A teen honoured by Theresa May for her fundraising died after contracting a rare water-based infection in hospital while being treated for cancer, an inquest heard.
Tragic Tatiana Stankovic-Davis, 13, dubbed an "inspiration" by the Prime Minister, was admitted to hospital in the spring of 2017 for treatment for leukaemia.
She raised nearly £20,000 while poorly to pay for new toys for children on hospital wards across the UK.
But while Tatiana was being treated at Bristol Children's Hospital for Acute Myeloid Leukemia (AML) in 2017 she caught rare water-borne infection Fusarium.
The fungal infection is so rare there have been less than 100 cases recorded in the UK – and there is no national standard for guarding against it, the inquest in Bristol heard.
And as a result of contracting Fusarium, Tatiana's AML returned – preventing her from receiving a life-saving bone marrow transplant she had been waiting for.
The findings have led to a full review being carried out of ward 35 at the hospital, where Tatiana was being treated, by the infection control team.
Issues were found with the drainage of the showers on the ward, and swabs revealed that Fusarium was present in 80 per cent of shower trays.
It was also found in the drainage system and the air vents. It was the first ever case of the infection at the Bristol hospital.
A new cleaning regime has now been introduced, along with a move to filter air through the vents to reduce the risk of fungal infections.
The inquest heard Tatiana, described by her family as a "beautiful red-headed Lego-loving girl who was brave and resilient", was diagnosed with a rare cancerous tumour in her bladder in March 2015.
The teen, who was partially deaf, underwent surgery followed by chemotherapy and radiotherapy treatment which resulted in her losing her hearing altogether.
During 2015 and 2016 Tatiana was in remission and had regular check-ups at hospital and started secondary school, and was told in January 2017 that she was clear of cancer.
But later that same month Tatiana started to suffer with swollen gums.
Devastating x-ray results revealed she had developed therapy-related Acute Myeloid Leukaemia (AML).
She underwent further chemotherapy treatment and was told that the only hope of a cure was a bone marrow treatment.
But the inquest heard any relapse of her AML could prevent any transplant.
Tragically, in March 2017, while in hospital, Tatiana developed the fungal infection Fusarium, for which she was treated with antibiotics and anti-fungal medication.
And in July, Tatiana relapsed where it was discovered her AML had returned.
A bone marrow treatment was ruled out due to the fact that the match found was not 100 per cent perfect, and the risk that she could still have a Fusarium infection.
Mum Nada said: "I asked Tatiana if she wanted to go through any more chemotherapy.
"However she was adamant she would tolerate more and kept saying she did not want to die."
After undergoing further treatment and preparing to be discharged, Tatiana complained of a pain in her right hip when visiting the bathroom on the hospital ward on August 6.
Further tests revealed a fracture in her hip, which medics believed to be caused by the AML.
Soon after, she became unwell, with a distended stomach and fluid on her lungs.
Her condition continued to deteriorate and Tatiana died at 3.45am on August 23 with her parents by her side.
A post-mortem examination was carried out 15 days after her death, and reviewed by Dr Andrew Bamber, a paediatric consultant in pathology.
The post mortem revealed Tatiana’s AML had spread and there were masses of AML cells in her liver, abdomen and lungs.
Dr Bamber said he could find no firm evidence of a Fusarium infection – or any other infection – at the time of her death.
But the post mortem did reveal Tatiana had previously undiagnosed Hypertrophic Cardio Myopathy.
He said although this was not a main cause of her death, he ruled it was a contributory factor.
The main cause of death was given as therapy-related Acute Myeloid Leukaemia.
The inquest heard after Tatiana’s death, infection control at the hospital had carried out a full review of ward 35.
The affected cubicles were closed and improvements to the drainage and showers were carried out to stop water collecting.
Bryony Strachan, clinical chair for women's and children's services at University Hospitals Bristol NHS Foundation Trust, told the inquest: "The cleaning regime was to the standard of any ward.
"The new cleaning regime was a precautionary measure to go above that standard.
"There are no national standards regarding Fusarium so we took a belt and braces approach.
"Fusarium is an extremely rare infection and it was our first ever case at the hospital."
Senior coroner for Avon Maria Voisin recorded a conclusion that Tatiana died from natural causes.
A University Hospitals Bristol NHS Foundation Trust spokesperson said: "We would once again like to offer our condolences to Tatiana’s family and friends.
"Today’s inquest concluded that Tatiana died due to natural causes, and we hope that this independent process has provided her family with answers to any questions that they had."
"Our thoughts remain with Tatiana’s family and friends on what has no doubt been a very difficult day for everyone involved."
AN INSPIRATIONAL GIRL
Tatiana, who friends said was ‘kind to everyone she met’, had raised nearly £20,000 while poorly to pay for new toys for children on hospital wards across the UK.
Consistently providing toys for children undergoing chemotherapy is costly, as strict infection control rules mean few toys can be reused.
A Lego fanatic, the 13-year-old wanted to share the joy of the little plastic bricks and their powers of distraction during her treatment.
Tatiana, helped by dad Simon, raised the money alongside the charity Fairy Bricks – a small organisation set up by three Lego enthusiasts with the aim of putting Lego in the hands of children in hospitals.
Tatiana was posthumously awarded a Lord Mayor's medal as well as a plethora of other awards for her fundraising exploits.
She and dad Simon were also honoured by the Prime Minister last year with a Points of Lights Award for their efforts – with Mrs May calling Tatiana "inspirational".
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