Vaccine-link inquest ruled out by High Court

The Dublin City Coroner has been prohibited by the High Court from investigating any indirect role the three-in-one vaccine may have had in the death of a Dublin man four years ago.

Mr Justice Geoghegan upheld a challenge by the Eastern Health Board to the decision by Coroner Dr Brian Farrell to investigate any role the vaccine might have played in the death of Alan Duffy (22), Howth Road, Clontarf.

Mr Duffy died on December 31st, 1995, after contracting pneumonia. He had received the three-in-one vaccine between October 1973 and February 1974.

The judge said any conceivable link between the vaccine and Mr Duffy's death was "too nebulous and indirect" to warrant investigation by the coroner.

After Mr Duffy, died the consultant who treated him had proposed to complete the death certificate to state he died of aspirational pneumonia due to cerebral palsy.

Mr Duffy's parents objected to this, alleging the pneumonia was due to his mental handicap which in turn, they alleged, was caused by an encephalopathic reaction to the pertussis vaccination when he was a child.

Because of the dispute, no death certificate was completed and the matter was referred to the coroner, who directed that an inquest be held.

The inquest was adjourned in December 1997 to allow medical investigations into the cause of death, which included investigating any role the vaccine might have played. Dr Farrell had proposed to reconvene the inquest last April. However, the Eastern Health Board took judicial review proceedings to prevent any investigation into a possible link between the vaccine and the death.

In a reserved judgment yesterday, Mr Justice Geoghegan said that while the EHB's application was outside the time limits, the issues were far too important to be determined on a time point and should be determined on their merits.

He said the Supreme Court had determined that a coroner was concerned with the proximate medical cause of death. Under Section 30 of the Coroner's Act 1962, the coroner was required to investigate how, when and where the death occurred.

While it would be unwise to set down any hard and fast rule, in his view a coroner should be investigating what was the real and actual cause of a death.

Mr Duffy's death appeared to be caused by pneumonia, the judge said. Any conceivable link with the three-in-one injection was "too nebulous and indirect to make it appropriate for an investigation by the coroner".

The fact the coroner ended up having to commission an independent report dealing with the alleged link was indicative of the impracticality of such an inquest. "I do not believe such an inquest was intended by the wording of Section 30 of the Coroner's Act 1962."

The judge said he found it difficult to understand where the power arose for the coroner to commission an independent medical report. Section 26 of the Act seemed to restrict the coroner's right to call on additional witnesses. Mr Justice Geoghegan said if he was right about that, there should not have been the 16-month adjournment of the inquest into Mr Duffy's death. Even if he was wrong, it was undesirable, to say the least, to permit an inquest before a jury to be adjourned for that long to get fresh expert evidence.

Insofar as the family wanted the question to be investigated, it would seem that was for the purpose of pinning fault. But in fairness to the coroner, the judge said, he did not think that was the coroner's approach. The coroner seemed to be genuinely investigating whether there could have been a link, independently of any question of fault.

He granted the EHB a declaration that the coroner's investigation of any indirect link between the vaccine and the death was in excess of his powers under Section 30 of the Coroner's Act 1962.

After hearing submissions on costs, the judge directed that the costs of Mr Duffy's parents be paid by the EHB.

He said the issue was of great importance to the board, for not just this but other cases. He made no order regarding the costs incurred by the coroner and the board.