Tag: Children’s Hospital of Philadelphia

  • Federal legislation would increase pathogen testing for infant formula following botulism cases

    Federal legislation would increase pathogen testing for infant formula following botulism cases

    A 2-month-old Bucks County infant was struggling to swallow and could hardly hold his head up.

    He was diagnosed last month with infant botulism, a rare, potentially deadly infection that affects the nervous system and can lead to paralysis.

    The family and their lawyer believe the baby, now recovering at home, ingested the bacteria that causes the infection from an infant formula subsequently recalled by its manufacturer, Nara Organics, over contamination concerns.

    Federal legislation proposed this spring could protect babies by requiring formula manufacturers to test for more pathogens. The bill, HR 7867, is awaiting hearings in the House Committee on Energy and Commerce.

    “I want responsible manufacturers, responsible industry partners, who say we know there is a risk of this and we’re going to be ahead of the game,” said U.S. Rep. Madeleine Dean, a Montgomery County Democrat and cosponsor of the bill.

    When asked for comment on the proposed legislation, Nara Organics pointed to safety protocols posted on its website saying the company exceeds the U.S. Food and Drug Administration’s current requirements.

    The New York-based company said it voluntarily recalled all of its infant formula on June 13 “in an abundance of caution,” after the FDA and the Centers for Disease Control and Prevention reported three cases of infant botulism in babies who had consumed Nara formula.

    As of July 6, a fourth case had been confirmed, and FDA testing identified the botulism-causing bacterium C botulinum in some of the company’s formula, according to an update posted on the company’s website.

    Nara Organics did not comment directly on the proposed regulations. When asked for its position on the legislation, the Infant Nutrition Council of America, which represents manufacturers, said its members “share the goal of ensuring families have access to safe, high-quality infant formula.”

    “Infant formula is among the most highly regulated foods in the United States, and INCA supports science-based, risk-based improvements that strengthen infant formula safety,” the organization said in a statement.

    The push to bolster regulations comes several years after federal regulators and lawmakers started looking more closely at infant formula safety in 2022, when a massive recall for a non-botulism bacterial contamination left shelves bare for months.

    But two recent infant botulism outbreaks linked to formula show the inadequacy of the steps that companies are already taking, said Bill Marler, a Seattle-based food safety lawyer who is representing Erica and Micky Goldfin, the Yardley couple whose son developed botulism after being fed Nara Organics formula.

    “We need to do more to protect these kids,” Marler said.

    A dangerous infection

    Infant botulism occurs when babies ingest C botulinum in foods or dust and dirt particles. The bacteria’s spores colonize in the large intestine and release a toxin that affects the nervous system.

    Symptoms include changes in facial expressions, such as smiling less, slow feeding, constipation, and low energy. Untreated, the toxin can spread and cause paralysis, making it hard for babies to breathe and eat.

    Infants are at greatest risk of illness because their digestive systems are still developing and less able to fight off infection.

    Nationally, 181 cases of infant botulism were reported in 2021, the most recent year for which CDC data are available.

    The Goldfins’ baby, identified by the initials W.G. in court records, spent two nights in the intensive care unit at the Children’s Hospital of Philadelphia, where he was treated with BabyBIG, the botulism antitoxin that is manufactured by the California Department of Public Health. The medication’s antibodies bind to the toxin and neutralize it, improving symptoms within 48 hours.

    On June 6, he returned home, where he is feeding well again, and regaining movement in his arms and legs. He is receiving weekly physical therapy for developmental delays in his gross and fine motor skills, according to the lawsuit.

    Testing challenges

    Federal regulators began looking more closely at infant formula in 2022, after Abbott Nutrition issued a massive recall over concerns of non-botulism bacterial infections.

    Abbott temporarily shut down one of the largest formula manufacturing plants in the country while it investigated the cause of the contamination, leaving families scrambling to find the formulas they relied on for their infants and medically fragile children.

    Pinpointing the exact source of contaminants can be challenging.

    The bacteria that causes botulism, for instance, could have been present in the Nara Organics’ powdered milk formula, in dust that settled on the packages during transportation, in the water used to mix it, or on the hands of those preparing the food, said Molly Potter, a senior clinical dietitian with Nemours Children’s Health in Delaware.

    According to its website, Nara Organics tests its formulas throughout the manufacturing process, first testing raw ingredients, then during production, and again with the final product.

    The tests the company uses include so-called sulfite-reducing clostridia (SRC) enumeration, which a leading international food-safety group recommends for identifying spores of the bacteria that causes infant botulism.

    But research published in June in the medical journal Frontiers in Microbiology found that SRC enumeration testing suggests that test wasn’t sufficient to consistently detect the bacteria.

    Researchers from IEH Laboratories & Consulting Group, a Washington-based firm that specializes in laboratory testing and analysis for the food industry, worked with ByHeart to analyze its infant formulas that had been linked to at least 28 cases of infant botulism this year and last.

    A bottle of milk prepared from infant formula.

    Improving safety

    Dean said she hopes the proposed legislation will open up more conversation about how best to improve infant formula safety.

    The bill tasks the FDA with developing a list of pathogens that formula companies should test for, and working with manufacturers to begin any tests they aren’t already doing.

    The FDA would also set a schedule for how often manufacturers need to test for the new list of pathogens.

    Under the legislation, companies would be required to report contamination results within a day, and retain records of positive test results.

    Dean is among more than two dozen lawmakers to sign on as cosponsors. Rep. Jefferson Van Drew, who represents South Jersey’s 2nd District, is one of two Republican cosponsors.

    Potter, the Nemours dietitian, said she hopes increased testing will help families feel more at ease.

    In the meantime, parents can reduce the risk to their children by only purchasing formula from reputable stores, checking expiration dates, and storing powdered formula canisters properly. Caregivers should make sure to mix formula in clean equipment, and wash their hands before preparing and feeding it to a baby.

  • How much did Philly-area nonprofit health system CEOs make in 2024?

    How much did Philly-area nonprofit health system CEOs make in 2024?

    Jefferson’s Joseph G. Cacchione ranked as the highest-paid CEO at the Philadelphia region’s nonprofit health systems in 2024, with total compensation of $7 million, according to The Inquirer’s annual review of public tax forms.

