Coroner: Nelson 3-year-old’s cause of death tied to undigested mass of hair, ‘environmental neglect’

NELSON — Three-year-old Tamsin Sauer died from a stroke brought on by dehydration and malnutrition that was caused by a trichobezoar – a mass of undigested hair in her stomach, Whiteside County Coroner Joe McDonald said Friday.

“Environmental neglect” was the other significant condition contributing to the child’s March 26 death, McDonald said, citing the final autopsy report, which he received Friday.

McDonald said he could not specify what the medical examiner in McLean County who performed the autopsy meant by the term. A message left at the McLean County coroner’s office was not returned.

McDonald said he had not encountered a bezoar as a cause of death in his 30-year-career as a coroner.

Records provided by the Illinois Department of Children and Family Services in response to a Freedom of Information Act request show the agency is investigating whether neglect or malnutrition may have played a role in the girl’s death.

The Lee County Sheriff’s Department, State Police and the State’s Attorney’s office also are investigating.

No one has been charged.

The DCFS records also show that from Jan. 22, 2018, to Dec. 7, 2021, the agency made two dozen visits either to the home in the 100 block of East Bassett Street, where Frank and Dana Sauer lived with their nine minor children and other adults, or to the children’s schools or relatives’ homes.

Six DCFS investigators conducted 10 investigations into multiple reports of abuse or neglect surrounding one or more of the children. In each instance, the allegations were deemed “unfounded,” records show.

The identity of who made the reports is not a matter of public record.

Frank Sauer said in an interview before the girl’s cause of death was announced on Friday, that he talked with the medical examiner in Bloomington shortly after Tamsin’s autopsy. He said he was told her cause of death was a bezoar that caused her to suffer strokes. The medical examiner’s office declined response to Sauer’s assertion.

Tamsin had been chewing on her hair, and pulling it out and eating it, but showed no symptoms of pain or distress, and was eating as usual, Sauer said.

“She was a normal kid, doing normal things,” he said. “She acted like a child, she played, she loved the winter, she loved the snow, she loved to sit and watch movies.”

Sauer said he told a doctor about his daughter’s habit the week before her death and was told she would outgrow it. He said Tamsin was taken to the doctor because she had a cold with a persistent fever, not because she was showing signs of pain or discomfort that a bezoar might have caused.

Due to medical privacy laws, the newspaper was unable to verify Sauer’s assertion.

At the time of Tamsin’s death, the nine siblings, all girls, ranged in age from 5 months to 17 years.

Three other adults also were living in the 960-square-foot, one-bath home at the time, the DCFS report says.

The DCFS investigated reports that the children were the victims of “environmental neglect,” that they were being inadequately supervised, locked up and left home alone; that the environment in which they lived caused a “substantial risk of physical injury” and/or was “injurious to their health and welfare;” that they did not have enough to eat and were not getting proper medical care.

Frank Sauer denied any wrongdoing and said, “There was plenty of food in the house.” Between him, his wife and the other adults, someone always was there to supervise the children, he said.

According to the DCFS, “environmental neglect” exists if “the child’s person, clothing, or living conditions are unsanitary to the point that the child’s health may be impaired.”

Investigators are advised to pay special attention to “the child’s physical condition and the living conditions in the home in order to determine whether the report constitutes an allegation of harm, and to take into account the child’s age (those 6 and younger are more likely to be harmed); developmental stage; physical condition; and mental abilities.

Frank and Dana Sauer’s five children are in DCFS custody, and Dana’s two girls with her previous husband are with their father while the investigation into Tamsin’s death proceeds. One child no longer is a minor.

About bezoars

According to webmd.com and other online sources, a bezoar is a mass of indigestible material — usually hair, fibers, food fibers or medication — that forms in the stomach and doesn’t pass through the intestines.

Bezoars are rare. They often, but not always, are painful, and rarely fatal when diagnosed.

Symptoms can include a lack of appetite, vomiting, nausea, abdominal pain, anemia, weight loss and bloating. Bezoars also can be asymptomatic.

Trichobezoars — bezoars created by undigested hair — are rare in children, and most common in girls.

Bezoars often are difficult to diagnose in very young children.