Finding into death of Mrs Z

70y · Female·Tiger snake envenomation

Mrs Z, a 70-year-old woman, died from tiger snake envenomation after being bitten on the left foot while sleeping. She received two vials of antivenom within 2.5–4 hours of the bite at Royal Melbourne Hospital, consistent with national guidelines. Despite appropriate antivenom administration, she developed severe consumptive coagulopathy and life-threatening intra-abdominal haemorrhage, dying in ICU. The coroner accepted expert opinion that medical management was reasonable and timely. However, the finding highlights an ongoing clinical debate regarding whether higher antivenom doses (more than one vial) might benefit cases with severe envenoming and massive venom loads, and recommends this case and another similar death be published to inform clinical practice.