    Madeline Bell at Children’s Hospital of Philadelphia collected $5.5 million in 2024, giving her the number two spot.

    Both also were top earners in The Inquirer’s 2023 compensation analysis. Jefferson is the largest system based here, both by revenue and number of hospitals, with 33 stretching from South Jersey to near Scranton. CHOP is among the nation’s top-ranked children’s hospitals.

    Janice Nevin at ChristianaCare joined the ranks of the top five. She received $3.5 million, about the same pay as the region’s fourth highest earner, Al Maghezehe at Capital Health, which has a network of outpatient clinics in Bucks County and two hospitals in Mercer County. Maghezehe’s compensation stands out because Capital had by far the lowest revenue among the systems with the 10 highest-paid CEOs.

    A couple of CEOs who left their positions before 2024 continued collecting long-term compensation, as is common in the industry.

    Most notably, Jefferson’s former CEO Stephen K. Klasko collected just over $1 million in 2024. He retired at the end of 2021, but remained an adviser through June 2022. The 2024 payment brought his total through 2024 to $48.7 million for 8½ years as CEO.

    Lori Herndon left AtlantiCare in June 2023. Her compensation the following year was $1.3 million.

    Other CEOs left during 2024, making it possible they will be listed in the next round of 990s. Those executives include Donald Mueller at St. Christopher’s Hospital for Children, Michael Laign at Redeemer Health, and Ronald W. Johnson at Shore Medical.

    Here’s a look at the numbers from The Inquirer’s review of the latest 990 tax returns of 20 nonprofit health systems, covering 11 health systems with operations concentrated in Southeastern Pennsylvania, seven in South Jersey, and two in northern Delaware:

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  • Inside Pa.’s measles outbreak: A family rides out the virus, doctors treat severely ill children

    Inside Pa.’s measles outbreak: A family rides out the virus, doctors treat severely ill children

    On a small Lancaster County farm last month, five of the eight King siblings sprawled on the living room floor, sucking on ice pops and listening to calming music, trying not to scratch their itchy skin.

    The next county over, in Hershey, children were lying in hospital beds as their immune systems battled an infection damaging their organs.

    They all had measles.

    One of the most contagious diseases has made a resurgence in Pennsylvania and across the country as growing numbers of people are refusing the highly effective vaccine that prevents its spread.

    Pennsylvania is now seeing its worst measles outbreak in 30 years, centered around rural counties just west of the Philadelphia metro area. Lancaster County has emerged as a particular hot spot, with 51 of the 89 total measles cases reported this year in the state.

    Anti-vaccination sentiment is prevalent in Lancaster County, where vaccination rates among kindergarteners are some of the lowest in the state. Known for its agricultural bounty and the Amish and Mennonite communities that dot its rural landscapes, Lancaster is also home to the state’s eighth-largest city with an economy heavily supported by tourism and entertainment.

    In Lancaster, doctors say many are flocking to local clinics and pop-up vaccination events as cases rise. But others, like the King family, remain resolute in their decision not to vaccinate, instead preparing to ride out what they hope will be an inconvenient summer interruption that builds character and family bonding.

    The family isolated in their home for weeks in June while all eight unvaccinated children, who range in age from a 1 to 15, recovered from measles. Their 14-year-old son experienced the most severe symptoms, and went to the emergency department when coughing and nausea rendered him unable to keep down water or medicine.

    “Measles isn’t fun, seeing your kids sick isn’t fun,” said Gina King, 41, who lives outside New Holland. But, she added, “I know this is going to be added to the King family core memories.”

    The 89 cases Pennsylvania has recorded so far this year exceed by more than five times the cases recorded in 2025. Doctors say the official tally may be an undercount, with many cases going unreported.

    The virus reached the Philadelphia region earlier this week, when Chester County reported two cases.

    An Inquirer analysis found both the metropolis and state increasingly have become vulnerable to a major outbreak. In the 2024-2025 school year, kindergarten vaccination rates in 50 of Pennsylvania’s 67 counties were below the 95% vaccination rate scientists consider necessary to keep the virus from spreading. And even in counties with vaccination rates near so-called “herd immunity,” school-level vaccine data show that susceptible communities pockmark the region.

    The majority of measles cases resolve in weeks with mild-to-moderate flulike symptoms, but the disease can take life-altering and even deadly turns, especially for young children.

    Doctors and nurses who spoke to The Inquirer could not comment on the King family’s experience because they did not treat them.

    But they cautioned that they have seen the harm measles can do to a child’s body: neurological damage, respiratory infections, and pneumonia, which can lead to death.

    “Each one of those cases where a child suffers something really devastating — it only takes seeing one for it to really be something that hits home very hard,” said Evan Shirey, a pediatric infectious disease physician who has treated several children with measles at Penn State Health Golisano Children’s Hospital this year.

    On the front lines of measles

    As a medical student, Shirey never expected he would treat a measles case himself. By 2000, vaccination rates across the United States were so high that the disease was declared eliminated.

    “I read the textbooks like they were history books,” Shirey said.

    But as vaccination rates decreased, he and other providers began preparing in the last couple of years. He feared inevitably seeing cases like the several adults and children treated at Penn State hospitals this year.

    He declined to share details on the cases, saying hospitalization numbers are low enough that doing so would risk compromising patients’ privacy.

    Shirey said he’s also fielding “constant” phone calls from pediatricians all over the state as they prepare for — or deal with — emerging measles cases.

    Intensive protection measures implemented at Penn State hospitals in Dauphin County, for example, include testing patients with respiratory symptoms, or who were potentially exposed to measles, and isolating them while they wait for test results.

    The virus is so contagious, it can infect nine in 10 people who haven’t been vaccinated.

    “Airborne diseases are a whole other world,” said Nancy Himmelberger, a critical care registered nurse at Golisano Children’s Hospital and the vice president of its nurses’ union, which is affiliated with SEIU.

    Shirey tries to explain to parents why vaccination is the best defense against measles. “I do encounter a lot of parents who truly want the best for their child, and they’re afraid because of what they see on TV or social media.”

    The Centers for Disease Control and Prevention recommends children receive two doses of the measles, mumps, rubella (MMR) vaccine at 1 year of age and before starting kindergarten, typically around age 5.

