An inquest into the death of a Waterford woman heard yesterday that, on the balance of probabilities, a painkiller she took to relieve the pain of her osteoarthritis caused her death.
Cork Coroners Court was told at the inquest into the death of Joan Flavin (71) that the deaths of an additional six people over the past 10 years could possibly be linked to the drug Nimesulide.
Nimesulide was sold under the brand names Aulin and Mesulid until May 15th last when the Irish Medicines Board recalled the product and suspended its licence here.
Ms Flavin, a widow, Windygap, Dungarvan, Co Waterford, was prescribed Mesulid in February 2006. She had previously undergone knee joint replacement surgery in February 2005.
Ms Flavin was admitted to the Mercy University Hospital in Cork on August 16th, 2006, after she presented to her GP with abdominal pains and jaundice. Acute liver failure was subsequently diagnosed and despite constant dialysis Ms Flavin died on September 10th last year at Cork University Hospital.
Her advanced age had ruled her out as a suitable candidate for a liver transplant.
Pathologist Dr Margaret Bolster, who carried out a postmortem at Cork University Hospital, said the woman died of "grave complications of liver failure".
Dr Bolster said, on the balance of probabilities, Ms Flavin died of drug-induced liver failure as a result of the use of the prescribed drug Mesulid. No evidence could be found of any other cause of damage to Ms Flavin's liver, such as hepatitis or a virus.
The inquest into Ms Flavin's death was initially adjourned from May 3rd to allow an expert from the Irish Medicines Board to be called to give evidence after two doctors testified they believed Mesulid was the cause of her death.
Ms Flavin's solicitor, Paddy Golden, also claimed at the initial hearing that he had received a letter from the Irish Medicines Board which said that six people here had possibly died as a result of taking the medication.
Dr Joan Gilvarry, director of human medicines with the board, said in evidence that Nimesulide was first given a licence in 1995. She said at that time it was decided the benefits of the product outweighed any risks.
In April 2002, Finland withdrew the licence for the drug amid reports of a likely link with liver toxicity. An EU scientific committee review also found Nimesulide's benefits outweighed any risks.
Dr Gilvarry said guidelines were issued to doctors in 2004 advising them of the outcome of the EU review.
Doctors were also advised to prescribe the drug at the lowest possible dosage for the shortest period of time.
The inquest heard Nimesulide did not become an issue again until early last May, when Prof Aiden McCormack at the National Liver Transplant Unit met Dr Gilvarry and told her of an audit he had conducted of liver transplants.
Nimesulide is currently the subject of an European Medicines Agency review, expected within three months.
The jury emphasised the importance of reporting adverse reactions to prescription drugs, saying doctors and patients should take the matter very seriously.
The jury recorded a verdict of death by misadventure and extended their sympathy to the Flavin family.
Cork city coroner Dr Myra Cullinane also offered her condolences to the Flavin family saying it was a tragic case.
Mr Golden, speaking on behalf of the family, said the Flavins wouldn't be pursuing a civil action following the death of their mother.