By the numbers

17

Total number of U.S. heatstroke deaths of children left in cars so far in 2014.

44

Total number of U.S. heatstroke deaths of children left in cars in 2013.

623

Total number of U.S. heatstroke deaths of children left in cars, 1998-present.

38

Average number of U.S. child heatstroke fatalities per year since 1998.

Of 606 child vehicular heatstroke deaths from 1998 through 2013:

51%

Child "forgotten" by caregiver (312 children)

29%

Child playing in unattended vehicle (177)

18%

Child intentionally left in vehicle by adult (111)

1%

Circumstances unknown (6)

Deona Bien had worked through seven years of infertility treatments, and finally she was pregnant with twins. One twin died.

Safety tips for kids and hot cars

Never leave children alone in or around cars. Do not let children play in and around cars.

Put something you'll need such as your cell phone, handbag, employee ID or brief case on your car's backseat floorboard. Then, you will always view that area when you get out to leave the car.

Open the back door of your vehicle every time you reach your destination to see if a child is in your car, even when think there isn't one.

Keep a large stuffed animal in the child's car seat when it's not occupied. When the child is placed in the seat, put the stuffed animal in the front passenger seat. When the stuffed animal is up front, you know the child is in the car.

Make arrangements with your child's day-care center or babysitter that you always will call if your child will not be there on a day as scheduled.

Keep vehicles locked at all times, even at home.

Keys and remote openers should never be left within reach of children.

When a child is missing, check vehicles and car trunks immediately.

If you see a child alone in a vehicle, get involved. If they are hot or seem sick, get them out as quickly as possible. Call 911.

Be especially careful during busy times, schedule changes and periods of crisis or distraction.

Use drive-thru services when available at stores, banks and so on.

Use your debit or credit card to pay for gas at the pump and other services that allow you to stay with your car.

For more information, go to http://wh.gov/lL8nX

Source: KidsandCars.org

And then came Aslyn Ryan.

Born with giant blue eyes, she would babble-sing from the backseat. Although Bien couldn't understand the words, she felt her little girl's joy.

But from that backseat, where babies like Aslyn must sit, her core temperature would reach 106 degrees one day. Like 80 percent of cases in which children die in hot cars, Aslyn wasn't left there on purpose.

Her car seat was directly behind the driver's seat of her babysitter's car. And the woman, a fellow 36-year-old mom, had a new routine. Changes in routine, Bien now knows, are common in hot car deaths.

Normally, the woman cared for Aslyn three days a week. But Bien, a nurse, had just taken a management post, so the sitter had begun to care for Aslyn five days a week.

It was February 2004, just days after Aslyn's first birthday celebration, a luau on the beach in Hawaii with a tiki pinata.

Then came the day her babysitter got out of her car and went into her house, forgetting Aslyn was still inside.

Bien called the sitter and left a message saying she could pick up her daughter early that afternoon. That phone message triggered the babysitter's memory.

Children cannot shed heat as well as adults, and Aslyn probably was left in the car about 50 minutes, Bien says. They lived in Hawaii then, and it reached 80 to 85 degrees outside.

The sitter, who wasn't charged with any crime, called Aslyn's father. Paramedics rushed Aslyn to the hospital.

"The first mistake any parent can make is to think it can't happen to me," Bien says.

S.C. tragedies

Aslyn's brain swelled, and she suffered global brain damage. Her organs shut down.

Even Bien, a nurse working with mothers and children, could not know what it felt like to see her own child dying.

"Walking in and seeing people performing a full code on your child - you never can be prepared for that," says Bien, now director of Trident Medical Center's women and children's service lines.

Two days later, Aslyn died.

Bien has since met or heard of parents from every socioeconomic stripe who also have lost children to hot cars: hospital CEOs, doctors, nurses, stay-at-home parents, you name it.

Already this year, 17 children nationwide have died after being left in hot cars.

Three of them were in South Carolina.

In May, a 13-month-old Hartsville girl died after being left in a hot car for hours outside of her father's workplace. Sophia Jane Goyeneche-Gray had fallen asleep in the backseat. Her father went into work, forgetting she was in the car.

Several hours later, he remembered. Police have charged him with unlawful neglect of a child.

In May, 13-month-old Jeremiah Kennedy of Florence died after his parents returned home from church. Each thought the other had gotten him out of the car.

He was suffering seizures when his parents found him 90 minutes later.

Jeremiah died three days later. His parents have been charged with neglect.

