The family of Michael Stuyvesant knows he beat the odds on a hot June day six years ago when he survived being accidentally left in the mini-van parked outside their Garland home.

Michael, 3 years old at the time, experienced brain swelling, seizures and other trauma caused when his body overheated. He was hospitalized for 10 days – three of them in intensive care – and then spent almost a month in a rehabilitation facility. Michael had to relearn skills such as walking, eating and playing.

His father says Michael still deals with short-term memory loss. But the Stuyvesants count themselves lucky that he didn’t die in the accident. On average, 39 children in the United States suffer fatal injuries every year from what’s known as pediatric vehicular heatstroke, a tragic and preventable danger. Four children have died so far in 2021 as of mid-June.

Eric Stuyvesant wishes his vehicle had been equipped with a device to remind him that Michael was asleep in the car seat that day in 2015. Some type of alarm “would have saved a lot of anguish, tears and heartache,” he said.

Legislation introduced last month in the U.S. Congress would require automakers to install technology that detects a backseat occupant, and then alerts the driver. The Hot Cars Act would make the technology a standard safety feature in every new passenger vehicle. The legislation calls for sensors and warning systems in an effort to protect unattended children and pets.

Here’s an example, a rear-seat reminder: If someone opens and closes a car’s back door within 10 minutes of starting the ignition, an alert will activate later whenever the vehicle shuts off. The alert chimes and a message on the instrument panel tell the driver to check for backseat riders. Supporters of the Hot Cars Act draw comparisons to other technology mandated over the years for auto safety, such as seatbelt reminders and levers for emergency release in trunks.

Chad Hamner, M.D., pediatric surgeon and trauma medical director at Cook Children’s, believes in the potential benefit of such devices whenever parents and caregivers unintentionally leave their little passengers behind.

 “It’s not a sign that you’re an unintelligent person or forgetful. It just happens,” Dr. Hamner said. “We get in a routine or we’re thinking about other things. It’s natural human behavior.”

When it comes to excessive heat, infants and young children are particularly at risk. Their bodies heat up five times faster than an adult in the same environment as a result of a larger surface area relative to body mass for heat exchange with their surroundings. Infants are at exceptional risk as they also have an immature temperature regulatory system.

What happens during heatstroke? Dr. Hamner said profuse sweating leads to loss of water and electrolytes, which can rapidly produce dehydration. A severely dehydrated child can’t maintain adequate blood pressure to support the delivery of oxygen and nutrients to their vital organs. According to Dr. Hamner, eventually heat stroke results in cardiovascular collapse and damage to muscles, the kidneys, the intestines and the brain. In the emergency department, the staff works fast to bring down the body temperature and replace lost fluids and lost electrolytes.

 Symptoms of hyperthermia include rapid pulse, shallow breathing, flushed skin, high fever, vomiting, dizziness, confusion and loss of consciousness. Organs start shutting down when the body core temperature reaches 104 degrees, said Sharon Evans, trauma injury prevention coordinator at Cook Children’s.

“Usually by the time the child is found (in a hot car), they‘re dead. They rarely even make it to the hospital,” she said.

Texas leads the nation in the most fatalities, with 132 since 1998, including five last year. Evans said public awareness campaigns in the state have made a difference. But she also favors the implementation of more technology, such as devices that detect motion or breathing in the back seat. She supports the Hot Cars Act.

Experts want caregivers and bystanders to know: 

1. Never leave a child unattended in a vehicle, not even for a second, even with the windows cracked and the air conditioning on.
2. Create a habit of checking the back and front seats before you walk away from the vehicle.
3. As a reminder, place something essential -- your purse, briefcase, shoe or other personal items -- next to the child during the drive.
4. Teach your children that a vehicle is not a play area. Keep the doors locked, even if the car is in the garage. Keep the keys out of reach.
5. If you see a child alone in a car, try to get him out. Call 911.

State law in Texas gives liability protection to anyone who forcibly enters a locked vehicle (by breaking a window, for instance) to reach a vulnerable person inside who faces imminent harm. State law also protects the confidentiality of anyone who calls to report suspected child abuse or neglect.

Statistics kept by the advocacy groups KidsandCars.org show July as the deadliest month for pediatric heatstroke. Even in milder weather, the temperatures inside a vehicle can quickly climb to a hazardous level. Studies found that in just 10 minutes a car’s internal temperature rises 19 degrees. To put it another way … 80 degrees outside, but a sweltering 99 degrees for anyone inside the vehicle.

KidsandCars.org keeps track of pediatric vehicular heatstroke in three main categories: A caregiver forgets the child (55% of cases), the child gets into the car on his or her own (26%), and someone leaves the child in the car deliberately (14%). A common thread in many instances is a deviation in the family’s routine on the day of the accident.

