Thursday, August 28, 2008

Cause of death may never be known

Although the woman who died at Timmins and District Hospital tested positive for the strain of listeria tied to the Maple Leaf Foods outbreak, it is possible it may never be known if that listeria was the cause of her death.
Timmins and District Hospital chief executive officer Esko Vainio told Timmins reporters Wednesday that any formal determination as to the patient’s cause of death would have to come from the coroner’s office. It was an indication that no autopsy has been performed on the deceased patient.
Ontario regional coroner Dr. David Eden told The Timmins Time he could not comment on whether an autopsy was performed because no name has been released.
“What I can tell you is, if we had received a request, we would act on it,” Eden said.
“There is a protocol for investigating infectious disease deaths. It is in the nature of infectious disease deaths that most of the diagnosis is made before death and generally when we do an autopsy in an infectious disease death, it’s because we’re not sure,” he added.
During Wednesday’s news conference, Vainio told reporters “the patient had multiple health problems” adding that no formal finding was made whether the Maple Leaf Foods strain of listeria contributed to that death.
Eden says if an autopsy is to be done, the request will have to come from a public health agency, such as the Porcupine Health Unit. “The lead role is with public health,” he said.
“To give you an example, with SARS, public health has the authority to order an autopsy, but they don’t have the authority to order it over the family’s objections.”
Eden explained that a coroner does have the right to order an autopsy over the family’s objections, but the coroner also has to weigh whether the medical knowledge learned would be beneficial.
Eden added that an autopsy that occurs after embalming and burial is not likely to reveal any new or startling information with respect to an infectious disease.
“I would think that the best information for diagnosing listeriosis is the information that was collected prior to death,” said Eden.
“Listeriosis is a condition that can be, and is, reliably diagnosed before death, so an autopsy would add very little useful information to that,” he said.
“If the most accurate test is a blood culture done during life, and you have that, why would you do a blood culture after death, which is less reliable?” he asked.

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