Source · Prevention of Future Deaths
Andre Mickley
Ref: 2015-0231
Date: 17 Jun 2015
Coroner: ARW Forrest
Area: Lincolnshire (Central)
0 responses identified · 1 indexed addressee
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AI-generated concerns summaryThe coroner noted that official drug information (SPC/PIL) lacks guidance for prescribers to inquire about a history of substance misuse and for patients to be cautious about potential adverse interactions between prescribed medicines and drugs of misuse. This gap applies to interactions beyond just SSRIs and cocaine.
Date
17 Jun 2015
56-day deadline
13 Aug 2015
stated in the report
Responses identified
0 of 1
Coroner's concerns
The coroner noted that official drug information (SPC/PIL) lacks guidance for prescribers to inquire about a history of substance misuse and for patients to be cautious about potential adverse interactions between prescribed medicines and drugs of misuse. This gap applies to interactions beyond just SSRIs and cocaine.
View full coroner's concerns
_ There are clear potentially adverse Pharmacokinetic interactions between Cocaine and the SSRI group of drugs, as well as case reports_ (e.g: FU Ket al. ) Journal of Analytical Toxicology. 24C7):648-50, 2000). In general, the Summary of Product Characteristics (SPC) and the Patient Information Leaflet (PIL) do not suggest prescribers seek a history of substance misuse or patients exert caution and seek advice before prescribing or medicines that have the potential to interact adversely with drugs of misuse. This includes adverse interactions other than just those between SSRI and cocaine
Report sections
Investigation and inquest
On gih March 2015 | commenced an investigation into the death of Andre Roderick Stewart MICKLEY, age 36 years. The investigation concluded at the end of the inquest on 17th June 2015. The conclusion of the inquest was Narrative Conclusion
Circumstances of the death
Andre was a term multiple user who had used Methadone; Cocaine, Diazepam, Heroin and Pregabalin for several years without major ill effects. On the morning of 17th February 2015 he used heroin and cocaine: He collapsed shortly thereafter, suffering a massive subarachnoid haemorrhage. Despite neurosurgical intervention, he died on 23rd February 2015. A few days before his collapse he had been prescribed Citalopram and this drug and its metabolites were present in hospital admission blood samples, together with Cocaine, Methadone and Heroin metabolites: Unit 1, Gilbert Drivve, Endeavour Park; Boston PE21 7TQ Tel: 01522 553374 Fax: 01522 516717 Email: HMCoroner_Southlincolnshire@lincolnshire gov.uk and long drug
A RW Forrest LLM, FRCP, FRCPath GMC Number: 1333523 Her Majesty's Senior Coroner for South Lincolnshire
A RW Forrest LLM, FRCP, FRCPath GMC Number: 1333523 Her Majesty's Senior Coroner for South Lincolnshire
Action should be taken
In my opinion action should be taken to prevent future deaths and believe you andlor your organisation have the power to take such action:
Copies sent to
Email: HMCoroner_Southlincolnshire@lincolnshire gov.uk any
Similar PFD reports
Report details
- Reference
- 2015-0231
- Date of report
- 17 June 2015
- Coroner
- ARW Forrest
- Coroner area
- Lincolnshire (Central)
Responses identified
Responses identified
0 of 1
1 response not yet linked
Organisations named in PFD reports are normally expected to respond within 56 days. Deadline: 13 Aug 2015 (stated in the report).
Sent to
- Medicines and Healthcare products Regulatory Agency