And just a few weeks ago, Logan Cox, a 3-year-old from Buford, went outside without his mom knowing it, got into the family's car with their dog and became trapped inside. Less than an hour passed before they found him.

Logan died four days later. His dog died, too. No charges have been filed.

Imagine the Lowcountry heat we live with most of the year.

On a 90-degree day, a car's temperature soars to 110 degrees within the first 10 minutes. Within 15 to 30 minutes, the heat inside reaches lethal levels. Once a child's core temperature rises to about 107, potentially lethal damage can occur.

The recent tragedies have led to a terrible but needed awareness, Bien says.

"I have never seen a response like this from the community," she says. "People are seeing this as a problem."

Saddest club

It took Bien two years to find someone who had been through the same thing, someone who understood.

"It's the saddest club in the world," she says.

Yet, it is one where having support from others who understand the unique emotions and challenges was hugely helpful.

For instance, after her daughter's death, Bien didn't fear death the way she once did. She wasn't suicidal. She just knew someone she loved so dearly had gone through it already - and would be there waiting for her.

Then there was the sheer magnitude of loss.

"It wasn't only losing my child but also that I lost a base of friendships because they don't know what to say to you. You're out there alone," she recalls.

Even today, what should she say when people ask how many children she has? She has an adult son and stepchildren. And Aslyn, of course.

Bien quickly turned to advocacy to prevent other families' agony.

"You can roll up into a ball and let the world go by, or you can advocate to help someone else," she says.

Bien started a not-for-profit called Hot Spot when she lived in Arizona. When she moved to the Charleston area in 2008, she also was working with the national nonprofit KidsAndCars.org to pass legislation named for Aslyn in Hawaii.

After she moved here, Bien rolled Hot Spot into the national group KidsAndCars.org. Today, she is vice president of KidsAndCars.org, which reaches out to families who have lost children to a variety of car-related deaths, including trunk entrapments and children asphyxiated by power windows.

"It has been over a decade since Deona lost her baby girl, Aslyn, and every day she is celebrated and honored by her mother," says Janette E. Fennell, founder and president of the nonprofit. "Deona is willing to do whatever it takes to make sure another family does not have to live with the unending grief."

KidsAndCars.org also pushes legislation and awareness to warn people not to leave children of any age in cars alone.

"So many people just don't know. They think it's OK to leave a child in the car for just a few minutes," Bien says.

The group supported back-up cameras now installed in cars. And its advocacy led to trunk releases now installed in cars for people locked, accidentally or intentionally, in trunks.

"I don't know of any (trunk entrapment) deaths since that piece was put into cars," Bien says.

Can the group reach that point with kids in hot cars?

Today, Kids and Cars has an online petition to ask the Obama Administration to fund research and development of technology that detects a child left alone in the rear seat of vehicles.

Cars already notify drivers if keys are in the car, if a battery runs low, if oil needs changing and if passengers aren't buckled up.

"Are we saying that a dead battery is more important than a dead child?" Bien asks.

Lives touched

Much as she loved bedside nursing, in her management post at Trident Medical Center in North Charleston, Bien can make more global changes at the medical center.

For instance, the hospital now sends all new babies home with a stuffed animal to put in the child's car seat when no child sits in it. Then, when a child is in the car, the stuffed animal sits up on the dashboard or somewhere else clearly visible. It's a visual queue to remind parents, no matter how sleep-deprived or distracted they become, a child is in there.

Trident Health System does the same thing at Summerville Medical Center's pediatrics unit. A grant from Toyota pays for informational cards to send home along with the stuffed animals. PetSmart donates the stuffed animals.

Each time a teddy bear leaves with a newborn, Bien sees hope in the wake of her own loss.

"Aslyn's journey lasted only one short year, but look at all of the lives she touched," her mother says.

Bien's colleagues at Trident agree. "Tragedy changed her life forever. She has spent hundreds of volunteer hours educating parents on hot car death prevention," says Nancy Quire, manager of labor and delivery at the North Charleston hospital. "Dee took a horrible tragedy and turned it into a lifesaving endeavor."

Seeing those babies leave, heading out with their parents into the roasting hot Charleston summer days, gives Bien pause to remember Aslyn. And what those parents, too, could lose.

"Being her mother, being able to love her for the year I had her, and all the things we've been able to do to honor her, have made me a better person," Bien says.

And saved countless lives, too.

Reach Jennifer Hawes at 937-5563 or follow her on Twitter at @JenBerryHawes.