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Coroner's Finding: ROWAN Marjorie June

Deceased

Marjorie June Rowan

Demographics

52y, female

Date of death

2009-05-03

Finding date

2014-01-31

Cause of death

ischaemic and hypertensive heart disease

AI-generated summary

A 52-year-old woman with depression, diabetes, and hypertension died at home from ischaemic and hypertensive heart disease. She was prescribed dothiepin 225mg daily for depression management. Following gallbladder surgery in April 2009, she had deranged liver function tests (elevated GGT and ALP). The coroner examined whether dothiepin should have been reduced given the liver dysfunction. Expert evidence from hepatologists and clinical pharmacologists confirmed her liver function impairment was cholestatic (from gallstones) rather than hepatocellular damage, and her overall drug metabolism capacity remained normal. The dose of dothiepin was standard and appropriate. No treating doctor acted inappropriately. Post-mortem toxicological findings were likely explained by post-mortem redistribution from the stomach rather than acute overdose. The death was not preventable based on available clinical information.

AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.

Specialties

psychiatrygeneral practicesurgeryhepatologypharmacologyforensic medicine

Drugs involved

dosulepinamisulpridebenzodiazepinesanti-hypertensive medicationoxycodoneantibiotics

Clinical conditions

ischaemic heart diseasehypertensive heart diseasemajor depressiondiabeteshypertensiongallstone diseasecoronary artery stenosischolestasis

Procedures

laparoscopic cholecystectomycholangiogram

Contributing factors

  • significant coronary artery disease with greater than 75% stenosis of right coronary artery and left diagonal branch
  • hypertension
  • diabetes
  • smoking history
  • possible QT prolongation from dothiepin at therapeutic levels
Full text

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