Role of mouth ulcer drug in death of Tyrone teacher Michelle Donaghy is probed
An inquest into the death of a Dungannon woman has heard evidence about the use of a medication for treatment of mouth ulcers.
Michelle Donaghy, a sociology teacher from Glebe Crescent, died at Craigavon Area Hospital, on May 18, 2012.
The 35-year-old had been suffering from Bechet's, a rare disease, and coroner Joseph McCrisken heard that Michelle had been brought to the Royal Victoria Hospital in Belfast by her mother Maureen Donaghy on May 16, 2012 after receiving a text message from her daughter saying that she had a "very bad" pain in her head.
In a statement, Mrs Donaghy said that she took her to the immunology centre at the hospital where Michelle had been receiving treatment and asked to see a doctor urgently.
She said that as Michelle had been unable to speak, she had to explain her symptoms to medical staff, saying that she was "very concerned" about the pain in Michelle's head.
Mrs Donaghy pointed out that previously she had been told to watch out for any serious pain Michelle experienced. She also reported that her daughter had not been able to eat or drink for two days. She said her daughter had not been able to tolerate a doctor shining a light to examine her eyes and she had been "screaming in pain".
Mrs Donaghy's statement went on to say that medical staff had wanted Michelle to show that she could drink water and a discussion followed about medication that she could take if she decided to return home.
However, when they returned home, she said that Michelle appeared to take a seizure and was rushed back to hospital.
Mrs Donaghy's statement added: "I feel that had the Royal kept her in overnight, Michelle would have had a far better chance."
Dr Raymond McKee, an intensive care consultant, told the hearing that Ms Donaghy had suffered a cardiac arrest while being transported to hospital, which would have resulted in brain damage due to lack of oxygen.
Counsel to the inquest Dr David Sharpe said one of the big concerns was that she may have taken Lidocaine and asked if it would have been administered in the hospital's intensive care unit.
Dr McKee said that there was no evidence that it had been administered during Ms Donaghy's hospital stay.
Dr David Edgar, consultant immunologist, told the hearing she had been admitted to hospital the previous August suffering from severe abdominal pain for which she had been given anti-inflammatory treatments. He acknowledged there had been difficulty in finding the exact cause of her symptoms.
Turning to the treatment of Michelle Donaghy's mouth ulcers, the coroner's counsel said that she had been prescribed Lidocaine initially by the Belfast Trust and then by Hammersmith Hospital in London.
Dr Edgar said Lidocaine would have been prescribed for its pain relieving properties. Immunology registrar Dr Niall Conlon told the hearing that Ms Donaghy's family had been unhappy with a number of aspects of her treatment previously. These included "poor control" of her symptoms, lack of improvement after assessment at Hammersmith Hospital and the level of care within the Belfast Trust.
Dr Conlon also spoke of a worsening of her mouth ulcers and said that Ms Donaghy would have experienced "considerable discomfort" and he accepted that she would have had difficulty tolerating fluids.
He remarked that a "relative stability in her physiological condition" on the night in question meant that it would have been acceptable to manage her condition as an outpatient.
Dr Conlon went on to say that he was aware that Ms Donaghy had been using topical Lidocaine. Asked if it could cause toxicity if it was used in "very large amount", Dr Conlon said that he had not come across that.
He also said that he was not aware of any medication taken by Ms Donaghy that could cause epileptic seizures.
Counsel to the coroner also asked consultant immunologist Dr Cathal Steele about the application of Lidocaine.
Dr Steele said that dabbing it on would provide "more focus and more control" than using a nozzle. The QC commented that there had been "no specific note about the use of the Lidocaine solution" from Hammersmith Hospital.