At a glance…
- A child in Queensland has died reportedly from a vitamin C deficiency, known as “scurvy”
- Once a common and deadly disease, scurvy is now exceedingly rare in Australia. The child’s death is a stark reminder that severe vitamin C deficiency can still have devastating consequences.
Scurvy probably brings to mind a time when sailors travelled the seas for months with nary a lemon to share. The convict era, the age of discovery or the age of colonisation. It feels like a relic from the past, and for most of us, it is. Modern Australians have great access to fresh fruit and vegetables. We also have access to supplements to supplement our diets. That’s why it was so shocking to hear the news that a young boy has died from a Vitamin C deficiency, aka scurvy.
Stephanie Gallagher, Deputy State Coroner for Queensland, has released her report on the sad death of Connor Dean, a six-year-old who suffered a cardiac arrest following a general anaesthetic. The report found that Connor had “severe vitamin C deficiency” and clinical and radiological features consistent with scurvy, a condition caused by prolonged vitamin C deficiency that is now rare in Australia.
Connor had Trisomy 21 (Down Syndrome), and his parents confirmed in the coroner’s report that he was a “fussy eater”. They gave him a multi-vitamin to ensure he had the nutrients he needed. Sadly, the multivitamin did not contain vitamin C. They were unaware of him having a Vitamin C deficiency until after his cardiac arrest.
Connor died at Queensland Children’s Hospital on August 10, 2024, three weeks after he was admitted with worsening leg pain and difficulty walking.
Why was Connor in hospital?
Connor had undergone surgery as an infant to repair a congenital heart defect and was described in the report as having global developmental delay. In July 2024, his parents took him to his GP after three weeks of worsening symptoms. What initially appeared to be a problem with his legs had progressed from knee pain and a shuffling gait to limping and eventually refusing to bear weight.
Urgent imaging did not reveal an obvious cause. Connor was admitted to Queensland Children’s Hospital on July 18 for further investigation. His blood tests showed some kidney dysfunction. While X-rays of his spine, ankles and foot did not show fractures or other abnormalities. While in hospital, Connor developed a cough and tested positive for parainfluenza. He subsequently required oxygen and treatment for dehydration.
Two days after his admission, he underwent an MRI under general anaesthetic. During the procedure, he required increasing cardiovascular support before rapidly deteriorating in recovery. Doctors initially considered a number of possible explanations, including infection, osteomyelitis, leukaemia and a pulmonary embolus. But further testing began to point towards a severe nutritional deficiency.
Connor’s vitamin C level was less than 1 micromole per litre. The reference range was 20–120. His MRI showed abnormalities in his bones that were considered consistent with scurvy, while he was also deficient in vitamins A and E and had borderline low vitamin D.
A growing concern about Connor’s diet
According to the findings, Connor’s paediatrician had longstanding concerns about his growth and nutrition.
By May 2023, Connor had become a “very fussy” eater and was no longer eating fruit or vegetables. Over the previous 11 months, he had gained just 300 grams, compared with an expected gain of around 1.5 to 2kg.
His paediatrician told the coroner he was concerned Connor’s diet did not provide enough calories, vitamins or minerals for him to grow and remain healthy.
“I became concerned with Connor’s diet during my review on 10 May 2023,” Connor’s paediatrician says in the report. They noted that his diet included “lots of white bread, some beef sausage, custard and chocolate.” And while he was offered vegetables at daycare, they didn’t believe he was eating them.
Connor was referred to a dietitian, and his family was advised to give him a multivitamin, alongside other supplements and vitamin injections. At the time, his doctor believed his nutritional requirements were being adequately covered.
However, when Connor was admitted to hospital in July 2024, testing revealed his vitamin C level was less than 1 umol/L; dramatically below the reference range of 20 to 120.
Doctors subsequently identified clinical and radiological signs consistent with severe scurvy, the disease caused by prolonged vitamin C deficiency.
The multivitamin at the centre of the findings
The coroner heard that Connor had been taking a product described as a multivitamin. However, after his hospital admission, his paediatrician discovered that the product did not contain vitamin C. It also did not contain vitamins K or E and provided only half the recommended amount of vitamin A.
“I am concerned that a product such as (the Product) is available in Australia,” the paediatrician said of the unnamed vitamin. “I believe that it is misleading to call this product a multivitamin when it misses essential vitamins such as Vitamin C.”
The paediatrician continues that Vitamin C enhances a person’s ability to absorb non-haem iron; therefore, they find it “illogical” not to include it.
His clinical opinion was that Connor would not have developed vitamin C deficiency and the clinical features of scurvy that led to his death if he had been taking a different multivitamin containing vitamin C.
Connor’s parents told the coroner they had given him his multivitamin and other supplements as instructed, but were unaware he had developed a vitamin C deficiency until after his cardiac arrest.
The manufacturer of the product rejected the suggestion that its product contributed to Connor’s death, telling the coroner that “multivitamin” means a product containing multiple nutrients and does not necessarily mean every essential vitamin is included.
It also said the product’s ingredients were clearly listed and that multivitamins are not intended to treat severe nutritional deficiencies.
What the coroner found
The coroner accepted that Connor had severe vitamin C deficiency, with the clinical and radiological findings consistent with scurvy.
His death certificate recorded the cause as hypoxic-ischaemic encephalopathy, due to cardiac arrest following general anaesthesia, in the setting of vitamin C deficiency. Down syndrome was recorded as a contributing condition.
While the precise mechanism that caused Connor’s cardiac arrest could not be definitively established, the treating doctors and forensic pathologist considered his severe vitamin C deficiency the most likely underlying factor.
Importantly, the coroner did not find there was sufficient evidence to conclude that the multivitamin itself contributed to Connor’s death. The findings noted an apparent lack of monitoring of Connor’s vitamin C levels before his cardiac arrest, making it impossible to establish that the product itself caused or contributed to the deficiency.
No further inquest was ordered. However, Coroner Gallagher said publishing the findings could help draw attention to Connor’s death and potentially prevent similar deaths from occurring in the future.
Connor was born in March 2018. He was six years old when he died.
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