Ms D - Non-inquest findings

57y · Female·Head and chest injuries due to motor vehicle collision (driver)

A 57-year-old woman with insulin-dependent diabetes died in a motor vehicle collision caused by hypoglycaemia while driving. Her insulin pump data showed 16 hypoglycaemic events in the preceding month, with multiple episodes at times consistent with driving. Her GP issued a 5-year driving certificate without endocrinology input, contrary to clinical guidelines recommending 2-year reviews and specialist assessment for insulin-dependent diabetics with hypoglycaemic unawareness. The coroner found no documented discussions about driving safety despite the endocrinologist previously documenting her as unfit for work due to diabetes. Key clinical lessons include: specialists and GPs must explicitly discuss driving safety with diabetic patients; insulin pump data indicating frequent hypoglycaemia should trigger urgent review; patients with hypoglycaemic unawareness require specialist-led fitness-to-drive assessment; and independent clinical services may better assess driver fitness than treating clinicians.