A woman who developed a deadly skin condition after she was admitted to hospital with pneumonia received a one in a million diagnosis, an inquest heard.
At a resumed inquest into the death of Teresa Kenny (86) from Brookview Gardens, Tallaght, Dublin 24, Coroner Dr Myra Cullinane returned a verdict of death due to adverse drug reaction.
The woman’s daughter Michelle Kenny said the culmination of the inquest process was a “huge relief”.
“She was a lovely person, so kind to everyone and intelligent. She didn’t deserve what happened to her,” Ms Kenny said.
“I feel like I can start grieving now, this has been a long and difficult process.”
Teresa Kenny died on February 20th, 2015 after she developed Toxic Epidermal Necrolysis (TEN) at Tallaght Hospital. The deadly skin condition causes the death of the epidermis, resulting in skin redness and blisters, leaving the body open to infection. There is no treatment for TEN and while the condition is associated with antibiotics there is no clear cause, according to pathologist Dr Yi Ling Khaw.
A previous inquest, at Dublin Coroner’s Court on March 13th last, heard that Mrs Kenny was admitted to hospital on January 14th, 2015 suffering from pneumonia.
Pneumonia
Family members with her on admission informed medical staff of a previous reaction to penicillin. The woman was treated initially for pneumonia and she was prescribed cephalosporin. Her condition improved slightly but at the end of January she tested positive for Ecoli and doctors were not sure of the source.
She developed septicemia and was given multiple antibiotics including vancomycin and meropenem. Three days before her death she was reviewed by two separate consultant dermatologists and all antibiotic medication was stopped. Consultant Geriatrician Dr John Doherty said the skin condition was triggered in the woman’s body and then ran “as a cascade” to cover 70 per cent of her skin. He said Ms Kenny’s age, her frailty and the infections she was fighting needed to be considered as factors in relation to the onset of TEN. The resumed inquest at Dublin Coroner’s Court heard evidence from the hospital’s microbiology, dermatology and pharmacology departments.
Consultant Dermatologist Professor Maureen Connolly, who diagnosed Mrs Kenny's condition, said the treatment is to stop all medication as so little is known of the skin infection.
“The complete mechanism isn’t really understood which makes it so difficult to treat it. At the moment the treatment is to stop the medication, in a lot of cases patients get better, in some cases they don’t,” she said.
The cause of death was Toxic Epidermal Necrolysis with bronchial pneumonia and emphysema and coronary heart disease as contributory factors.
“The working diagnosis is that it was related to the medication,” Coroner Dr Myra Cullinane said, returning a verdict of death due to adverse drug reaction.
“I know the family found it very distressing. She is most unfortunate to receive a one in a million diagnosis,” the coroner said.