Coronial
VIChospital

Finding into death of Eliza Gill

Deceased

Eliza Gill

Demographics

18y, female

Date of death

2016-09-13

Finding date

2019-02-05

Cause of death

Colchicine toxicity

AI-generated summary

An 18-year-old female died from colchicine toxicity after intentional overdose of her father's medications during a mental health crisis. She ingested approximately 10-15g of colchicine (dose 0.25mg/kg), below the guideline threshold of 0.5mg/kg used at that time for charcoal administration. The Emergency Department appropriately consulted poisons information but received advice based on outdated guidelines. While activated charcoal and early toxicology referral might have improved outcomes, the clinicians' management was reasonable given available evidence. The case prompted critical revision of national colchicine toxicity guidelines, which now recommend charcoal for all intentional colchicine ingestions >0.1mg/kg and mandatory toxicology consultation, recognising death can occur at doses below 0.5mg/kg.

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

Specialties

emergency medicineintensive caretoxicologycardiologypsychiatry

Error types

diagnosticsystem

Drugs involved

colchicineverapamilcefalexinibuprofendesvenlafaxinest john's wortmidazolammorphinelidocaine

Clinical conditions

colchicine toxicityverapamil toxicitymulti-organ failureaspiration pneumoniadepressionacute anxietyintentional drug overdose

Procedures

intubationmechanical ventilationextracorporeal membrane oxygenation (ECMO)ICU admissioncardiac monitoring

Contributing factors

  • Ingestion of colchicine 0.25mg/kg (10-15g from father's medication)
  • Verapamil co-ingestion causing cardiac complications
  • Outdated poisons information guidelines not recommending charcoal for doses <0.5mg/kg
  • Delayed recognition of severe toxicity risk for doses below guideline threshold
  • Potential delay in initial assessment (28 minutes from triage to physician review)
  • Multi-organ failure from colchicine toxicity
  • Aspiration pneumonia from vomiting during critical illness

Coroner's recommendations

  1. The Australian Commission on Safety and Quality in Healthcare should assist clinical experts in developing National Poisons Information Guidelines to ensure consistent, evidence-based practice across all state poisons centres.
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