Iron tablets overdose death of girl (17) - parents demand answers

TRAGIC: Katie Douglas (S)
TRAGIC: Katie Douglas (S)

THE family of a teenage girl who died from an overdose of iron tablets want questions answering over her treatment at the Royal Blackburn Hospital.

Katie Douglas died three days after her 17th birthday in the intensive care unit of the hospital where she was being treated after taking around 130 iron tablets, 28 co-codamol tablets, four ibuprofen tablets, cough mixture and 250ml of vodka.

But her heartbroken family believe delays in administering the drug desferrioxamine to counteract the effects of iron poisoning led to her death.

Katie, a former pupil of Edge End High School, Nelson, was described as a bubbly and pretty young woman who loved her hair and beauty course at Nelson and Colne College.

A five-day inquest at Burnley Town Hall has been hearing evidence from clinicians who treated Katie when she was admitted to Blackburn’s A&E unit on April 12th, 2008 - the day of her 17th birthday.

Katie had returned home to Aylesbury Walk, Kibble Bank, on the night of April 11th when her mum Yvette Howarth found her crying and upset. Shortly afterwards, Katie took the lethal cocktail.

Miss Howarth told the inquest: “She wouldn’t tell my why she had taken the tablets. She was very upset.”

An ambulance rushed Katie to the Royal Blackburn Hospital where she arrived at just after 12-30 a.m. and was seen by Dr Iqbal Hussein and staff nurse Joanne Todd.

Over the hours that followed, Katie was assessed by a number of healthcare staff. It was not until late on, on April 12th, it became apparent Katie was suffering from severe iron poisoning and needed the drug desferrioxamine to counteract the effects.

After delays in a bed becoming available in the intensive care unit, Katie was eventually transferred there at 6-30 p.m. where she remained until her death on April 15th.

On the first day of the inquest, Dr Hussein told barrister Mr Louis Browne, acting on behalf of the family, this was his first experience of dealing with an iron overdose. He told the hearing: “There were moments when she first came in that Katie was quite stable and able to hold a conversation.

“At that stage we were waiting to find the results of blood tests from the laboratory which would reveal the levels of drugs in her system. However, the first two samples came back haemolysed which is the disintegration of red blood cells in the sample.

“This can be caused by samples being left lying around or improperly taken and was quite a common problem at the time. This inhibited me greatly in devising a plan. It meant we had to take new samples. We agreed intensive care was required but no beds were available.”

Asked by Mr Browne if Dr Hussein was aware of the drug desferrioxamine he replied he knew “vaguely about it from medical school” but as a junior doctor “my first point of reference would be my senior colleagues”.

Staff nurse Joanne Todd said Katie was vomiting and was transferred to a resuscitation area which has monitoring equipment and a higher ratio of patient and staff where she was cared for by staff nurse Heather Clark.

Staff nurse Clark said: “I didn’t think she was going to die. It came as a shock to me.”

The specialist registrar working in A&E was Dr Stewart Teece who first saw Katie at 2-45 a.m. He took the decision not to administer desferrioxamine.

Dr Teece said a toxicology database named Toxbase is available for clinicians with information on drug poisoning and treatments. Mr Browne asked Dr Teece why, if Toxbase recommends the use of desferrioxamine, it was not given at this stage.

The registrar replied: “I consulted other references apart from Toxbase and estimated Katie’s weight which was necessary to determine the level of antidotes that might need to be given.

“Desferrioxamine is not a safe drug and, if used incorrectly, can make the situation worse. It can cause acute respiratory distress syndrome. My concern was in giving this drug without the results.”

But Mr Browne said: “There is not a single mention in the notes of her body weight or consultation of academic databases. The assumption is that it didn’t happen.”

The inquest is expected to conclude on Tuesday.