Saturday, May 24, 2008
Doctor says snakebite probably killed woman
The doctor said the family reacted correctly, but the woman suffered an extreme reaction.
A Henry County woman who died last week after collapsing in her yard is believed to have been killed by a snakebite, her doctor said Thursday.
June Engle, 62, of Ridgeway was working in her garden about 2 p.m. May 13 when, according to her husband, she cried out in pain.
"I heard her scream and she said 'Something bit me,' " Joe Engle recalled. "I could see blood flowing from her left finger. She started toward the house ... and then collapsed before she got to the door."
Engle said he performed mouth-to-mouth resuscitation for about a minute, then called 911. His wife was taken to Memorial Hospital of Martinsville and Henry County, and about two hours later was flown to the University of Virginia Medical Center.
"What our conjecture is, she had a reaction to the bite, almost like an anaphylactic reaction, almost like an allergic reaction," said Dr. Kyle Enfield, a fellow in pulmonary and critical care who treated June Engle at UVa.
Joe Engle said his wife of 44 years had no allergies that he knew of. Enfield also said she had no medical conditions and took no prescribed medications that would have contributed to her reaction. But over the course of the day, Engle said, his wife's condition got progressively worse.
"Her whole body just broke down," he recalled. "She just stopped functioning, basically. Liver. Kidneys. Her lungs were filling up with fluid, and the signs just didn't look good at all.
"It got down to the point that the doctor recommended we take her off of the ventilator," he said. "That's what we decided to do, because there was no hope."
June Engle was taken off the respirator May 15, her husband said, and she died later that day. Enfield said the family declined an autopsy and the medical examiner reviewed the case but did not believe there was a need for further inquiry.
Although the specific cause of death is not known, Enfield said he believes it was a product of organ failure caused by snakebite.
Engle said he didn't see a snake that day and hasn't seen one in the garden since last year, but he also believes a snake caused the bites.
"She had a couple of bites on the back of her left hand and what looked like a couple of marks on her forearm, which could've been bites as well," Enfield explained. He said the bites were far enough apart to rule out the possibility of a spider bite.
"When she got to us, her arm was swollen, so it made it difficult to get an exam," he added. "That's one of the reactions to snakebite."
Although death by snakebite is very rare in Virginia, Enfield thinks it could have been a timber rattlesnake, a copperhead or a pit viper, also known as an eastern cottonmouth. All three species exist within the state, according to the Virginia Department of Game and Inland Fisheries.
Calvin Reynolds, director of health statistics for the Virginia Department of Health, said death by snakebite is "a very rare occurrence" in the state. He said there have been only two reported deaths in Virginia over the past 15 years -- one in Chesterfield County in 1993 and another in Lee County in 2004.
"It's an exceedingly rare kind of reaction," Enfield agreed. "It's just one of those very sad things where everything was done the right way and a very sad outcome occurred. The family really needs to rest assured that they did everything appropriately."
He said that after a snakebite, the most important thing to do is "try to keep the person calm. Immobilize the arm but don't put a tourniquet on it. Get the person medical attention as soon as possible. Which is all the things the family did."
Engle said he's still overwhelmed by the swiftness of it all.
"It's strange, happening on a beautiful spring day when you're out working on something you love and nobody's shooting at you or dropping bombs on you," he said. "You're in a safe environment and, wham. It hit her like a ton of bricks."




