Inquest into the death of Francis Kamaranga

28y · Male·asphyxiation following severe swelling to the larynx due to anaphylactoid reaction to Haemaccel

A 28-year-old Aboriginal male died from anaphylactoid reaction to Haemaccel, a plasma volume expander administered pre-hospital following a severe laceration to the radial artery. Initial management was appropriate, but anaphylaxis was not recognized until 2:05am despite clear symptoms from 1:47am (swollen tongue, facial swelling, gurgling breathing). Adrenaline, the standard emergency treatment for anaphylaxis, was delayed until recognition of the condition. Clinical lessons: maintain high suspicion for anaphylaxis even when alternative diagnoses seem plausible; early recognition allows prompt adrenaline administration which may alter outcomes. The surgical airway was difficult given massive swelling but appropriately performed. Broader learning: anaphylaxis can be triggered by blood products and Haemaccel; reactions may be delayed up to 60 minutes and triggered by dose volume/rate rather than initial administration; alcohol may potentiate histamine release.