    The vaccine is among those required for students to attend school, though Pennsylvania’s lax rules allow families to opt out for medical, religious, or philosophical reasons.

    In response to rising cases, Pennsylvania earlier this year updated its guidelines to recommend babies be given their first dose as early as 6 months.

    Once someone is infected with measles, Shirey stresses, no treatments are available that specifically target the virus.

    Vitamin A may be given to children who have been hospitalized with severe measles symptoms, but it is not a cure and cannot prevent the disease. Excessive amounts of vitamin A can be dangerous.

    “For measles, it is supportive care and trying to manage the complications that occur,” Shirey said.

    Gina King and her daughters pick strawberries at their home in Lancaster County.

    Trying to change vaccine perspectives

    When King and her husband, Shawn, began their family 15 years ago, they thought carefully about each vaccine recommended for their babies. They read package labels and looked up ingredients. For each shot, they considered whether they were more comfortable with the risk of side effects from the vaccine, or the risk of illness from skipping it.

    When their pediatrician recommended a hepatitis shot before traveling to India, the Kings decided the risk of the disease was greater than any potential side effects.

    But when it came to the measles, mumps, rubella (MMR) vaccine, they were uncomfortable that the rubella portion of the vaccine was developed using cells of an aborted fetus.

    The approach used in some vaccines grows viruses in fetal cells. Scientists then extract proteins from the viruses to develop vaccines, according to the Children’s Hospital of Philadelphia’s Vaccine Education Center.

    Vaccines themselves do not contain fetal material. And most major religions promote vaccination, even if they oppose abortion, reasoning that parents have a moral duty to protect their children and the health of the public.

    Gina and Shawn King’s sons relax in hammocks after being cooped up inside with measles for several days.

    Measles at home

    The Kings weren’t aware their children had been exposed to measles, but knew cases were spreading locally. When their two oldest sons, aged 14 and 15, began showing symptoms, they locked down their home.

    They appreciated how people can be contagious before and after they experience symptoms. They have relatives with cancer and Down syndrome, conditions that could put them at risk of severe illness if they contracted measles.

    “If you made the choice to not vaccinate, you knew there was a risk of getting sick,” King wrote in a tip sheet she created to share with other families. “We should care about others enough to be willing to make some sacrifices to protect vulnerable people.”

    Grandparents offered to help care for the children, but the Kings declined for fear of getting anyone else sick.

    Instead, friends and family left treats for the kids on the front porch, picked up grocery orders, and checked in through video chat.

    Days four, five, and six, were the thorniest, King said. She draped chilled washcloths over the foreheads of her usually independent teens, brought them tea, and read books to them.

    She spent at least one night sitting beside the bed of her 14-year-old son, whose coughing and nausea were so bad he couldn’t eat or drink, and she worried he’d become dehydrated.

    “I just wanted to be there and keep an eye on him,” she said.

    A few days after the boys started feeling well enough to go outside, the five girls, who range in age from 4 to 12, were sick. The baby experienced the most mild symptoms among the siblings.

    King, who is vaccinated, also got sick, though her husband, who is not vaccinated, has yet to develop symptoms. Vaccinated people, in rare instances, can contract measles, and infection is more likely in an outbreak.

    After being inside all day, it became part of the family’s routine to tuck the kids into the back of their family ATV with blankets and more ice pops, and ride around their property to say goodnight to the sheep, cows, horses, and fruit trees.

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    Community support

    Elsewhere in Lancaster, church communities and friend groups are encouraging people who are sick to stay home, as well as those who are unvaccinated with a higher risk of severe illness.

    Claudia Beiler, a Lancaster mother of five and a Christian wellness influencer, said she has dropped off vitamins, coffee, and dinner for friends and others in her community who were quarantining at home.

    Beiler has posted frequently to her more than 110,000 Instagram followers about her decision not to vaccinate her children. She has also offered tips about how to weather measles cases at home.

    Like the Kings, she says families who don’t vaccinate must avoid spreading the virus to vulnerable people.

    “There’s a seriousness I’m proud of,” she said. “It feels like a lot of care and kindness.”

    At Penn Medicine Lancaster General Hospital, physician Jeffrey Martin is heartened when he hears that residents have decided to isolate themselves when diagnosed with the virus. He sees it as a measure of the community spirit inherent to Lancaster County.

    But isolating once symptoms emerge isn’t enough to protect the community, since the virus can spread days before the first sneeze or cough. The disease’s signature rash typically does not appear for several days.

    “‘I can accept the risk’ doesn’t play well with infectious disease,” he said. “Creating space for people to think about that on another level is really important.”

    Amid the latest outbreak, Martin said, clinics run by the state health department and Penn Medicine have seen high attendance, with unvaccinated patients choosing to get the shot.

    Martin and his colleagues don’t ask many questions about why: “We’re just thankful that people are showing up,” he said.

  • ‘Rock star’ Ben Franklin, with some help from Queen and Bruce Springsteen, reminds us that Philadelphia is the soul of America

    ‘Rock star’ Ben Franklin, with some help from Queen and Bruce Springsteen, reminds us that Philadelphia is the soul of America

    We all have a mental image of Benjamin Franklin, thanks to the $100 bill: balding, middle-aged, with tiny glasses and a stern look.

    But what if he had a full head of hair poking out the sides of his tricorn? What if we saw Franklin singing and jamming on a guitar?

    The Sound of America, a new musical showing at FringeArts this month, imagines Franklin as a young man: America’s very first rock star who finds fame after discovering electric rock and roll from the power of a lightning strike.

    In the musical, he gains fame and fortune as a rock star. But stardom sweeps him up and pulls him away from the people and values that once defined him as a struggling musician, leaving him to question his true identity.

    Leading the ensemble cast is a newly minted Temple musical theater graduate, Kohl Pilgrim. Last week, he stood with fellow actors Federica Andino-Vega and Jameson May, who play Franklin’s wife Deborah Read and his best friend Hugh Meredith, respectively.

    Pilgrim and cast play their instruments live, serving as both performers and a band.

    Delivering their lines and singing at microphone stands, Nashville Bluebird Cafe-style, the three practiced blocking the scene where Franklin and Read first meet. After a flirty exchange, a naive and confused Franklin finds out Read is married to a man who has disappeared without evidence of his death.

