An Ottawa family is looking for answers after their daughter died of meningitis less than 24 hours after being sent home from the Queensway Carleton Hospital’s emergency department with a prescription for penicillin and an uncertain diagnosis.
Lily Mueller, 23, died on June 27. It wasn’t until after her death that meningococcal disease was confirmed as the cause, says her distraught mother, Roxsanna Mueller.
The regional coroner’s office is investigating the death and Ottawa Public Health officials have contacted people who might have been exposed to the infectious disease to get treatment, if necessary.
Meningitis is spread through saliva, often through sharing drinks, cigarettes and food, or kissing. It cannot be spread by simply being in the same room as an infected person or by sharing a computer.
Mueller said the family is trying to cope with the sudden illness and death of their healthy and fit daughter. And they want answers about why Lily was sent home from the hospital when she originally showed up with a high fever and stiff neck, both symptoms of meningitis.
“I want to know why they let her go,” said Mueller. “Why did they let her walk out the door with penicillin when they didn’t know what it was?”
Dr. Andrew Falconer, chief of staff at Queensway Carleton, said in a statement to this paper that the hospital wants to talk to the family once they are ready.
“We extend our deepest sympathies to the family and have reached out to them in hopes of discussing the details when they are ready. We realize this must be a very difficult time.”
The young woman, who worked at a west-end fitness club, complained to her mother during the evening of June 25 that she felt “really horrible” and had a stiff neck. Her mother gave her some Advil and told her to try to get some sleep.
Early the next morning, around 4 a.m., Mueller said her daughter came into her bedroom in distress, saying, “Something is wrong: I can’t move my neck, I have a sore throat, my head hurts.”
Mueller said her daughter’s temperature was 105.3 degrees Fahrenheit (a temperature over 100.4 usually indicates a fever from an infection or illness).
Lily’s father rushed her to the hospital. Two hours later, Lily returned home telling her mother she had been told doctors weren’t sure what she had, but that it was probably Strep throat or mononucleosis. She was given a prescription for penicillin.
Over the course of the day, her family watched in alarm as Lily’s condition worsened. Her mother filled the prescription and tried to give her penicillin, but Lily began vomiting and couldn’t keep anything down. Her temperature remained between 102 and 103, her mother said.
Mueller said she rushed her daughter back to the hospital around 5 p.m. after she had put her in the bath to cool her down and she began screaming about the pain in her neck.
On her second trip to Queensway Carleton’s emergency department, Mueller said, her daughter was rushed in immediately. By then, Lily’s skin was white, her lips were turning blue and she was complaining about pain when she tried to breathe.
Over the next several hours, she was given intravenous antibiotics and fluid and eventually intubated to allow her to breathe. Mueller said when she returned to her daughter’s bedside after she had been intubated she “just about fell on my knees.”
Her daughter was sedated, hooked up to machines and surrounded, she said, by four or five doctors. Mueller said a doctor told her daughter had a “very strong virus … is it Strep? Is it Mono? We don’t know.”
Mueller said she asked about meningitis, but was told her daughter’s “were not the symptoms.”
She was told Lily was on a very broad spectrum of antibiotics for everything she could possibly have.
A doctor eventually sat her down and said: “This is a very highly infectious disease. We don’t know what it is, but it looks like she is septic.”
Lily Mueller died about 3 a.m. the next morning, her mother said. Her entire family was with her.
“It was a nightmare. I couldn’t believe I was talking to her the day before and she was lying there dead.”
Both she and Lily’s father were upset and in disbelief.
“I was screaming at them ‘You sent her home. Why did you send her home?’ They just had no answers as to why they sent her home.”
Ottawa public health officials have since vaccinated family members against meningitis and treated them with prophylactic antibiotics in case they were infected. No one else has become ill. Officials also asked the family for a list of whom Lily had been around seven days prior to becoming ill in an attempt to trace the source of the infection. Mueller said the source is not known.
Dr. Robin Taylor, associate medical officer of health with Ottawa Public Health, said meningitis is rare and often difficult to trace. Because it is a reportable disease, meaning it must be reported to public health officials, they are required to trace contacts and treat those who have been exposed.
“It is very rare. It is tragic when it occurs. Our job really is to make sure anybody who might have been exposed is followed up with.”
Cases of meningitis reported to Ottawa Public Health have risen slightly in recent years — from 15 in 2013 to 21 in 2017. In 1991, public health officials vaccinated 250,000 young people in Ottawa after four teenagers died of meningococcal disease.
A headache, fever, sensitivity to light and a stiff and sore neck are signs of meningitis. It tends to be more common in younger people, who spend a lot of time together and are more likely to share food and drinks.
Infants are routinely vaccinated against meningococcal disease and a separate vaccine is today given in Grade 7 in Ontario. Taylor said immunization has proven to be effective in decreasing the risk of the infection, although strains have changed since vaccination has become more common. There is more than one kind of infectious meningitis.
“It is a very rare and incredibly serious disease.”