Inquest into the Death of ST
Deceased
ST
Demographics
0y, female
Date of death
2014-11-20
Finding date
2017-03-29
Cause of death
Pneumonia in an infant with surgically repaired congenital heart disease, prematurity and failure to thrive
AI-generated summary
A 9.5-month-old girl with complex medical history (prematurity at 29 weeks, congenital heart disease status post multiple repairs, necrotising enterocolitis with ileostomy, failure to thrive) died from acute pneumonia caused by rhinovirus, norovirus, and secondary Staphylococcus aureus infection. She was in out-of-home care with her grandparents at the time of death. The coroner found all medical care was appropriate, including hospital-based care at KEMH and PMH and community nursing via Hospital in the Home. While the HiTH nurse did not perform vital signs observations during a visit on 18 November when the child was unsettled, the coroner accepted this was not substandard practice. The death was from natural causes and essentially unpreventable given the child's significant medical vulnerabilities and the rapid progression of pneumonia.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Drugs involved
Clinical conditions
Contributing factors
- Rhinovirus respiratory infection
- Norovirus infection
- Secondary Staphylococcus aureus pneumonia
- Microcephaly with reduced brain weight affecting arousal response to hypoxia
- Immune deficiency secondary to prematurity and complex medical history
- Congenital heart disease with recent surgical repair
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