A three-year-old girl who died on her second visit to the emergency room in as many days had an aggressive bacterial infection, not pneumonia as her family was told.
Nimrat Gill died Feb. 7 at Abbotsford Regional Hospital, after what initially seemed to be a cold quickly worsened.
Her parents brought her to the ER, but staff told them to treat her with Tylenol or Advil every few hours. When she started vomiting later that night, she was brought back, and died within five hours.
Initially the family was told by hospital staff that her worsening condition could be because of the blood work, or because her body was fighting a high fever. After her death, their family doctor received the X-rays taken while the tot was still alive, and they were told that Nimrat had a severe case of pneumonia that caused further infections.
But nearly two months after the girl's death, the Fraser Health Authority released an update on its investigation into her case.
Officials said the BC Coroners Service will make a formal determination of cause of death when its independent review is complete, but that Fraser Health's lab tests suggest she had a bacterial infection.
Nimrat had a fast-moving, aggressive form of Group A streptococcal disease. In most cases the disease causes mild illnesses like strep throat, but if it invades the lungs or blood it can be more serious. The bacteria is common, and easily transmitted through contact with a person who is infected, or their saliva or mucous.
Life-threatening cases of Strep A are rare, but there have been a number of reports recently about Canadians losing limbs. Earlier this year, a Manitoba mother lost three limbs to a strep infection, which her family initially believed to be the flu.
Conditions associated with invasive Strep A include meningitis, blood poisoning (septicemia), and necrotizing faciitis, often called "flesh-eating disease."
"Much like other severe or invasive cases, when you detect earlier, sooner, there can be more options for management," Fraser Health's chief medical health officer Victoria Lee told CTV News.
"Our hearts go out to the family."
In light of Nimrat's diagnosis, Fraser Health is consulting with the vice president of medical affairs at BC Children's Hospital, who is an expert on care for severe pediatric infections. The VP, Dr. Niranjan Kissoon, reviewed the tot's care at the Abbotsford hospital, and submitted a report to Fraser Health with his recommendations.
As a result, Fraser Health is taking six actions, including sepsis screening for all pediatric patients regardless of symptoms.
Fraser Health will also implement regular simulation training on what to do in pediatric emergencies, and improve mechanisms already in place for collaboration between Abbotsford's pediatric and emergency departments. The authority will continue to educate staff on standards for clinical documentation, and is comparing Abbotsford's escalation processes and shift handovers to best practices at other Fraser Health sites.
The health authority will also implement a Pediatric Early Warning Signs decision tool currently being tried out in Richmond.
Fraser Health CEO Michael Marchbank said there's no way to know whether Nimrat would have survived had she been diagnosed earlier.
"Nothing we can do can bring Nimrat back, but we need to learn as much as we can and implement changes that will help us moving forward in improving patient care,” Marchbank said.
The girl's family has hired a lawyer who is conducting an investigation into what happened.
With files from CTV Vancouver's Maria Weisgarber and Shannon Paterson
