A 12-year-old girl from Burnley died at her grandmother's house after taking a 'very high' amount of the opioid painkiller tramadol.
Kaitlin Clegg, of Tiber Avenue, died in her sleep on September 13th, 2017, at her gandmother Margaret Crook's home in Browsholme Avenue where she had gone after leaving school early due to being poorly.
During an emotional inquest at Burnley Coroner's Court Kaitlin's devastated parents, Jason Clegg and Kelly Canovan, who had both also been prescribed tramadol, tearfully hugged Margaret after being told Kaitlin had tragically taken without their knowledge high amounts of the very strong painkiller, unaware of the risks.
A police investigation found, on the balance of probabilities, that Kaitlin had taken her grandmother's tramadol after it had been left on a coffee table with ibuprofen and paracetamol prescribed by a doctor for Kaitlin.
Paediatric pathologist Dr Melanie Newbould, who conducted the post-mortem examination, said that toxicology tests showed a "very high concentration" of tramadol in Kaitlin's blood, which had caused her death.
She said: "In most cases of child deaths at Kaitlin's age we would look at sepsis and viral infections such as meningitis. However, there was no evidence of any of these. There were no signs of any underlying serious disease.
"Toxicology tests however produced a positive result. There was evidence of ibuprofen and paracetamol, but also a very high concentration of tramadol. Although we have to carefully interpret post mortem results, which can produce high levels, in Kaitlin's case it was very very high indeed.
"It is impossible to tell how many pills she had taken or over what period."
Coroner Mr Richard Taylor heard that Kaitlin had not been enjoying good health in the months leading up to her death including suffering from appendicitis and asthma. She had also been complaining of pains in her arms, legs and shoulders.
Her father Jason Clegg told the inquest that Kaitlin had spent the night at his house on the Saturday before her death and had seemed fine. He told the inquest she knew that tramadol was used to treat pain and added it was possible she had taken them from his house but he did not know.
Kaitlin's mum, Kelly, also told the hearing how she had been prescribed tramadol but was "99% sure she would not have had the opportunity" to take them from her house.
Mr Taylor told how he had read text messages sent between Margaret and Kelly which were clearly "loving, caring and concerned messages about Kaitlin, but also a question over whether she may have taken tramadol."
Miss Canovan said: "I think if Kaitlin was in pain, knowing what all three of us take it for, then yes she would have taken it."
Det. Insp Paul Barlow, from Burnley CID, said: "Theoretically the tramadol could have been taken from all three relatives, but as she was under the care of her grandma at the time, and it was left on a coffee table within easy reach, then it made some sense to me that it was taken there."
Recording a conclusion of misadventure, the coroner said that Kaitlin had taken the tramadol deliberately when in distress and pain without knowing of its effects on her.
Mr Taylor said: "I have a picture of a 12-year-old girl who was in physical discomfort from unknown causes. An exchange of text messages between her mother and grandmother demonstrates caring, loving concerns but also questions about whether she had taken tramadol.
"At some time Kaitlin had taken the tramadol. How, when and where is not clear but it's more likely than not that it occurred at her grandmother's house. Whilst in pain she took the medication hoping it would do her some good. Tragically it did not."