Controversies are growing over the cause of the death of a local restauranteur, who died of sepsis on Oct. 6, six days after being bitten by K-pop star Choi Si-won’s family dog.

A late discovery of pseudomonas in the victim’s blood is at the center of the controversies over where the victim had the pseudomonas infection – at the hospital that treated the deceased, or from the saliva of Choi’s dog, or elsewhere.

Choi’s 10-kg French bulldog was not on a leash and bit the victim, surnamed Kim, by the leg in an elevator on Sept. 30. Kim immediately went to an emergency room of Inje University Seoul Paik Hospital, to get tetanus shot and went home.

A picture of Choi Si-won, a member of K-pop idol group Super Junior, with his dog (Credit: Choi Si-won’s Instagram)

She saw a doctor on Oct. 2 again. Four days later, she revisited the emergency room due to complain about pain and hemoptysis. After receiving endotracheal intubation and resuscitation at 10:15 a.m. on the same day, she was moved to an intensive care unit, but died at 5:10 p.m.

The bereaved family and Choi settled the case, and Kim’s funeral was also held peacefully. However, news reports revealed later that the hospital discovered pseudomonas in Kim’s blood, which sparked a controversy over the routes of the transmission of the bacteria. On Oct. 24 when the news reports came out, “pseudomonas” was trending top on Korea’s major news portals. Pseudomonas, which caused sepsis in Kim, infiltrates into a broken skin from surgery or wounds.

People talked about a possibility that Kim’s death may have to do with a secondary infection with pseudomonas at the hospital. Choi’s father also backed this view by saying, “I heard that the authorities cannot confirm an exact cause of her death, due to possibilities of mistreatments or secondary infection,” on his social networking site. Choi’s family also submitted a veterinarian’s view that pseudomonas was not found in the dog’s mouth to the Gangnam-gu Office. The district office only fined Choi’s father with 50,000 won ($44.2) for violating Animal Protection Law and not keeping the dog on a leash.

However, Choi and his family are under mounting criticism that they are trying to avoid responsibility by passing the buck to the hospital.

Experts said it was difficult to conclude that pseudomonas in the blood of the deceased was a result of an infection within the hospital. Depending on species, transmission routes can vary, they said. Pseudomonas has a variety of types including pseudomonas aeruginosa that has resistance to antibiotics, pseudomonas putida and pseudomonas fluorescens.

“Among various types of pseudomonas, some are infected mainly at a hospital, but the others come from the dirt or straws,” said Lee Jae-gap, a professor at Hallym University Kangnam Sacred Heart Hospital’s division of infectious disease. “If the name is exactly pseudomonas aeruginosa, we can suspect an infection within the hospital. But if it is pseudomonas putida or pseudomonas fluorescens, the infection might have occurred in a community.”

Lee noted that Kim’s hospitalization was too short to suspect a secondary infection at the hospital. Usually, an infection within a hospital can be judged for patients who stayed at least for 48 hours at the hospital, he added.

Apparently pushed by the growing controversies, Inje University Seoul Paik Hospital flatly denied the possibility of the victim’s pseudomonas infection within the hospital, revealing Kim’s treatment records under the consent of the bereaved family.

“Our culture test on Kim’s blood and sputum showed that she had a general pseudomonas, not multidrug-resistant pseudomonas. It means there is no possibility that she got infected with the bacteria during her visit to the hospital,” the hospital said. “The patient visited and stayed at the outpatient clinic and the emergency room for 37 minutes and 27 minutes, respectively. There is no chance of a secondary infection.”

Considering that the dog’s bite made her visit the hospital and the victim died of sepsis, the cause of the death may have to do with the dog bite, the hospital added.

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