the hospital.
Something similar happened in September when the school nurse at Frisco's Lone Star High School attempted to administer oxygen to a student. The tank exploded, according to media reports, spraying the nurse, a student, three firefighters and an assistant principal with the chemical and sending them to the hospital.
Wortham says the oxygen units are designed, manufactured and distributed by Frisco-based Oxysure.
"The portable oxygen is another tool available to our personnel to use in a medical situation until paramedics arrive," she writes. "The District usually also has AEDs at every facility."
Wortham did not address why the unit malfunctioned, when it was last inspected or whether the twin cases of malfunctioning oxygen tanks has prompted the district to enact any changes. She prefaced her responses with a note that "the District's comments are limited since we are unsure of legal action being considered."
Oxysure said in a statement that its product worked properly in Meaghan's case and in others.
"The cause of this tragedy appears to the be accidental swallowing of a pushpin and is unrelated to our product," the company said. "We are unclear as to why we are being brought into it."
FISD, the statement continues, "has hundreds of our units, and has successfully used the product in hundreds of saves since 2008."
The media reports last fall were inaccurate. The Oxysure unit is not a "tank" and is not "compressed." It's easy to confuse our product with traditional oxygen units, since that's closer to the public's frame of reference.
Our product is break-through, safe, accessible, life-safing technology and we work hard every day to re-frame the mindset around supplemental oxygen. Our job is to re-educate the public around this product since it's breakthrough technology.
Bottom line is, OxySure units contain inert powders that, when deployed, provide medically safe and pure oxygen. OxySure saves lives.
Frisco ISD would have been responsible for inspecting the units, the company said.
Paramedics arrived soon after the oxygen tank malfunctioned and took Meaghan to the hospital. After doctors discovered the pushpin, they decided she needed to be airlifted to the Children's Medical Center of Dallas. Before they could load her on the helicopter, however, her condition worsened.
"After several minutes of intense care," the police report says, "the lead doctor came into the hallway and notified the family that Meaghan had died."
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It's not clear from the police report or autopsy that a properly functioning oxygen tank or a teacher trained to provide CPR would have saved Meaghan. But those are big "what ifs" -- too big, say the Kennedy sisters. They hope Meaghan's death can still prompt changes at Frisco ISD: a ban on pushpins; mandatory CPR training for teachers; a better system to ensure the emergency medical equipment is in proper working order.
As much as anything, they want to raise awareness: Beware of kids and pushpins.
This post has been updated with a response from Oxysure
Send your story tips to the author, Eric Nicholson.