Bee sting 'cannot be ruled out' in 40-year-old Kerry woman's death

Asthma sufferer and beekeeper was found to have died of natural causes, most likely asthma

The autopsy had found no external evidence of bee sting but "tiny" pinpoint or pinprick marks were noted in the right shoulder and right femur area, the coroner said.  File picture: Darragh Kane

A bee sting "cannot be ruled out" as the cause of death of a 40-year-old asthma sufferer and beekeeper, the coroner’s court in Killarney, Co Kerry,  was told.

Alexandra Underdown of Cummeenboy, Kenmare, was found to have died of natural causes, most likely asthma, at her home at Cummeenboy. 

But a bee sting cannot be ruled out, coroner for south and East Kerry, Aisling Quilter said, and question marks remain.

The inquest heard that tiny pinpoint marks were found on Alexandra’s shoulder and femur but there was no obvious external sign of a bee sting, such as swelling. 

Three weeks before her death, Alexandra had suffered an unusually severe reaction to being stung on the face.

Her mother, Julia Underdown, told the inquest she displayed no obvious signs of suffering an asthma attack, such as wheezing, on the morning of her death on October 11, 2019, during a telephone call to her sister Winne. 

Julia and Winne had just arrived in the Azores and at 8.30am, Winne rang Alexandra to say they had landed safely.

At 2.18pm, they got a call to say Alexandra had passed away.

On the day of her death, there were signs in the kitchen that Ms Underdown had prepared syrup for winter feeding her bees, that she had finished with the bees, and had removed her full bee suit before collecting her young son from his pre-school, her mother told the inquest in Killarney.

Her bee suit and wellingtons were on the ground and she had taken ice packs from the freezer and antihistamines from the medical box.

Alexandra had suffered from asthma since the age of four and had managed the condition all her life, and if it had been bad that day, she would not have got into her bee suit, her mother said.

She always carried her inhaler with her and had access to a nebuliser. In response to questions from the coroner, her mother said Alexandra had been stung many times, and was not allergic to bees.

However, three weeks before her death, she was stung while painting outside and her face, ears, and eyes swelled and the family advised her to see a GP to possibly get an Epipen. The swelling disappeared after a couple of days.

“She had never had such a reaction before,” Julia Underdown told the inquest.

Neighbour John Foley, in a deposition read by Supt Flor Murphy, told of receiving a phone call from Alexandra saying she could not breathe. 

He could see her standing in the kitchen, but by the time he went into the house, she had passed out on the floor and he and his partner tried to revive her. 

Emergency personnel also tried at length to revive her but failed.

Garda Seán Twomey of Kenmare gardaí said he attended the scene at 3.30pm and paramedics were there over an hour already.

The autopsy had found no external evidence of bee sting but "tiny" pinpoint or pinprick marks were noted in the right shoulder and right femur area, the coroner said. 

Death was as the result of respiratory failure, Ms Quilter read from the pathologist report.

Asthma attacks and bee stings are both very hard to establish, the pathologist had noted, Ms Quilter told the family.

Oedema, which was present in the postmortem, would support a bee sting but dense mucous would support asthma, particularly as an obvious bee sting site was not present.

The medical cause of death was respiratory failure, most likely this was caused by asthma "but bee sting cannot be ruled out", the coroner said.

A verdict of natural causes was appropriate, Ms Quilter said.

The coroner and Supt Murphy both offered their condolences to the family. This was such a tragic loss especially as there was a question as to what caused Alexandra’s death, the coroner said.