Kassiha Francis has died.

The 17-month-old from Grenada - whose shy smile and grossly deformed right leg moved readers across the region to donate nearly $120,000 for medical care - passed away Dec. 3 after returning home to the Caribbean.

The cause of death was infection, according to Sgt. Keith Douglas of the Royal Grenadian Police, which flew in a pathologist from Trinidad late last week to perform an autopsy on Kassiha.

Hubert Daisley, the pathologist from the University of the West Indies, told me the infection invaded her heart, brain, kidney and spleen.

"She had convulsions prior to death," said Daisley, who did not specify the infection's origin. "Having that leg, there's a chance it might have arisen from there."

The news shocked the orthopaedics staff at Children's Hospital of Philadelphia, which released a happy, healthy Kassiha after a successful operation in late October.

"When she left here, there were no signs of infection," nurse practitioner Ray Kleposki told me. "The wound was completely healed."

Kassiha's death crushed Chiron and Joy Thompson, the Germantown couple who hosted Kassiha and her mother, Jeanette, at their home for six months and came to adore the toddler as one of their own.

"We had so much hope, so much support," said Chiron Thompson, the Philadelphia school teacher and pastor who began the improbable fund-raising mission with $400 of his own money.

"We're destroyed and distraught."

A short, fragile life

Kassiha, regular readers will remember, was born with Klippel-Trenaunay-Weber syndrome, causing rare tumors of the blood vessels. Her right leg was so big, it literally weighed her down, like an anchor.

Sepsis, or a full-body infection, was always a risk with her condition. When blood doesn't flow freely, Kleposki explained, it can pool. If bacteria bursts in, the body has difficulty fighting it.

After reading about Kassiha in a Caribbean newspaper, the Thompsons flew her and Jeanette to Philadelphia. The Grenadian natives-turned-U.S. citizens felt an obligation to help a child from the impoverished land they left behind.

Kassiha was first treated at Shriners Hospital for Children, then referred to Children's, where surgery would cost $81,000.

Thanks to the generosity of many strangers, Kassiha had the pre-paid operation Oct. 25.

John Dormans, Children's chief of orthopaedics, chose to amputate only Kassiha's foot, saying more surgery would be necessary as she got older.

Jeanette was disappointed. She worried deeply that Kassiha would be teased and scorned.

Dormans was sympathetic, but stressed the importance of Kassiha's learning to walk and run. When the toddler left Philadelphia three weeks later, she was standing for the first time on her own.

Fears from afar

Privately, the Thompsons worried about how Kassiha would fare in Grenada.

Hurricane Ivan devastated 90 percent of the Caribbean island in 2004, flattening thousands of homes, washing away the economy. The eight-member Francis family - quite poor by Jeanette's own admission - lives without indoor plumbing, raising concerns about whether Kassiha's health would be affected by her living conditions.

Before Kassiha left on Nov. 15, Chiron Thompson shared with me this fear: "We don't want the child to go home and develop an infection."

Eighteen days later, she was dead.

Reached by phone yesterday, Jeanette Francis told me that Kassiha had seemed to be thriving.

"My baby was good," she said. "She made three steps already. She was walking. She was happy."

A fever came and went the day before Kassiha died.

"Then she started to tremble and shake," and died on the way to the hospital.

The mother's voice trailed off as the sounds of her five other children filled the void. Kassiha will be buried tomorrow, Jeanette said before hanging up.

"Forgive me, I'm not myself right now."

Now what?

A financial follow-up:

More than 1,000 Inquirer readers, aided by the First Hand Foundation, of Kansas City, donated nearly $120,000 to help Kassiha. After the cost of the $81,000 surgery at Children's, the National Penn Bank account established for her care contains $38,371.05, including deposits made the day she died.

So now what, besides begging folks to stop sending checks?

"That money is for medical, medical, medical," Thompson always said, assuring donors in thank-you letters that their generosity would not be misdirected.

As such, he hopes to transfer what's left of Kassiha's fund to worthy medical causes.

He'd give some to Shriners Hospital (www.shriners.com/hospital), which has long provided free care to children such as Kassiha.

He'd give some to the First Hand Foundation (www.firsthandfoundation.org), which gives medical grants of up to $25,000 to youngsters in need all over the world.

Thompson also wants to use some of the money to bolster health care in the Caribbean, perhaps at a hospital in Grenada.

"This way," he said, "at least we can keep Kassiha's name alive."