Inquest into the death of Harriet Ostler

1y · Female·sudden cardiac death on a background of rhinovirus infection

Harriet Ostler, a 19-month-old toddler, was admitted to Port Macquarie Base Hospital with viral respiratory symptoms and died from sudden cardiac death due to underlying myocarditis/cardiomyopathy precipitated by rhinovirus infection. Clinical lessons include: (1) recognising that pulmonary consolidation on chest X-ray can indicate cardiac pathology with fluid overload, not just infection; (2) interpreting abnormal vital signs (respiratory rate >70, elevated heart rate) as requiring escalation despite fever; (3) the importance of blood gas sampling when vital signs deteriorate; (4) implementing Between the Flags vital sign monitoring systems to trigger medical review; and (5) establishing clear escalation pathways rather than vague instructions. The coroner noted the underlying cardiac pathology was not recognised. Whilst an abnormal blood gas or correct CXR interpretation might have prompted investigation, whether earlier recognition would have prevented sudden cardiac arrest remains unclear given the rapid deterioration.