    “We tend to see [Founding Fathers] as these infallible perfect people who created the perfect society,” director and Temple professor Kyle Metzger said. “It’s exciting to see a young Founding Father making mistakes and being complex and messy. It’s important to remember these were people, too, who didn’t have all the answers and were trying their best.”

    Setting out to write a write a rock musical, the choice of protagonist was a no-brainer for the musical’s cocreator and Emmy-award winning producer Randall Lane and longtime friend and singer-songwriter Todd Schwartz.

    “Under Poor Richard, he was the lyricist for colonial America,” said Lane, referring to Franklin’s pseudonym under which he published a yearly almanac. “And then when he discovered the lightning rod, he literally became the first American who was world famous, and toured the world.”

    Just like a young rock star.

    Federica Andino-Vega (left), who plays Franklin’s wife Deborah Read, adjusts Gerson Malave’s wig during a dress rehearsal for “The Sound of America” on June 24.

    Lane, who is also the editor in chief of Forbes magazine, lives in Saratoga Springs but feels deeply connected to Philadelphia through the years he went to Penn to study history and political science.

    For him, Franklin “checked every box.”

    “He was a teenage fugitive who ran away from home and every Friday he was hanging out [at] the Leather Apron Club,” the mutual-improvement society Franklin and his friends founded in 1727, said Lane.

    Every week, they’d meet in taverns, “jamming out intellectual ideas,” said Lane. In the case of his musical, they create a garage band.

    Franklin, after all, invented the glass harmonica.

    The musical’s soundtrack includes 23 original songs cowritten by Lane and Schwartz, influenced by Queen, Nirvana, Bruce Springsteen, and the Beatles. Metzger describes the production as “80% rock concert, 20% musical.”

    Kyle Metzger (center), the director for “The Sound of America,” directs the cast inside FringeArts for the forthcoming musical on June 24.

    The cast will serve as narrators at the front of the stage, while a live band plays behind them. Floor seats will be available and swaying arms and singing along will be highly encouraged. It’s meant to feel like a concert and not just another historical “rock” musical (sorry, Hamilton).

    “I’m always drawn to theater that’s untraditional or pushing into other mediums or incorporating other art forms,” Metzger said.

    True to style, The Sound of America also doubles as a walking tour led by Pilgrim, still in character as Benjamin Franklin. After curtain call, audiences can participate in a tour of Franklin’s Old City house and grave, a short walk away from the FringeArts venue.

    Needless to say, Pilgrim has had to really pack on the homework for this portion of the show.

    “Most of my free time when I am not in rehearsal or with friends, I am home reading his autobiography,” he said. “I am reading anything I possibly can because there’s probably going to be a kid that’s like ‘What’s his favorite food? Did he like burgers?’ So I’m researching that, too.”

    Barrymore award-winning director Kyle Metzger is also a professor in Temple’s Musical Theater program.

    When asked about Franklin’s favorite drink, Pilgrim was certain it was wine. As for his hypothetical Jersey Shore vacation spot, Pilgrim named Cape May.

    “I think he would like the houses,” he said.

    “I want to pay homage to how honest, wise, and hard-working he was,” said the actor, who sought inspiration from iconic rock figures like David Lee Roth, Elvis Presley, and Sir Roger Daltrey, frontman of the Who.

    Daltrey, in fact, makes a remote cameo in the musical, in support of Teen Cancer America, the nonprofit he founded along with Who bandmate Pete Townshend.

    Lane and Schwartz’s royalties will be donated to the charity, which partners with Children’s Hospital of Philadelphia (CHOP). The production is also collaborating with Federal Donuts & Chicken for a specialty doughnut called “The Ben”; a portion of its sales will benefit the cause.

    Kohl Pilgrim, the actor bringing Ben Franklin’s rock and roll persona to life, inside FringeArts.

    “We want this to be a really big win to fight cancer, but we think that it’s also super true to the spirit of Benjamin Franklin,” Lane said. “He was a rock star in all the senses, but he was also somebody who really cared about where he lived, and we want to leave Philadelphia better than we found it.”

    But as with any rock star, Franklin’s story would be nothing without his entourage.

    In addition to wife Read and bestie Meredith, the ensemble cast includes British antagonist Lord Wedderburn, played by Kaedon Knight and Franklin’s illegitimate son William Temple Franklin (aka “WTF”), played by Gerson Malave.

    Read is the only female character in the show, accompanying Franklin on his journey to stardom. Though she is often forgotten in history, her common-law marriage to Franklin saw her holding down the Franklin household and publishing company with a shotgun during the unrest of the Stamp Act.

    “She was a baddie, the baddie on Market Street,” Andino-Vega said. “But [Franklin] got most of the spotlight just because she was very shy and a bit illiterate. I want to shine a light on those special ladies that have been forgotten, and bring them up a little more in a way where they can also be seen like Ben Franklin.”

    The cast of “The Sound of America” are committed to delivering a rock concert, not just a musical.

    The cast and crew, largely Philadelphia-based and/or raised, are deeply committed to reflecting the grit of the city through this unique portrayal, especially in light of the 250th anniversary of the nation.

    “It’s almost like Ben was talking to us saying this year’s really important and this summer is important to Philadelphia,” Lane said. “It gives everybody that visits Philly a reminder that Philadelphia was the birthplace of democracy and it’s the soul of America.”

    The Sound of America runs July 1-Aug. 1 at FringeArts, 140 N. Christopher Columbus Blvd. Tickets start at $60. soundofamericamusical.com, 215-413-1318, or hello@fringearts.com.

    A previous version of the article misidentified the actors playing Hugh Meredith and Lord Wedderburn. Jameson May and Kaedon Knight play the characters respectively.

  • CHOP names Joseph Mitchell to succeed Madeline Bell as CEO

    CHOP names Joseph Mitchell to succeed Madeline Bell as CEO

    The Children’s Hospital of Philadelphia announced Tuesday that Joseph Mitchell will succeed Madeline Bell as CEO, when Bell retires Oct. 1 after a nearly 40-year career at the University City nonprofit.

    Bell, 65, became CHOP’s CEO in July 2015 following eight years as chief operating officer. During Bell’s tenure as CEO, CHOP more than doubled its annual revenue to more than $5 billion, added a hospital in King of Prussia, and started building a $2.6 billion patient tower on its main campus.

