Stephanie and Eric Biesenbach drove their 11‑day‑old daughter, Gwen, to a freestanding emergency department in New Braunfels, Texas, after the infant’s umbilical cord stump began bleeding profusely. The parents had declined the standard vitamin K injection at birth and were instead giving Gwen oral vitamin K drops.
When the family arrived at the Lonestar 24HR ER on a warm August evening in 2023, the on‑call physician, Dr. Nicole Malouf, covered the oozing belly button with a special gauze. After the bleeding appeared to stop, she discharged the family. Within minutes, Gwen’s pajamas were soaked through, prompting the parents to return.
Attempts to Control the Bleeding
Dr. Malouf documented a series of escalating interventions over nearly three hours. She applied a second type of pre‑treated gauze, then used silver nitrate sticks to cauterize the vessels. In total, seven distinct methods were tried, including applying strong pressure that caused Gwen to vomit. The physician consulted her husband—also a doctor—and a local hospital nurse, but none could identify a definitive solution.
Medical records note that the baby’s heart rate rose to 177 beats per minute and she grew increasingly pale. The physician eventually decided to transfer Gwen to a nearby hospital that had pediatric specialists and a neonatal intensive care unit.
Transfer Delays and the Critical Role of Vitamin K
The transfer plan involved a NICU transport team from North Central Baptist Hospital in San Antonio, roughly a half‑hour away. Dr. Malouf called for an ambulance, but the transport unit did not arrive until nearly two hours later. When the team finally reached the ER, they inquired whether Gwen had received a vitamin K injection. An ER nurse reported that the shot was not on hand.
At 3:45 a.m., minutes after the ambulance’s arrival, the transport team administered a vitamin K injection into Gwen’s left thigh. The bleeding stopped shortly thereafter.
Aftermath and Broader Context
Following the incident, the Biesenbach family filed a complaint with the Texas Medical Board, alleging that Dr. Malouf failed to recognize vitamin K deficiency bleeding (VKDB). The case highlights a growing trend: families opting out of the vitamin K shot despite its long‑standing use since the 1960s. Recent studies cited in the source indicated that between 2017 and 2025 the rate of VKDB rose 347 percent, underscoring the protective effect of the inexpensive injection.
Freestanding emergency rooms, which number more than 200 in Texas, are not attached to hospitals, potentially complicating rapid transfers to higher‑level neonatal care. The Biesenbachs’ experience illustrates how delayed recognition of VKDB and limited access to the vitamin K shot can extend an infant’s suffering and increase the burden on emergency providers.
Gwen’s parents emphasized that they had been giving her oral vitamin K drops, trusting them to provide protection. The eventual administration of the intramuscular shot proved decisive, prompting calls for greater awareness among parents and clinicians about the risks of declining the standard vitamin K injection.
Helene Elliott is the Lead Science & Space Reporter at News Raise. She reports on aerospace missions, astrophysics discoveries, quantum research, and environmental technology.