That’s what happened to the Stuyvesants on June 10, 2015. Eric Stuyvesant normally dropped off Michael at daycare and then drove his wife Michelle to work. But this particular day, to get Michelle to work earlier, he drove her to the office first with the intention of stopping off at daycare on the way back. But the phone rang, autopilot kicked in, and he forgot about Michael.

“I drove down to my regular exit, drove home, finished my phone call, went in the house and cooked my breakfast,” Stuyvesant said. “About 45 minutes later I remembered we hadn’t been to the babysitter.” He found his son “barely hanging on.”

He rushed Michael into a cold shower, gave him mouth-to-mouth resuscitation and put an ice pack on his carotid artery while waiting on paramedics to arrive. At the hospital, doctors put the boy into a coma to reduce swelling in his brain. Recovery wasn’t easy.

Stuyvesant and others emphasize that heatstroke accidents can happen to anyone. Because of what his family went through, Stuyvesant now makes the case for all new cars to come equipped with the features that the Hot Cars Act endorses.

“If we have technology in our vehicles that remind us that our cell phone is plugged in, our headlights are on, our turn signal has been blinking for awhile, we ought to have technology that remind us we forgot where we are and we need to turn around and go to the babysitter.”

“She was always so happy. Everybody was her friend,” said Mary, Julia’s adoptive mother. “She did not know a stranger.”

Julia was the kind of person who trusted people easily. So years later, when a young woman reached out to her on social media, she didn’t think much about the individual wanting to be her friend. She began to correspond and eventually started meeting her at a local park where Julia liked to skateboard.

“We were so protective of her, and only started letting her go to the park by herself when she was 17,” said Mary. “Still, I would drive around to check on her. She would always say, ‘Mom, why are you always worrying?’ I would tell her, ‘That’s my job.’”

Mary was worried about the new friend in Julia’s life. Something seemed off. But, like most teenagers, Julia didn’t want to listen to her parents. After all, she had finished high school early and was working toward her dream job as a nursing assistant. Julia completed school in December, but hadn’t graduated yet. It was the week of prom when Mary last heard her daughter’s voice.

“She called me after her job interview and told me how it went, and then she said, ‘I’m going to stay with my friend for a couple of days, but I’ll be back in time to do prom stuff later this week,’” said Mary.

At the time, Julia was 18 and Mary knew she couldn’t tell her daughter what to do. Still, she didn’t like the plan.

“I said, ‘Okay, I can’t tell you not to, but I don’t want you to go,” she explained.

At 7:30 the next morning, two state troopers arrived at Mary’s home. They told her and her husband that Julia’s body had been found on a tollway in Dallas. From there, the truth about Julia’s friend unraveled. She was what law enforcement officials call a “bottom girl,” someone who manipulates and baits vulnerable victims into human trafficking. It turned out that Julia’s ‘friend’ had been paid by a human trafficking ringleader to deliver the teen for commercial sex trade. Mary believes Julia was thrown out of the vehicle when she would not comply.

Julia died on May 2, 2018, just 20 days before her graduation.

“Two hours later, my phone rang. It was the person who interviewed Julia calling to let her know she got the job,” said Mary. “That broke my heart all over again.”

This month, a grand jury in Collin County is expected to hear the case against the ringleader charged in Julia’s death. If the grand jury decides to indict, Mary says it will be the first ‘Death by Human Trafficking’ trial in Texas.

Mary and Chris are hoping their daughter’s death can save the lives of others. Working with Rep. DeWayne Burns, R-Cleburne, they’ve created a bill that, if signed into law, will require driver’s education students across Texas to be educated about human trafficking. It’s called ‘Julia’s Act.’

On April 7, Julia’s family testified in favor of the act in front of the House Committee on Licensing and Administrative Procedures. In an uncommon move, the act was voted out of the committee the same day, setting forth a high probability it will move to the full Texas House for a vote.

“People need education. They have to know that this happens. I wasn’t educated, and now I’m looking every day to see what else I can learn,” said Mary. “I felt like, if we could get it into the schools, then maybe kids would listen since it’s coming from someone else besides their parents.”

What is Human Trafficking?

A lot of confusion exists about human trafficking. It is not the same as human smuggling, and it rarely involves victims being kidnapped at random. Human trafficking is the process of “trapping people through the use of violence, deception or coercion and exploiting them for financial or personal gain.” Trafficking victims can be exploited for sex and/or labor. It occurs anytime anything of value is exchanged for sex, such as money, food, shelter or gifts.

At Cook Children’s Medical Center, the Child Advocacy Resources and Evaluation (CARE) Team treats human trafficking victims under the age of 17.

