Hypoxic brain injury due to combined drug toxicity
AI-generated summary
Donna Mousley, aged 46 years with long-standing panadeine forte and diazepam dependence, presented to an addiction medicine specialist seeking management. Dr C. prescribed methadone 40mg on 9 November 2010 after consultation. She commenced methadone despite having taken codeine earlier that day. On 11 November, after her third methadone dose (45mg), she became unresponsive with respiratory depression and was found in cardiac arrest. She suffered hypoxic brain injury and died. Toxicology revealed multiple drugs at low levels including methadone, diazepam, citalopram, and verapamil. The coroner found the death resulted from combined drug toxicity rather than methadone alone. Dr C.'s critical failure was not explicitly advising a 36-hour washout period after the final codeine dose before methadone commencement, increasing overdose risk. The coroner found no basis to criticise any health professional and did not make an AHPRA referral.
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Specialties
addiction medicinegeneral practicepharmacyemergency medicineintensive care
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