Seven-year-old River Ross doesn’t remember the day he was airlifted to Johns Hopkins All Children’s Hospital following a car crash in January 2016. It’s a day his parents, Kristine and Brian, and their extended family will never forget.

Kristine had a broken arm and jaw after losing control of her vehicle and hitting a tree. River’s twin, Alex, and their one-year-brother escaped injury, but the lap belt system holding River’s booster seat in place may have malfunctioned. Thrown forward against the seat, he sustained a serious skull fracture and a severe traumatic brain injury (TBI).

As a Manatee County firefighter, Brian responds to many serious accidents. This time was completely different. “Nothing can prepare you for seeing your own family in that situation,” he explains.

River was taken by ambulance to a nearby hospital and then by helicopter to Johns Hopkins All Children’s Hospital. The trauma team and Pediatric Intensive Care Unit staff were ready and waiting. Pediatric neurosurgeon Luis Rodriguez, M.D., performed surgery to repair the skull fracture—a procedure that was just the start of a long road to recovery.

“River was minimally responsive for the first two weeks and was hospitalized for a total of three weeks,” says James Chinarian, M.D., a pediatric physical medicine and rehabilitation specialist with the Johns Hopkins All Children’s Institute for Brain Protection Sciences. “A serious TBI can impact speech, movement, cognitive function and memory, and it is hard to predict how quickly or how fully a patient will recover. River’s team of doctors, nurses, acute care rehab and child life therapists provided outstanding care, which gave River the best chance for a full recovery.”

Those weeks are still a blur to Kristine and Brian. One of them was usually at his side day and night. They remember the kindness and compassion of the staff and are thankful for their expertise.

“It really was a scary time for a while,” Kristine recalls, “but once he started laughing at bathroom jokes we knew he was going to be okay.”

As River began to make progress and no longer needed such focused and complex medical care, it was time for another ambulance ride. He was discharged from Johns Hopkins All Children’s and transferred to an inpatient pediatric rehab program for three weeks, with his parents supporting him and cheering him through the long days of therapy sessions aimed at helping him recover speech and motor skills.

River returned home to continue his long recovery, seeing Dr. Chinarian for frequent follow-up evaluations and going for pediatric speech, occupational and physical therapy at Johns Hopkins All Children’s Outpatient Care, Sarasota. His parents helped with specific therapy exercises at home, too.

River returned to school in August. At other times, you are likely to find him playing in the backyard with his brothers.

“His speech has improved and his ataxia (difficulty with walking and coordination) is improving too,” says Kristine. “He’s not running quite as fast as he used to but that’s getting better every day, and mentally he’s already made just about a full recovery. We are very thankful.”

“River’s recovery would not have been possible without the coordinated team approach at Johns Hopkins All Children’s Hospital,” says Chinarian. “This begins in the field, at the scene of the accident. It progresses through the emergency department, the PICU and acute hospitalization, and then ultimately to rehabilitation, which is typically the longest part of the journey. In keeping with our focus on family-centered care, River’s family was involved every step of the way. His recovery would not have been so complete without their love and support.”

Car Seat Safety

Brian is a member of Southern Manatee Fire Rescue, which is a very active member of the Manatee County chapter of the Suncoast Safe Kids Coalition led by Johns Hopkins All Children’s Hospital. He enjoys teaching children and families about pedestrian and bike safety, fire safety and child passenger safety. His family’s story is a reminder of the importance of using the child passenger safety seat appropriate for weight, age and height. You can learn more about child passenger safety classes and car seat safety inspections on our Child Passenger Safety Car Seats page.