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Monday, 01 September 2014

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Egremont woman had 'worst case of alcohol withdrawal', inquest heard

AN EGREMONT woman who died in hospital was suffering from the worst case of alcohol withdrawal a doctor had ever seen, an inquest heard.

North and West Cumbria coroner David Roberts heard that Yvonne Heron, 49, of Daleview Close died in August 2006 at the West Cumberland Hospital in Whitehaven.

Mrs Heron was admitted to hospital on July 6 with acute alcohol withdrawal and went into cardiorespiratory arrest six days later.

She was resuscitated and put on a ventilator but when her condition did not improve support was withdrawn and she died on August 4.

Dr Mitali Gangopadhyay, who carried out the postmortem, said that chronic alcoholism contributed significantly to the cause of death.

She said that Mrs Heron died from a series of pulmonary emboli which affect the transfer of oxygen to the blood.

Mrs Heron, who also suffered from two seizures, was disorientated when she was taken to hospital.

Large doses of the sedative drug Chlordiazepoxide, used to treat alcohol withdrawal, were administered.

But despite treatment she tried repeatedly tried to leave the ward, refused to take her medicine and became abusive to staff.

She was sectioned under the Mental Health Act when it was decided that she was too disorientated to understand the severity or her condition and might pose a risk to herself or others.

Questions were also asked about whether Mrs Heron was taking her medication and it was suggested that she had been abusing alcohol for much longer than she had told doctors.

Consultant cardiologist Dr Kate Willmer sees at average of 50 cases of severe alcohol withdrawal a year but told the inquest that this was the more severe case she had ever seen.

She was concerned that Mrs Heron showed symptoms of a life-threatening neurological condition often brought on by alcohol withdrawal.
She also feared Mrs Heron, who was 5ft 3in and weighed just over five stones, was being over sedated.

“I was uncomfortable with the doses that we were using because I had never used such high doses before," she said.

“The more severe the alcohol withdrawal is, the more difficult it is to get the balance right.

“Even if it’s the safest drug in the world and most people survive a serious overdose, it can still cause serious harm.”

But consultant psychiatrist Bert Lazlo, who increased Mrs Heron’s dose of Chlordiazepoxide, said that it was safe drug and also denied claims that it had been used as a “chemical restraint.”

“It was the right thing to do. She should have been on a much higher dose much sooner,” he said.

Medical staff, who were struggling to cope with Mrs Heron and were concerned about what effect her behaviour would have on other patients, considered having her moved to the hospital’s psychiatric ward.

But Dr Lazlo said that she should be left in the acute ward with nurses who are trained to deal with physical problems and should not be moved to the psychiatric ward until her condition was stable.

He also claimed that he had asked a psychiatric nurse to provide support and had requested that Mrs Heron was monitored regularly.

Dr Willmer and Dr Lazlo agreed that in an ideal world Mrs Heron should have been treated at a specialised drug and alcohol unit but there are no such facilities at the county.

The inquest is continuing today.

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