A CORONER has recommended greater communication between blood-monitoring clinics in hospitals and GPs after an inquest heard how a 69-year-old woman died from a brain haemorrhage as a result of the interaction of a blood-thinning drug with antibiotics.
Cork city coroner Dr Myra Cullinane made the recommendation after returning a verdict of medical misadventure at the inquest into the death of Breda Dunlea of Ballybrack, Carrignavar, Co Cork, who died at the Mercy University Hospital on December 12th, 2006.
Ms Dunlea was on the blood-thinning drug warfarin to prevent blood clotting and lessen the risk of stroke. Her warfarin levels were monitored regularly and her blood-clotting levels were found to be within her target range.
The inquest heard that Ms Dunlea died as a result of a brain haemorrhage caused by interaction between warfarin and antibiotics prescribed for a respiratory infection. Ms Dunlea’s GP, Dr Noel O’Regan, told the inquest he had prescribed the antibiotic Augmentin when she presented with a severe flu-like infection on October 13th, 2006, and when it did not clear up, he prescribed another antibiotic, Erythromycin, on November 13th. Ms Dunlea failed to improve and when she returned to the surgery on November 21st for a third visit, she was seen by Dr O’Regan’s colleague, Dr Cecelia Kingston, who prescribed another antibiotic, Clarithromycin.
He was aware Ms Dunlea was on warfarin and that she was being monitored for the drug but there was no policy whereby the warfarin clinic would contact GPs about a patient’s warfarin levels.
Dr Kingston said she was aware that Ms Dunlea was on warfarin and it was her practice to inform patients taking antibiotics about the possible reaction with warfarin but she could not recall if she had done this when she prescribed Ms Dunlea the Clarithromycin. Ms Dunlea collapsed at home on November 23rd, lapsed into a coma on December 7th and died five days later. Consultant respiratory physician at the hospital Dr Terry O’Connor said death was due to brain haemorrhage caused by drug interaction between warfarin and the antibiotics.
Dr O’Connor said he had come across other such cases. Her case highlighted the need for greater interaction between GPs and warfarin clinics, he said.
After the inquest, the family welcomed the coroner’s verdict and said they hoped her recommendation would be implemented.