Allergic reaction to peanuts led to death of nurse, inquest hears

A WOMAN who died from acute anaphylaxis after eating sweets containing nuts also had a heart condition that made her more vulnerable…

A WOMAN who died from acute anaphylaxis after eating sweets containing nuts also had a heart condition that made her more vulnerable to an allergic reaction, an inquest heard yesterday.

Belinda Hart (29), Standford Green, Crumlin, Dublin, was discovered dead in bed on December 11th, 2007, after work colleagues at Our Lady's Children's Hospital, Crumlin, raised the alarm when the occupational therapist from New Zealand failed to turn up for work.

A postmortem by State Pathologist Prof Marie Cassidy found that Ms Hart, who had been living and working in Dublin for five months, died from anaphylactic shock due to nut ingestion, with hypertrophic cardiomyopathy (a heart condition characterised by increased thickening of the heart muscle) as a major contributory factor.

The inquest into her death at Dublin City Coroner's Court yesterday heard that Ms Hart had been speaking to her mother on the phone at about midnight and that she died rapidly in her sleep soon after the conversation when the anaphylactic reaction triggered a cardiac event.

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Her death was so sudden she did not develop the usual symptoms associated with anaphylaxis, such as swelling of the throat.

Praline sweet wrappers discovered in the bin in Ms Hart's room are believed to be the source of the nut products. Praline contains a variety of nuts, from which the presence of peanuts cannot be excluded, the inquest heard.

An inhaler used by Ms Harte after playing netball on the evening of December 10th may also have sensitised the heart and provoked an arrhythmia, Prof Cassidy said, but it would not have caused this reaction on its own.

Hypertrophic cardiomyopathy can lead to cardiac arrhythmias, or abnormal heart rhythms, and can cause sudden collapse and death. It was unusual in Belinda's case as it these usually occur when the person is conscious.

The inquest heard that Ms Hart, who was described as a sociable, friendly and conscientious woman, was booking flights on the day before her death to spend Christmas in London with her brother Richard.

She last saw Richard in Paris on November 20th, where they were celebrating her 29th birthday, and it was during that trip that Belinda purchased the praline sweets.

Her mother, Bronwen, who was the last person to speak to her daughter before her death, told the inquest that Belinda had been mildly allergic to peanuts and so she was very careful to avoid foods containing peanuts, but she would eat other nuts.

Ms Hart told the inquest that over the course of the conversation with her daughter on the night of the 10th, her daughter spoke to her for an hour and a half and was in great form. She never complained of feeling unwell.

The coroner recorded a narrative verdict in accordance with the medical evidence and expressed his condolences to the Hart family, including her parents, her sister, Melissa; her brothers Robert, Philip and Richard; and to her sister-in-law, Melanie, on their loss.