    Mitchell, 51, joined CHOP as president in April 2025 following a national search by CHOP’s board for Bell’s successor. In 2024, Bell had notified the board of her intention to retire, CHOP said.

    Before coming to Philadelphia, Mitchell was an executive vice president at Boston Children’s Hospital and president of Franciscan Children’s, a specialty hospital that Boston Children’s acquired in 2023.

    “The opportunity to lead an institution that is so iconic, impactful, and relevant, and has the opportunity to impact pediatrics and have an indelible imprint on kids and families was just irresistible,” Mitchell said in an interview this week. “It was an easy decision to move my family from Boston to Philadelphia.”

    CHOP is financially strong as Mitchell assumes the top job, but like other health systems it will face financial pressure from Medicaid cuts starting next year. The nonprofit has also been under fire from the Trump administration for its program that serves transgender youth.

    Mitchell trained as a urologist and worked at McKinsey & Co. as a consultant for 14 years before becoming CEO of Franciscan Children’s in 2021. He led a financial turnaround effort there and planned for a dramatic expansion of its campus in Boston’s Brighton neighborhood.

    “Joe brings a fresh perspective, a patient-first approach, and a strong strategic mindset,” Greg Davis, CHOP’s board chair, said in a news release. “We are confident he will guide CHOP into its next chapter with continued excellence and impact.”

    Bell’s tenure as CEO

    Bell, who started at CHOP as a nurse, oversaw substantial growth of CHOP’s footprint in West Philadelphia and on the eastern side of the Schuylkill with two research towers on Schuylkill Avenue near the South Street Bridge. CHOP also expanded its specialty-care network in the suburbs.

    CHOP became the pediatric partner for Main Line Health, Lehigh Valley Health Network, and ChristianaCare under Bell’s leadership. Such relationships with systems focused on adults help steer patients needing advanced specialties to CHOP. CHOP has long been Penn Medicine’s pediatric partner.

    Madeline Bell sat next to Philadelphia Eagles owner Jeffrey Lurie last year during a ceremonial signing of documents for the Lurie family’s $50 million donation to create the Lurie Autism Institute at the University of Pennsylvania and CHOP.

    In a prerecorded statement for staff and others viewed by The Inquirer in advance of the transitional announcement, Bell highlighted medical breakthroughs in cell and gene therapy during the past decade, as well as an expansion of behavioral health services. The Lurie Autism Institute, a partnership between the University of Pennsylvania and CHOP, launched last year thanks to a $50 million gift from Philadelphia Eagles owner Jeffrey Lurie and his family.

    Also last year, CHOP received its largest gift ever, $125 million from Comcast CEO Brian Roberts and his wife, Aileen. The new patient tower expected to open in 2028 will bear their name. In 2024, real estate investor Mitchell L. Morgan and his family donated $50 million toward the cost of one of the two research towers near the South Street Bridge.

    After retiring, Bell plans to continue as honorary consul of Spain for the Philadelphia region, a position she started last July, and hopes to remain on the board of Comcast-NBCUniversal, she said. Also, she will continue to support CHOP philanthropically and will remain a resource for Mitchell.

    CHOP is among the nation’s largest pediatric systems. It has 774 licensed hospital beds and employs 31,000 people. In the nine months that ended March 31, CHOP had 27,643 inpatient admissions and 1.3 million outpatient visits.

    Joe Mitchell’s priorities

    Since arriving in Philadelphia, Mitchell has immersed himself in getting to know CHOP, visiting primary care and specialty sites, as well as the hospitals, he said. The next step was broadening his responsibilities to the point where most of CHOP’s senior executives are now reporting to him.

    He said it’s too soon for him to address specific strategic moves, but emphasized that his priority is expanding access to care for children and families.

    Joseph Mitchell will succeed Madeline Bell as CHOP’s CEO this fall.

    That could get harder with Medicaid cuts looming next year. Nearly 50% of CHOP’s patients have the insurance for low-income families.

    “We’re doing everything we can to preserve access for families, to advocate for funding and resources at the state and federal level,” said Mitchell, who grew up in St. Louis in a family “that was deep into healthcare.”

    He moved to Boston for a residency at Brigham and Women’s Hospital. That’s where he met his wife, Vivian. They have two children, 17 and 14, and the entire family has fallen in love with Philadelphia, he said.

    “CHOP has embraced me, but Philadelphia as a community has really embraced us,” he said.

  • ‘Snuffed her life out’: Man accused of randomly shooting CHOP nurse in Tredyffrin Township appears in court

    ‘Snuffed her life out’: Man accused of randomly shooting CHOP nurse in Tredyffrin Township appears in court

    Hours before Steve Jahn shot Megan Nieberle to death on a March evening this year, prosecutors said, he drove around Tredyffrin Township for hours with a gun in his hand.

    In dashcam videos played in a Chester County courtroom Monday, Jahn is seen gripping a semiautomatic handgun in his Chevy Silverado truck, muttering to himself and glancing back and forth erratically as cars pass by.

    Those utterances, prosecutors said, offer a view into the mindset of a man about to commit murder.

    “Get out of the [expletive] way,” Jahn says an one point, one hand on the wheel, another on his firearm. “You don’t belong here.”

    “Ya’ll [expletive] are dead,” the 44-year-old says in another clip.

    Though it would be hours before Jahn, who police said was homeless, encountered Nieberle, a 53-year-old mother of three and a nurse at Children’s Hospital of Philadelphia, prosecutors used the videos from Jahn’s dashcam to bolster their contention that he had been prepared to harm someone that Saturday.

    Jahn, a Berwyn native, was arrested a day after the March 7 shooting and charged with first- and third-degree murder, aggravated assault, and reckless endangerment.

    The hearing marked the first time Jahn appeared in a case that shocked the Chester County community and kick-started a conversation about mental illness and firearms.

    Some residents questioned why police did not act more forcefully to ensure that Jahn, who had been in a mental health crisis that day, was checked into a nearby psychiatric unit.

    Jahn, wearing a red prison jumpsuit and sporting a beard, showed little emotion during the hearing, as Nieberle’s loved ones looked on, some in tears.