“Usually, these are kids who have already been abused. They may have a history of sexual abuse, or are runaways because they don’t have a stable home or are in foster care,” explained Stacey Henley, RN, nurse manager of the CARE Team. “We also see a lot of LGBTQ kids whose parents kicked them out because of their sexual orientation.”

Henley describes human traffickers as ‘master manipulators’ who prey on the vulnerable.

“They are really, really good at understanding human needs and behaviors,” said Henley. “I know that sounds crazy to say, but they are looking at what the person needs, whether it’s love, food or a place to live and they’re fulfilling that need.”

She says knowing how many human trafficking victims are out there is nearly impossible because it’s heavily underreported. Part of the issue is that those being exploited often don’t see themselves as victims.

“A lot of times, the victim will say the trafficker is their boyfriend. They’re being manipulated, which is part of the problem because often teachers and medical professionals are looking for someone who’s wide-eyed and mouthing, ‘Help me,’ but that’s not what happens,” Henley said. “They’re not going to say, ‘I need help, get me out of this,’ so we have to look for other clues.”

To aid with this, Henley is leading the implementation of a child sex trafficking screening tool currently in use at Cook Children’s. Her hope is that a few questions asked by clinical therapists may uncover victims hiding in plain sight.

She also points out that human trafficking is a form of child abuse and should be treated as such. Sadly, the CARE Team has seen many cases of parents trafficking their own children, usually for drugs.

“It’s really sad. The best thing we can do is get them into a stable environment and help them get the resources they need for counseling,” said Henley.

Taking Down Predators

The Human Trafficking Unit at the Tarrant County Sheriff’s Department is dedicated to taking as many predators off the streets as possible. With three investigators and a lieutenant, the unit carries out operations each month focused on helping victims and arresting human traffickers and their clients.

“When we find people who are being trafficked, we look at them as victims and set them up with an organization called Unbound Fort Worth that will help them get out of that situation,” said Detective Chris Jarvis, an investigator on the Human Trafficking Unit.

The unit also performs operations focused on the online solicitation of minors, in which they go undercover online posing as children. Detective Jarvis says they regularly catch adults who are trying to solicit sex from kids on the internet.

“Parents need to be involved with what their child is doing online,” he said. “Check their phones, make sure you’re reading their messages and know who they are talking to.”

He says some of the apps that predators use most often include:

• Facebook
• Kik
• Instagram
• Whisper
• Grindr
• Skout
• Meet me

“These are some of the biggest sites that children get on. People can go on there and talk to your child. The more experienced ones can actually find locations, even without asking,” said Detective Jarvis.

This situation is not unusual to the CARE Team at Cook Children’s. Though not always through human trafficking, young patients are frequently seen after being sexually assaulted by an adult they met online.

“I recently saw a victim who met a man on Whisper. It happens, and parents need to be looking for these apps on their kids’ phones,” said Henley.

If lured into human trafficking, Detective Jarvis says it can be extremely difficult to escape. He says traffickers isolate victims from friends and family members, take them to places that are unfamiliar and watch everything they do. They also tattoo victims as a way to brand them. Common human trafficking tattoos include bar codes, lips, cartoon characters, initials and crowns.

Life expectancy for human trafficking victims is much lower than the average person. They’re often murdered or suffer the detriments of drug use and sexually transmitted diseases. That’s why it’s so important to get victims the help they need to overcome the manipulation, which often involves long-term counseling.

A Problem Everywhere

Christi Thornhill, APRN, director of the Trauma Program at Cook Children’s travels all over Texas speaking to medical professionals about human trafficking. She says there’s not a place she’s been that hasn’t seen this problem.

“Before I speak to a group, I always Google ‘human trafficking’ and the name of the town and it never fails,” said Thornhill. “I was in Mineola, Texas, with a population of 5,000 and found an article about a bust.”

She’s also seen victims from upper-class communities like Southlake and agrees that the hardest part about this crime is the manipulation piece.

“We’ve had people from all walks of life arrested for paying for sex with young victims. Police officers, judges, coaches, doctors, clergy members, teachers. Do you really think these kids are going to tell anyone?” she said.

Thornhill points out that believing claims of sexual abuse is one of the key things that people can do to prevent a child from falling into human trafficking. She says children who are sexually abused, but not believed by their adult caretaker, stand to suffer mentally, including loss of self-esteem and self-worth, making them easy prey for traffickers.

In addition to monitoring what children and teens are doing online, parents need to know who their kids are hanging out with.

“We’ve seen cases where kids are being recruited in schools, so it’s really important to be aware of what your child is doing and who they are friends with,” said Detective Jarvis.

It’s also important to note that not all trafficking victims are runaways or missing. The CARE Team at Cook Children’s has seen cases where kids are being trafficked while still living at home with their parents.

“I’ve seen kids who have been trafficked after school, but still make it home and sleep in their own bed at night,” said Henley. “When someone is profiting from someone else having sex with a child, that’s trafficking.”

