The pediatrician who treated a three-year-old foster child before her death six years ago testified at a coroner's inquest in Prince George, B.C., that a perfect storm of medical conditions may have caused her death.
Savannah Hall was found unresponsive by her foster mother and rushed to Prince George hospital in January 2001. She died two days later in Vancouver.
Dr. Marie Hay, a pediatrician testifying at the inquest into Hall's death, said she believes a seizure, combined with several other illnesses, led Savannah to suffocate in her bed.
Savannah had signs of pneumonia, a bacterial ear infection and was low in calcium, magnesium, potassium and sodium, said Hay.
The illnesses made Savannah so weak that when she had a seizure and vomiting, she was unable to lift her head to breathe, Hay said she believes.
Her theory is backed up by an article in a British medical journal, she testified.
Hay testified Savannah's foster mother told her the girl wasn't well, and had been put to bed on her back with a bottle of milk, bananas and raw egg.
She believes the girl had been weakened by an ear infection and a virus that gave her a cold and inflamed her heart.
Hay told the inquest the raw egg mixture, perhaps meant to soothe the girl, instead made her vomit in her pillow.
Too weak to turn over, Savannah may have choked on the vomit and breathed it into her lungs, cutting off oxygen to her brain, testified Hay.
That, combined with low sodium levels in Savannah's blood, could have caused a seizure thatled to swelling in the brain and a rapid drop in body temperature, said Hay.
But Hay said her theory doesn't explain bruises found on Savannah's body or what the doctor believes is a 40-minute gap in the foster mother's description of what happened the night six years ago when the child was rushed to hospital barely alive.
Harness used to restrain child
On Tuesday the inquest heard provincial social workers approved the use of a restraint in the playpen where Savannah slept in her foster home.
Scott Horvath, a senior social worker with the Ministry of Children and Families, testified he visited Savannah Hall's foster home after hearing reports about the foster parent's use of a restraint on the girl while she slept.
He testified he found the foster home to be "a typical middle-class home, clean and well kept" and he observed a body harness attached to the playpen where Savannah slept.
Horvath believed Savannah had night terrors and he "signed off" on the harness as a "safety measure," but he testified he never confirmed that it was medically necessary or safe for Savannah Hall.
Savannah's biological mother, Corinna Hall, also testified at the inquest Tuesday, saying that during her visits to see her daughter, the child appeared hungry, undernourished and withdrawn, and had unexplained bruises on her body.
The inquest, which began Monday, is scheduled to continue until Nov. 2.