    Assistant District Attorney Kathleen Wright said prosecutors had linked Jahn to the crime scene using GPS data from his vehicle, gunshot residue recovered from his hands and clothing, and remarks he made while in police custody.

    Though the footage of Jahn was illuminating, Wright said, the shooting itself was not captured on the dashcam because Jahn had removed the device shortly before the shooting.

    Wright called Tredyffrin police officers and county detectives to the stand to testify about the scene they had encountered near the intersection of Old State Road and Contention Lane, where Nieberle was found in the driver’s seat of her silver Acura SUV around 10:47 p.m. with a gunshot wound to the head.

    She was bleeding heavily, the officers said, and was taken to a nearby hospital, where she died the next morning.

    Chester County Det. Matthew Shumway of Chester County said data recovered from Jahn’s truck allowed investigators to identify him driving down the dimly lit residential street that night.

    Approaching Nieberle’s vehicle, Jahn slowed his truck to 6 mph, Shumway testified. He fired once through her driver’s side window, the detective said, a shot captured on a neighbor’s doorbell camera.

    Played in court, the short video showed Jahn’s headlights cut through the darkness and illuminate an approaching vehicle. Within seconds, a loud bang rang out.

    Jahn’s attorney, Brian McCarthy, did not contest many of prosecutors’ assertions about how events unfolded that night, but he argued that first-degree murder was not appropriate because Jahn had not shown premeditation and intent to kill, conditions required to meet the threshold for that crime.

    “What we did see does not establish murder in the first degree,” McCarthy said of the dashcam footage. The person in that video, he said, was a “troubled man looking back and forth, not a cold-blooded killer.”

    Wright, the prosecutor, countered that Jahn’s actions were premeditated. She said Jahn had rolled down his window, aimed his weapon, and would have “had to have known” that there was someone inside an oncoming vehicle.

    Of Nieberle, Wright said, Jahn “snuffed her life out and left her there to die.”

    District Judge Patricia A. Zaffarano ruled that prosecutors had presented sufficient evidence for the case to proceed to trial on all charges.

    Jahn will be formally arraigned on July 2. He remains in custody in the Chester County Correctional Facility after being denied bail in March.

  • Safe sleep tips for babies to avoid SIDS and other injuries

    Safe sleep tips for babies to avoid SIDS and other injuries

    I remember the four-month-old boy, unmoving in his hospital bed, who had suffered severe brain damage from a sleep accident. This four-month-old boy had slept on the couch with a parent. When morning came, he was lying between couch cushions and not breathing.

    Paramedics revived the baby and took him to a hospital. The baby survived, but his brain went so long without oxygen that he would likely never grow up to walk or talk. He was the first of too many babies that I have seen who sustained severe injuries, or have died, from suffocation or Sudden Infant Death Syndrome (SIDS).

    Parents visiting in pediatrician’s offices in the last 30 years have probably heard us talk about “safe sleep.” We see a lot of misinformation and confusion about sleep practices these days, with social media rife with images of sleeping babies in hazardous conditions. Serene captions misleadingly encourage improper positioning and unsafe environments.

    Many people who get their health information online are unaware of what “safe sleep” means.

    The American Academy of Pediatrics (AAP) defines safe sleep as having babies sleep solo on their backs on a firm, flat mattress. Loose blankets, pillows, toys, or other soft objects should be kept out of the sleep space. In pediatric clinics, we call these recommendations the “ABCs” of safe sleep: Alone, on their Back, in a Crib.

    We know this advice saves lives. After the AAP recommended that babies be placed on their backs to sleep in 1992 rates of SIDS plummeted by over 50% in 10 years. Yet this progress has plateaued. SIDS remains the leading cause of death in children under 1.

    Frances Avila-Soto is a physician in her second year of residency training at the Children’s Hospital of Philadelphia.

    As pediatricians, we still have work to do to prevent SIDS deaths. For starters, we must address persistent racial and ethnic disparities.

    Black and American Indian/Alaska Native infants throughout the 2010s were more than double or triple as likely to die of SIDS, compared with white infants. The reasons are complex. Low socio-economic status, unemployment, and housing instability are associated with higher risk for SIDS. These issues often stem from systemic racism.

    We can’t trace how many SIDS deaths result from online misinformation. That makes me all the more committed to talking about the importance of safe sleep practices.

    At my primary care clinic in South Philadelphia, I see patients from a wide range of cultural and ethnic backgrounds. I often hear questions about babies sleeping from families flooded with conflicting information from social media or their peers.

    Here are some common concerns, and what I share to educate families:

    “I’m worried that if they’re not next to me, I won’t notice if something is wrong.”

    Avoiding bedsharing doesn’t mean your baby can’t be near you. The AAP recommends sleeping in the same room as your baby for at least the first six months. This means you can keep an eye on them and comfort them easily, but they still have their own space where they can sleep safely.

    “Our babies have always slept in bed with us. It’s part of our culture.”

    It is true that cultures have different sleep practices. But the sleep environment can also be different in many countries — including bedding/mattresses, the house, environmental exposures, and other factors. Here in the U.S., we know from decades of research that following the ABCs is what’s safest for your baby. 

    “My baby will only sleep in my arms. They won’t sleep when I put them in the crib.”

    Babies are constantly learning new skills, such as rolling, eating, and babbling. They can learn to sleep on a new surface. It’s all about establishing a routine. You can still comfort and hold your baby until they fall asleep, then move them to their own sleep surface. If you must share a bed with your baby — or worry that you may fall asleep while your baby is in your bed — make sure to remove any pillows, sheets, blankets, or any objects that could cover your baby’s face.

    Your pediatrician is not judging you by asking how your baby is sleeping. We know how challenging sleep is with infants. We want your baby to be safe and to minimize harm from confusing or misleading advice.

    Discuss questions about safe sleep with your pediatrician. You can also visit CHOP’s Pediatric Health Chat for more information on safe sleep and children’s health.

    The views expressed in this article are those of the authors and not necessarily those of CHOP. This information is not intended to provide medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional regarding any health or medical concerns.

    Frances Avila-Soto is a physician in her second year of residency training at the Children’s Hospital of Philadelphia, with a focus on leadership development in issues involving equity, advocacy, and policy.

