The Christmas Day death of a five-year-old northern Iowa girl has been ruled an accident, and a pre-existing condition may have contributed to her death. A deputy state medical examiner says Katie Vorland of Ventura was strangled when the family’s Doberman dragged her by the scarf around her neck. The doctor also discovered scarring on Katie’s heart caused by a viral infection and he says that may have been a contributing factor to the girl’s death.