Inquest hears how mum overdosed on methadone
Coroner rules medicine ‘complication’ led to death
AMUM-OF-TWO overdosed on methadone she had been prescribed to help overcome her heroin addiction, an inquest has heard.
Natalie Edgington, who suffered from chronic liver disease, died less than a month after being prescribed the drugs by Turning Point, a drug and alcohol service.
After she started taking them, family members said she became seriously unwell and would regularly vomit and struggle to get out of bed.
Natalie’s mother, Linda, raised concerns about the effect the drugs were having on her daughter, but nothing was done and the 28-year-old was found dead in February last year.
At Rochdale Coroner’s Court on Monday, a coroner ruled that ‘a complication of a prescribed medication’ had caused Natalie’s death and that opportunities to prevent it had been missed.
Catherine McKenna, the area coroner for Greater Manchester North, said methadone had been prescribed without relevant information about Natalie’s liver function having been obtained, while a follow-up review should have been carried out after Mrs Edgington contacted the service.
The inquest heard that Natalie, from Heywood, had struggled with alcohol addiction for several years and also suffered from severe depression and psychosis.
Her GP at Hopwood Medical Centre, Dr Yasmin Shabbir, revealed that Natalie had also been diagnosed with chronic liver disease following a stay in hospital in 2019.
After being discharged, she was prescribed medication but failed to take it.
The court heard that Natalie had started using heroin about two years prior to her death and, by the end of 2019, was smoking it on a daily basis.
She decided to tell her mother about her addiction in January of last year, claiming she was smoking two rolls of heroin each day.
Mrs Edgington urged her daughter to seek help, before she referred herself to Turning Point.
An initial appointment with a healthcare professional was held on January 22.
The inquest heard that Natalie had revealed she had been smoking up to five bags of heroin per day and mentioned that she suffered from chronic liver disease.
A urine sample was taken but Natalie was told she would need to return for another the following week before a prescription could be issued.
Dr Joseph Kavu, a consultant psychiatrist at Turning Point, told the hearing that this was to prove Natalie was ‘using drugs as often, and in the quantity, she declared she was.’
Following the appointment, a letter was sent to Natalie’s GP requesting her medical history and that a liver function test be carried out.
However, no response was ever recorded.
Despite this, Natalie was prescribed a ‘standard dose’ of methadone at the following week’s appointment and told it would gradually increase every three days.
Mrs Edgington told the hearing that her daughter immediately became unwell after taking the medication.
“It started the day she started taking it,” she said.
“She was that sick she could not get up out of bed. She was drinking litres and litres of ice water and vomiting.
“She was almost comatose throughout the full three weeks.
“She knew she had to take it or else the support would have stopped.
“She got worse the last week of her life.
“I said right from the onset that the methadone killed my daughter. They gave her too much.”
Mrs Edgington said she urged her daughter to contact Turning Point to report how she was feeling, however she was ‘lethargic’ and unable to get out of bed.
On February 11, Mrs Edgington eventually ended up phoning the service herself to tell them her daughter was unwell.
However, no follow-up appointment was ever arranged.
As her situation worsened, Natalie asked her mother to accompany her to A&E on February 24.
“She realised too late that there was something wrong,” said Mrs Edgington. “She wouldn’t go without me.
“She said let’s have one more night and go tomorrow. Tomorrow never came.”
The evening before, Natalie stayed at her mother’s house and Mrs Edgington left for work at 7.30am, leaving her daughter at home.
At 3.25pm that day, Natalie phoned a friend and asked him if he would bring round some water.
She then phoned her mother 15 minutes later to say she would not be picking up her prescription from the chemist that day.
“She said it was the methadone that was making her ill,” Mrs Edgington told the inquest.
When the friend arrived at the house soon after, he discovered Natalie unresponsive in bed.
Paramedics were called but they were unable to revive her.
Forensic toxicologist Julie Evans told the inquest that a post-mortem examination had revealed 1.7 milligrams of methadone per litre of blood in Natalie’s system.
She added that someone with an impaired liver would struggle to process the drug, which could lead to a build-up within the blood.
Pathologist Emil Salmo gave Natalie’s cause of death as ‘methadone toxicity due to fatty liver disease.’
Dr Kavu told the hearing that prescribing methadone to anyone with liver disease was ‘not safe’ and that doing so without knowing the full extent of Natalie’s liver function had ‘presented a certain amount of risk.’
However, he said there were ‘not many other alternatives’ to the drug and explained that contact should have been made with the gastroenterologist who diagnosed Natalie to help build up ‘a clearer picture.’
He added: “It brings about risk in terms of an overdose.
“There is a balance clinicians try to strike between getting people sooner so they stop using illicit drugs while waiting for this information.
“I suppose in this instance it is this balance that has not been struck.”
Delivering her verdict, Ms McKenna said she would write to Turning Point to express her concern over the evidence she had heard.
She said she was ‘not satisfied’ that there was a system in place to ensure liver function tests were carried out prior to prescriptions being made.
Following the hearing, Mrs Edgington paid tribute to her daughter, who she described as ‘lovely’ and ‘fun.’
She said her daughter had been born in Bolton and lived there until 2015 when she relocated to Heywood to be closer to her.
“Everybody loved her,” she said. “We had a very close relationship.
“I saw her every day of her life. We would never go to bed without saying ‘I love you.’”
She added that she felt ‘vindicated’ by the coroner’s conclusion.
“I feel massively down,” she said.
“My daughter is dead and she would still be alive if it was not for them.
“My daughter has two children who are motherless. They don’t understand why she is not here.
“She was on the right path. She asked for help and they failed her.
“I don’t want this to happen to anybody else. No mother should have to bury their child.” let