  • AI is reshaping childhood. Here are the risks and benefits parents should know about, according to CHOP researchers.

    AI is reshaping childhood. Here are the risks and benefits parents should know about, according to CHOP researchers.

    Artificial intelligence presents a mixed bag of risks and benefits for children that vary by age, according to Children’s Hospital of Philadelphia researchers who reviewed dozens of academic studies on the emerging technology.

    For young children, an AI chatbot could help with language development, yet it could also distort their perceptions of social interactions.

    For adolescents, the technology could help with career exploration, but its record of inappropriate responses to mental health matters raises concerns.

    The researchers summarized the current evidence on generative AI — tools that imitate human intelligence to produce content in the form of text, audio, images, or videos — in a review article published Wednesday in the medical journal Pediatrics. They reviewed 55 published works largely released in the last five years, including nearly three dozen peer-reviewed studies and a mix of news articles, blog posts, and pending legislation.

    They separated the potential effects across early childhood (ages 0 to 5), middle childhood (6 to 11), and adolescence (12 and older) to lay out the considerations for families.

    Guidance for parents on how AI might reshape childhood remains limited, despite its rapid spread into children’s learning and play, said Robert Grundmeier, a primary care pediatrician at the Children’s Hospital of Philadelphia and the lead author.

    Nearly two-thirds of teens use chatbots, like ChatGPT or Gemini, with 28% doing so daily, according to a Pew Research Center survey last year. They are using the tools for everything from searching for information to getting help on homework and having a digital companion to chat with.

    “Our children are getting exposed to AI at incredibly young ages, well before they have a smartphone,” Grundmeier said.

    The article was what’s called a “state-of-the-art review,” meaning it covers a topic that is rapidly changing, and for which there’s not yet a lot of rigorous research, he said.

    He hopes other researchers will dig deeper into the area “so that we can actually start to, in the future, make some concrete recommendations about best practices.”

    The Inquirer spoke with Grundmeier about what parents should know about children’s use of generative AI in a conversation lightly edited for clarity and length.

    Robert Grundmeier is a pediatrician at CHOP and lead author on the recent article
    What are the takeaways of your review?

    There’s a lot of opportunity, clearly in the educational domain, in helping to really creatively tailor and customize educational materials.

    One of the biggest concerns that came up had to do with the reliance on artificial intelligence as a companionship tool. You can interact with it in a way that you might a friend. And there are some nice things about that, in terms of being able to explore ideas in a non-judgmental way. But I think there’s a tremendous concern, especially from a child development perspective, that children could learn incorrect mental models of human interaction.

    How might interacting with AI differ?

    AI tools are typically designed to promote engagement. While a human might challenge your ideas and push back — friends do it all the time — an AI tool is typically a little less likely to push back and challenge you in a way that might make you unhappy with the interaction.

    There’s more nuance in the human interaction.

    What are the potential risks and benefits of AI in early childhood?

    There’s a lot of opportunity for creativity, storytelling, and supporting language development that could be a really nice benefit of AI in preschool-aged children. The concern regarding incorrect mental models and not correctly understanding what a human interaction is meant to be like is really most notable, however, in this age category.

    It’s really essential that a parent always remains involved in any AI interactions, looking at the output from AI alongside their child, and preferably pre-screening what’s being generated to make sure their young child is not accidentally exposed to any harmful content.

    What about for school-age children?

    There’s a lot more opportunity to personalize education to people’s different learning styles.

    But similarly, there are definitely school rules that have to be followed on the appropriate use of AI. To the extent parents can start to promote an idea of AI literacy and make sure that their child is not handing over their learning to the AI, then I think there’s a lot of good opportunity there.

    We want to promote skill development, not cause people to have their skills atrophy because they’re relying on the AI to do their homework.

    What are the considerations for adolescents?

    There are social interaction concerns. We reference some of the news related to problems with teenagers using AI tools as a companion or a friend. In particular, there was some research that showed that AI tools may respond very inappropriately to questions about mental health topics, including suicide. There really needs to be a lot of guardrail development on the part of the AI vendors to make sure that teenagers do not have harmful interactions with AI.

    What are potential benefits of adolescents using AI?

    AI is here to stay as part of our futures and our professional careers. To the extent that AI literacy can be supported in the adolescent age group, so that they can enter the workforce as a professional who knows how to use AI appropriately, I think that’s a worthwhile educational effort.

    It can also be a valuable tool for career exploration and college choice. There’s a lot of information about different colleges and career paths, and AI tools are good at summarizing, synthesizing, and interpreting something in light of what you might say are your priorities.

    Is there anything that you feel is still uncertain or needs to be clarified through future research?

    The manner of interacting with AI keeps changing. For example, various household ambient AI tools (devices that passively listen to us) have been in existence for a while, but now the types of interaction have become much more complicated. We need to understand what are safe and effective ways to use these tools in the household in a way that’s supportive of child development.

    Another category of research that is really important is developing guardrails, evaluating them, and making sure that they’re adapted appropriately for different age stages.

    As a pediatrician, what have you been hearing about AI from parents?

    I was chatting with the family of an elementary school-aged child about school performance, and the mom indicated some difficulties supporting his reading comprehension. They had discovered, with support from his school, that they could use AI tools to create reading comprehension paragraphs that they could practice with at home to help their child learn how to really focus on their reading. I thought that was actually a fantastic example.

    What I’m struck by is really the creativity that families are approaching this with. There’s a lot of good opportunity there, as long as we pay attention to the risks and make sure guardrails are in place appropriately.

  • Most Philly-area health systems had improved financial results in first half of fiscal 2026

    Most Philly-area health systems had improved financial results in first half of fiscal 2026

    Six of eight nonprofit health systems in Southeastern Pennsylvania and northern Delaware posted improved financial results for the six months that ended Dec. 31 compared to the year before. Still, half of them had operating losses, according to financial data reported last month to bond investors.

    Jefferson Health and Temple University Health System reported results that were worse than the same period last year.

    Children’s Hospital of Philadelphia remained the region’s most profitable health system, with a 6.2% operating margin, up from 5.2% the year before. CHOP posted $2.7 billion in total revenue in the last six months of 2025, up from $2.4 billion the year before.

    Nonprofit health systems in South Jersey, such as Cooper, Inspira, and Virtua, do not report comparable financial results until they file their annual audited financials statements in the spring.

