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.
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