Stacey Camille Alexander-Harriss · Prevention of Future Deaths report

On the 8th October 2020 I commenced an investigation into the death of Stacey Camille Alexander-Harriss. The investigation concluded at the end of the Inquest on the 28th April 2021. The conclusion was a narrative conclusion:

Mrs Alexander-Harriss died as a result of an overwhelming bacterial infection caused by a dog bite.

Mrs Alexander-Harriss was bitten by a dog on the 15 June 2020. In the late afternoon of the 17 June 2020, she began to feel unwell and was taken to hospital by ambulance.

The dog bite itself appeared, superficially, to be healing. The paramedics suspected sepsis (unknown cause) and placed a pre-alert call to the hospital. Mrs Alexander-Harriss arrived in the emergency department at 1904. The emergency department team noted that she was very unwell, with a metabolic acidosis. IV fluid resuscitation was provided promptly on arrival to hospital. Within the first hour of arrival in hospital, Mrs Alexander-Harriss underwent a clinical examination; venous blood gas; laboratory bloods were taken; IV fluids and oxygen administered; painkillers administered; ECG and chest x-ray carried out and her care was escalated to an emergency department consultant. The full blood count led to a primary suspected diagnosis of neutropenic sepsis and she was commenced on IV Tazocin for this. The Tazocin was commenced at 2035. Transfer to the ITU team took place at 2052. Mrs Alexander-Harriss received one to one care in ITU. In the early hours of the 18 June 2020, Mrs Alexander-Harriss suffered a cardiac arrest, from which she could not be successfully resuscitated. A blood culture received after she had passed away revealed the bacterial growth of Capnocytophagia canimorsus. This organism is commonly found in the mouth of dogs. There is a possibility that earlier administration of Tazocin might have made a difference to the outcome.

The evidence during the course of the Inquest gave rise to a concern as to a knowledge gap in relation to the organism Capnocytophagia canimorsus. The attending doctors were not familiar with this form of bacteria living within the mouths of dogs and cats and how easy it is to infect people with this organism. A severe traumatic injury is not required for infection to develop. This organism can cause an overwhelming infection in susceptible individuals. The Inquest heard that conditions such as type II diabetes and hepatic steatosis render the individual to a higher risk of serious infection. The inquest heard that raising awareness of this organism and the underlying high risk medical conditions within the medical profession, may prevent future deaths.

The Inquest also heard that there may be a need for greater public awareness in relation to the need to seek urgent medical attention if a person suffers from a relevant underlying illness and becomes generally unwell following a dog or cat bite.