THE DUBLIN county coroner is to carry out an inquest into the circumstances surrounding the death of a woman who was terminally ill with breast cancer, following concerns that she may have been administered excessive doses of medication prior to her death.
The Irish Timeshas learned that staff of Our Lady's Hospice, Harold's Cross, alerted the coroner last July following the death of a woman in her 60s at her home in Dublin.
The woman was terminally ill and was being cared for in the community by the hospice home care team and other healthcare professionals.
Although her prognosis was poor and she was being given medication by means of a syringe driver, a nurse who visited some hours after the woman had died noted that some ampoules of emergency medication were unaccounted for.
The patient had been visited in the early hours of the morning by a locum doctor who had been called by the family because the woman had become distressed.
It is understood the patient had been given an intramuscular injection of Oxynorm, a morphine-like drug at a dose approximately 10 times that suggested in hospice guidance notes. The woman was also injected with Midazolam, a sedating medication but at a dose apparently six times the suggested amount.
It is understood that the patient passed away within an hour of this treatment.
It is standard practice in palliative care to include both these drugs within a syringe driver which is used when a patient with terminal cancer has difficulty taking medication orally.
This device delivers the appropriate dosage under the skin on a continuous basis over a 24-hour period.
The dose of each medication changes depending on whether the drug is administered orally, intramuscularly or subcutaneously.
Hospice home care teams routinely leave an “emergency pack” of injectable drugs in a patient’s home, so that any problems can be adequately dealt with by a visiting doctor or nurse.
The Irish Timeshas learned that following the intervention of the Dublin county coroner, the family was asked to delay the woman's funeral to allow a full postmortem to take place. It is understood that the postmortem examination included sending tissue specimens to specialist laboratories for analysis.
A Garda inquiry has been completed as is normal in a coroner’s case. An inquest into the woman’s death is due to open in April. The coroner, Dr Kieran Geraghty, will seek to determine the cause of death and will examine all the circumstances surrounding her end-of-life care.