Inquest told of dose risk

A LARGE morphine dose given to a Cairns woman by a GP prior to her death was “not appropriate in any setting” and “fraught” with risk, a Cairns court has heard.

Redlynch woman Margaret Ann Cahill, 61, died at Cairns Hospital on September 13, 2017 after going into cardiac arrest in her Cairns home the day before and never regained consciousness.

She was being treated for a nerve root compression in her neck by Dr Barbara Gynther in the McLeod Street Medical practice where Mrs Cahill also worked as a medical receptionist.

An inquest into her death resumed in the Cairns Coroners Court on Tuesday, five months since it began, after Coroner Nerida Wilson had ordered further evidence from several medical experts.

In his final submissions, counsel assisting the Coroner Joe Crawfoot told the court he had initially submitted the 60mg morphine dose prescribed to Mrs Cahill by Dr Gynther was appropriate, but on the back of the doctors’ evidence his submissions had changed.

During the inquest the court heard Mrs Cahill had been taking Endone, OxyNorm, diazepam and Palexia (tapentadol) between July and August.

There was a question over whether she had taken a 200mg dosage of Palexia either just before or just after attending an “urgent consultation” with Dr Gynther on the morning of September 11.

Mr Crawfoot said it was for “reasons unknown” Mrs Cahill or her husband had not disclosed whether she had taken anything prior to the appointment, but whatever conversation occurred between the couple and the doctor lacked “clinical rigour”.

He said had Dr Gynther been aware she might have taken a “different course” in prescribing the intramuscular morphine injection.

“(But) it was fraught … and made the risks associated with that dose even greater,” he said.

“The dose was not appropriate in any setting.

He also said Mrs Cahill should have been monitored before she left the clinic after receiving the shot and Dr Gynther should have requested to speak to her on the phone during the day, rather than just her husband.

The court heard Mrs Cahill fell asleep after arriving home with medical evidence suggesting she likely slipped into a coma during the day.

Coroner Nerida Wilson is expected to deliver her findings on Friday.