Hit in Chest by Line Drive, a 12-Year-Old Player Remains in a Coma

By NATE SCHWEBER
Published: July 16, 2006 in New York Times

When Yankees third baseman Alex Rodriguez called 12-year-old Steven Domalewski, his father, Joe, answered.

Steven, Domalewski’s youngest son, has been in a coma at St. Joseph’s Regional Medical Center in Paterson, N.J., since his resuscitation early last month after a line drive to the chest off a metal bat stopped his heart.

But on July 3, Steven surprised his nurses by flexing the muscles in his left arm on command.

Steven, clad in a blue hospital gown and lying next to a poster of Rodriguez, had not been able to follow the simple prompt 20 minutes earlier. Then Sandra Maiorano, director of nursing at the International Brain Research Foundation, attached two electrodes to his right forearm and began sending electric impulses to increase oxygen flow to his brain.

“We had an immediate response,” Maiorano said.

Doctors at St. Joseph’s did not return calls seeking information on Steven’s condition.

Dr. Philip A. DeFina, founder and chief executive of the foundation, said he was cautiously optimistic about Steven’s recovery.

In the past year, doctors affiliated with the foundation used the same techniques to bring a 65-year-old man and a 41-year-old woman out of comas, DeFina said. Steven is much younger, so his chances of a full recovery are far better, DeFina said.

On June 6, Steven was hit by a line drive during a Police Athletic League baseball game in Wayne, N.J. He sustained commotio cordis, a rare and often fatal disruption of the heart’s electrical system caused by a sharp impact to the chest at a precise moment between heartbeats.

Steven Yabek, a pediatric cardiologist in Albuquerque who has written extensively about commotio cordis, said that of almost 140 cases reported to a national registry in Minneapolis — most since the early 1990’s — about 15 percent of the patients survived.

DeFina, whose teenage daughter piqued his interest when she showed him a newspaper article about Steven, said Thursday that Steven was still in a persistent vegetative state, but that he was slowly improving.

When DeFina visited the hospital on July 3, Steven squeezed his hand. Steven also turned his eyes toward voices in the room, and he was keeping his eyes open longer.

The difference in Steven’s condition between visits four days apart was “pretty significant,” DeFina said.

The International Brain Research Foundation, which works with Bellevue Hospital Center, is a privately financed organization of doctors and researchers. They are treating Steven at no charge, DeFina said.

Steven is undergoing physical therapy to maintain his range of motion and muscle mass, his aunt Marie Fullerton said. His father continually moves Steven’s limbs, she added.

Steven’s mother, Nancy Domalewski, has also kept a vigil by his bedside, often massaging his legs, Fullerton said.

Doctors from the foundation advised the Domalewskis to surround Steven with familiar sights and sounds to stimulate his brain. His hospital room is decorated with pictures of friends and filled with stuffed animals from well-wishers, Fullerton said.

When she visited Steven recently, she watched a video made by his seventh-grade classmates at Anthony Wayne Middle School four times. Several of Steven’s friends visited and sang a song, causing Steven’s eyes to well with tears; DeFina was encouraged by that emotional response.

Steven also started a nutritional regimen of B-12 vitamins and fish oils rich in omega-3 fatty acids, which are believed to repair brain damage, DeFina said. He also takes medication to slow the transmission of natural sedative chemicals like endorphin, which is common in coma patients, and increase the transmission of chemicals like dopamine, DeFina said.

The mix of vitamins and medication was developed by Dr. Julian Bales, chief of neurosurgery at West Virginia University Medical Center. Bales used the same regimen to help Randal McCloy Jr., the lone coal miner who survived the Sago Mine disaster in January.

DeFina said, “I don’t want to give a time frame, but if Steven continues with the improvement at the same rate that’s occurring this early, we’re confident that he will definitely recover.”

One man who is pulling for Steven’s recovery is Rodriguez, who called him from Manager Joe Torre’s office on June 28 after hitting a game-winning home run in the 12th inning against the Atlanta Braves. Rodriguez told Joe Domalewski that he hoped Steven could soon be his guest at Yankee Stadium and meet the team, said Rick Cerrone, senior director of media relations for the Yankees. Joe Domalewski told Rodriguez that it was not a good time.

“Alex is basically waiting for Joe to call and say, ‘Now it’s a good time to call,’ ” Cerrone said.