Fighting Back

You can help deter human trafficking by keeping an eye on your neighborhood. Watch for suspicious activity such as multiple cars coming and going from homes, as well as different people at all times. If you see something strange, call the police.

Red flags to watch out for in kids include:

• Missing school
• Changes in demeanor and attitude
• Odd tattoos
• Seeming like they can’t make a decision or are being controlled

“It takes a community to keep an eye out and be aware of this,” said Detective Jarvis. “We can’t do it alone.”

As for Julia’s parents, they are continuing their push for human trafficking education and hoping to extend the requirement for all state license holders. They’re also hoping to enact stiffer penalties for those convicted of human trafficking.

“The thing that really got me is that we are in a small town,” said Mary. “But going through the process and learning what I’ve learned, it doesn’t matter where you live. These people are looking for anyone willing to talk to them, and they prey on the brokenhearted.”

The first Texas dispensaries are now opening and selling their products to eligible patients across the state. But Texans who are interested in pursuing the so-called CBD oil treatment say there are several obstacles to getting the medicine.

There’s roughly 30 doctors across the state eligible to prescribe the medicine. Also, CBD oil is still federally illegal, so people have to pay out of pocket to secure it. And there are only three Texas dispensaries who can sell the medicine — two in Austin and one in Schulenburg.

In this video documentary, The Texas Tribune followed two families as they began their journey in pursuing medical cannabis treatment.

Full story here.

Last year, 24 kids died in the U.S. and from 1998 to present, 676 children have died.

“What’s heartbreaking is that this is a serious public health issue that is totally preventable,” said Dana Walraven, Community Health Outreach manager at Cook Children’s and Safe Kids Tarrant County Coordinator. “Every mom and dad out there must realize it can happen to you. Texas leads the nation in child heat-related car deaths.”

Parents may mistakenly think they can safely leave a child in a vehicle for a “quick” errand, but that’s simply not true. Temperatures inside the car can be 20 or more degrees hotter than the temperature outside, rising to dangerous levels in minutes. Unfortunately, it only takes a few minutes for tragedy to occur.

Safe Kids Worldwide says that heatstroke is the leading cause of non-crash, vehicle-related deaths for children.

“Heat is much more dangerous to children than it is to adults,” Walraven said. “When left in a hot vehicle, a young child’s core body temperature may increase 3 to 5 times faster than that of an adult. This could cause permanent injury or death.”

Heatstroke, or hyperthermia, occurs when the body isn’t able to cool itself quickly enough and the body temperature rises to dangerous levels.

Safe Kids recommend the “ACT” method to prevent tragedy to your child or to a child you see left in a car:

• A: Avoid heatstroke-related injury and death by never leaving your child alone in a car, not even for a minute. And make sure to keep your car locked when you’re not in it so kids don’t get in on their own.
• C: Create reminders by putting something in the back of your car next to your child such as a briefcase, a purse or a cell phone that is needed at your final destination. This is especially important if you’re not following your normal routine.
• T: Take action. If you see a child alone in a car, call 911. Emergency personnel want you to call. They are trained to respond to these situations. One call could save a life.

It’s difficult to think that as parents, we could “forget” our children, but it happens each year with no exception to socioeconomic or education level. Often times, a change in routine, a distraction along the way, or the event a child falls quietly asleep, unseen, in the back seat, allows for a parent/caregiver to “forget” and leave a child in the car.

Here are some important tips to help prevent unintentional injury to your child:

1. Dial 911 if you see an unattended child in a car. Sometimes, people don’t want to get involved or just assume the parents are on the way out. But as you read earlier, it doesn’t take long for a child to die in a hot car. If you see a child or children alone in a car without an adult, call 911 immediately.
2. Never leave your child alone in a vehicle, even for 1 minute. Windows left slightly open will not affect rising temperatures in the car.
3. Set safe habits: leave a cell phone, purse, briefcase, etc. in the back seat before driving, forcing you to always check the back seat and see a child is/is not back there.
4. Program your cell phone and/or computer to remind you to drop off your child each day.
5. Have a plan with your daycare provider to contact you within a few minutes of being late or absent. Let your daycare know that you want them to call you if you are late or you have not called in saying your child will not be in that day.
6. Teach children not to play in any vehicle.
7. Lock all car doors, even at home.
8. If a child goes missing, always check the cars and trunks.

Learn more by clicking here. Also, visit noheatstroke.org for the latest on heatstroke deaths of children in vehicles.

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Every year children are rushed to the emergency room to be treated for car related injuries, many don't even involve traffic or another car. Some injuries occur without the car ever leaving the driveway. Click here for some of the top dangers to be aware of and the key things you can do to help make your car safer for your kids.