Pediatric Orthopaedic Practitioners Society POPS

Question from POPS member Susan Laham

Posted over 2 years ago by Suzanne Hilt

Hello all,
We previously had a DME company locally that would rent out EZ vests for our bigger kids in spica casts. They are no longer renting them and are a purchase item only. We only have 2 insurance plans in Michigan that will pay for them. This is becoming a hardship for some of our families that don't have $160 to pay for this item. Our hospital won't allow us to take in used items due to liability. Do any of you have a similar problem or any suggestions? Our Foundation has purchased 6 for our department, but they won't last long.

Thanks so much!
Sue Laham
Helen DeVos Pediatric Orthopaedics


Chuck Wyatt over 2 years ago

Our trauma hospital CMC Dallas the larger kids are given an evenflo titian car seat which I think is somehow rated to be used with a spica cast. I am going to attach a link to something I found on Seattle's Children's website. Not sure if this answers your question or not.,d.amc

Tracy Curtis over 2 years ago

Our material services department purchases the EZ-on vests and then we bill for them as part of the surgical package (our kids get their spicas on in the OR). This way, they are covered. We have the same difficulty with insurance not covering them in the outpatient world.

We also use Hippo spica car seats as a rental, though Britax unfortunately stopped making these as of Dec 2015 so it is difficult to get your hands on them. We find that many folks can in fact use their regular convertible car seats (not the infant seats so much) as long as the side cup holders are removed. Sometimes, they even fit in their sibling's car seat as long as the weight and height restrictions are met. The titan, Diono and marathon brands also work.

Susan Laham over 2 years ago

Thanks Chuck!

Susan Laham over 2 years ago

Thanks Tracy!

Leslie Rhodes over 2 years ago

Hi Sue! We have had similar problems with our spica casts recently and over the years at LeBonheur in Memphis. Our EZ on vests are provided through our Safe Kids Foundation through a grant. We actually loan them out and surprisingly, most of the time, get them back. I like the idea of billing as a part of the surgical package- that may be an option you can explore. And your hospital not allowing you to take them back in due to liability- I wonder what that really means. If you have a Safe Kids coalition, maybe they can help you out because it is not really the hospital. Once the Hippos stopped production we had a huge uproar over what we were going to do as far as car seats. We have been recommending the Diono Radian R100 for parents to purchase and are working on getting a new grant for the hospital to supply these car seats. It is still an unsolved problem at our institution. We take it patient by patient and figure it out as we go right now...

Anne Stuedemann over 2 years ago

Hi! I wrote to our car seat team, here is their reply:
"We do request a donation... even for the "loaners" - the HIPPOs, and the other special needs car seats. Those that are "conventional" - the modified EZ on Vest.. as well as the HIPPOs - recycling them for another child to use. We are trying to send out the padding, harness ad covers to a professional cleaner now... but that still is labor intensive - about 30-40 minutes per seat.
We have had a loaner program for the HIPPOs for many years; when families do not return the HIPPO the hospital eats the cost of providing an appropriate restraint. Our goal is to send these babes home as safe as possible. We try to use a conventional car seat when the casting angle allows. We have Graco Symphony's in Distribution for those kids and those are not "returned". We would rather provide a $150 car seat or the modified EZ on vest to the child - one that can be used after the cast is removed than use a loaner seat."

Susan Laham over 2 years ago

Thanks Leslie and Anne!

Amanda Mccullough over 2 years ago

All great info. Building off of this...about a year ago there was a great post about who to contact regarding whether the Hippo car seats would be coming back into manufacturing. I can't seem to go that far back on our discussion board. Does anyone have that information or know how to find the archived info?! Has anyone heard any rumblings of this? Thanks!

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