Whiting, Edith

68y · Female·Anaphylactoid reaction to intravenous CT scan contrast medium leading to cardiorespiratory arrest

A 68-year-old woman with asthma presented to hospital with abdominal pain suggestive of biliary obstruction. A CT scan with intravenous contrast was ordered to clarify the diagnosis before potential surgical transfer. She had asthma exacerbations requiring medication twice on the day of the scan, though documentation of the second episode was disputed. The contrast injection triggered a severe anaphylactoid reaction with bronchospasm and cardiorespiratory arrest. Resuscitation was suboptimal: adrenaline administration was delayed when it should have been given immediately as the mainstay of anaphylaxis treatment; intubation required multiple attempts; and fluid resuscitation was inadequate. The coroner found the decision to use contrast was not unreasonable given the clinical context, but the resuscitation response lacked coordination and appreciation of anaphylaxis management principles. Better early adrenaline administration and increased fluids might have improved survival chances, though recovery remained unlikely given the severity of the reaction.