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Coroner's Finding: GREET Shirley Blanche

Deceased

Shirley Blanche Greet

Demographics

87y, female

Date of death

2014-10-13

Finding date

2016-09-12

Cause of death

digoxin toxicity with hyperkalaemia

AI-generated summary

An 87-year-old woman with atrial fibrillation, chronic pain, and renal failure intentionally overdosed on approximately 79 digoxin tablets. She called the ambulance and disclosed the overdose. Despite receiving activated charcoal and appropriate ICU care with 26 vials of DigiFab antidote, she suffered cardiac arrest and died from digoxin toxicity with hyperkalaemia. The coroner found that hospital staff took all possible steps to prevent her death. This case illustrates the challenges of managing intentional drug overdose in elderly patients with multiple comorbidities, where rapid drug absorption and severe electrolyte disturbances can lead to fatal arrhythmias despite appropriate antidotal therapy.

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

Specialties

emergency medicineintensive carecardiologytoxicologypsychiatry

Drugs involved

digoxindigoxin antibodies fab fragments

Clinical conditions

digoxin toxicityhyperkalaemiacardiac arrhythmiacardiac arrestatrial fibrillationrenal failureintentional drug overdose

Procedures

activated charcoal administrationdigifab antidote administrationcardiopulmonary resuscitation

Contributing factors

  • intentional overdose of digoxin
  • rapid drug absorption
  • severe electrolyte disturbance (hyperkalaemia)
  • cardiac arrhythmia leading to cardiac arrest
  • chronic renal failure
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