    Here’s a summary:

    Jefferson Health: Jefferson had an operating loss of $201 million in the six months that ended Dec. 31, compared to a $55 million loss the year before. The $201 million loss included a $64.7 million restructuring charge related to severance for 600 to 700 people laid off in October and other changes designed to improve efficiency in the 32-hospital system that stretches from South Jersey to Scranton, Jefferson said.

    University of Pennsylvania Health System: Penn had an operating profit of $189 million in the first six months of fiscal 2026, up from $117 million in the same period a year ago. Operating income increased, even after Penn put $43 million into reserves for medical malpractice claims. Two years ago, Penn had recorded charges totaling $90 million for the same purpose.

    ChristianaCare: ChristianaCare, Delaware’s largest health system, posted a $37 million operating gain, up from $33 million in the first six months of fiscal 2025. The health system’s revenue rose 9% to $1.75 billion, helped in part by its expansion into Pennsylvania. ChristianaCare took over five of Crozer Health’s freestanding outpatient locations in Delaware County.

    Temple University Health System: Temple had a $50.5 million operating loss in the six months that ended Dec. 31. In the same period the year before, Temple reported a $13.5 million operating gain. The nonprofit attributed some of the losses to costs related to the opening of Temple Women & Families Hospital in September.

    Main Line Health: Main Line had an $8.7 million operating profit in the six months that ended Dec. 31. Main Line’s swing from an $8.9 million loss in the same period of 2024 benefited from a change in accounting for depreciation that reduced expenses. Without that change, Main Line would have had another loss.

    Tower Health: Tower had an operating loss of $16 million in the first six month of fiscal 2026, according to its report to bondholders Friday. In the same period a year ago, the Berks County nonprofit’s loss was $16.1 million.

    Redeemer Health: Redeemer reported an operating loss of $14.7 million, compared to a loss of $19.5 million the year before. The improvement happened even though the health system in Philadelphia’s northern suburbs increased revenue by just 1.2%, to $227 million.

  • Penn expert says whether to take antidepressants during pregnancy is a ‘risk-risk conversation’

    Penn expert says whether to take antidepressants during pregnancy is a ‘risk-risk conversation’

    When Sarah Bynum was pregnant with her first child in 2017, her primary care doctor suggested she stop taking her antidepressant.

    He told her there wasn’t enough research to justify staying on the medication.

    By the time she delivered her daughter, the Delaware County woman’s anxiety was so bad that she decided never again to go through a pregnancy without her antidepressant.

    Bynum, who has taken medication for anxiety since she was a teenager, is one of the nearly 18% of women in the U.S. on an antidepressant. She takes a drug known as an SSRI, the most common class of antidepressants, which medical societies generally consider safe to use during pregnancy.

    Still, roughly half of women taking an antidepressant discontinue their use of the medication while pregnant, according to a 2025 study in the medical journal JAMA Network Open.

    Kelly Zafman, an OB-GYN at the Hospital of the University of Pennsylvania, decided to research the issue that has also recently been under discussion on the federal level. She’s observed that patients often get mixed-messaging from providers.

    “The other side of the conversation that gets missed is this risk of not continuing medications,” said Zafman, who is in her final year of fellowship training in maternal-fetal medicine.

    Preliminary findings from her research showed the risk of a mental health emergency nearly doubled in women who discontinued SSRIs or SNRIs (another popular type of antidepressant), compared to those who stayed on their medication. She presented the unpublished results this month at the meeting of the Society for Maternal-Fetal Medicine.

    The analysis used data from 1,462 privately insured Pennsylvania women with active antidepressant prescriptions who gave birth between 2023 and 2024. While pregnant, 81% of them stopped or interrupted usage.

    Zafman said the highly personal decision comes down to factors such as the patient’s prior pregnancies, mental health history, and how well-controlled their symptoms are.

    Ultimately, the potential risks have to be weighed against those of untreated depression or anxiety.

    “It’s really a risk‑risk conversation,” Zafman said.

    Evolving research

    The American College of Obstetrics and Gynecologists discourages discontinuing antidepressants based on pregnancy alone, highlighting the risks of untreated mental health conditions. Studies have linked uncontrolled depression during pregnancy with preterm birth, low birth weight, higher suicide risk, and impaired mother-infant attachment.

    Research on the safety of antidepressants in pregnancy continues to evolve. Some potential risks identified in older research appear overstated when compared with more recent, better-designed studies, Zafman said.

    She cited as an example a rare but serious condition called persistent pulmonary hypertension — which causes a breathing issue — for which scientific evidence remains conflicting.

    “There’s definitely an association, but it’s not totally clear how causative it is,” Zafman said.

    Another concern, neonatal adaptation syndrome, tends to involve mild difficulties with feeding and breathing that resolve within days. Medical intervention is rarely required, and the treatment essentially is to cuddle and feed your baby, Zafman said.

    While antidepressants potentially pose risks in pregnancy, she said, overall, the risks of long lasting effects are “extraordinarily low.”

    A personal decision

    Bynum, a patient at Penn Medicine, was not on antidepressants during her first pregnancy. (She was not part of this particular study but has participated in other research with Zafman.)

    Five months into the pregnancy, she learned her daughter would be born with a congenital heart defect that would require monitoring, and later, surgery.

    Family and friends tried to help her, but they weren’t able to calm her heightened anxiety the way her medication usually would.

    When she became pregnant with her second child, she knew she wanted to have a “more mentally healthy pregnancy.”

    “I needed to be mentally and physically present not just for myself, but my daughter,” she said.

    She asked her OB-GYNs if she could continue on her antidepressant, Paxil. They weren’t sure.

    She turned to the fetal heart experts at Children’s Hospital of Philadelphia, who looked into the medical evidence and told her it was fine to continue taking her antidepressant.

    Sarah Bynum decided she would not go without her antidepressant for future pregnancies.

    Bynum has since had three healthy pregnancies while taking the antidepressant.

    She felt it was the right decision.

    “I need to focus on having a healthy pregnancy with as minimal stress as possible,” Bynum said. “And if that means taking a medication, that’s what’s gonna work.”

    Editor’s note: This story has been updated to clarify a quote by the researcher.