Mixed drug and alcohol toxicity, primarily due to propranolol
AI-generated summary
Pamela McCall, aged 45, died from mixed drug and alcohol toxicity on 12 February 2013. Her de facto partner, Dr B., a general practitioner, had been prescribing propranolol and panadeine forte for her since 2008 without formal consultation, examination, or informing her treating GP Dr S.. Bennett wrote 60+ recorded prescriptions informally, sometimes via text message requests. McCall had a history of stress, migraines, and back pain but declined mental health support. On 10 February 2013, McCall collected three bottles of propranolol (300 tablets total) from a pharmacy, then ingested propranolol and paracetamol with alcohol at home. Bennett was absent at a festival. Clinical lessons: informal prescribing without proper documentation or communication between practitioners is dangerous; addictive medications require oversight; patients with psychological distress need formal mental health referral; absence of formal consultation removes safeguards.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Informal prescribing by Dr B. without formal consultation or examination
Lack of communication between prescribing doctors
No monitoring or investigation of appropriateness of doses
Patient's underlying psychological distress and stress not adequately addressed
Absence of safeguards around addictive medication (panadeine forte)
Patient declined mental health support
Large quantity of propranolol dispensed (300 tablets) on single prescription
Delayed police notification by ambulance service
Coroner's recommendations
Steps need to be taken by Ambulance Tasmania, in consultation with Tasmania Police Service, to develop reporting guidelines to ensure timely involvement of police at the scene of any likely suspicious death or anticipated suspicious death
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