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13/06/2008 10:15 AM - (SA) 'Oxygen may not have saved her life' 13-06-2008
Heloïse Schwab died on January 26, 2003, eight days after she collapsed in a pharmacy in Gordon's Bay. Last Friday, five years after the tragedy and two years after the inquest began in 2006, Magistrate Schalk Engelbrech, assisted by Dr Isabel Brouwer, a senior consultant in forensic pathology, found her death was caused by anaphylactic reaction to medication, which led to severe brain damage and organ failure. They also found no prima facie evidence to indicate that her death was caused by any act, or negligence on anyone's part. The girl's mother had asked the court to investigate negligence and insisted that her daughter was allergic to penicillin and that the doctors and pharmacist had not made sufficient enquiries about possible allergies. Mr PJ Theron, acting for the mother, also argued that an otherwise healthy young woman had walked into the doctor's rooms that morning, only to be carried out dying a few hours later. Mr Engelbrecht said, however, that Heloïse had been anything but healthy that day. She had a fever and infection. Prof JJ Joubert a locum after a telephonic consultation with Dr JF Eloff, prescribed an antibiotic, Keflex, and Myprodol, while pharmacist Dirk du Toit dispensed the generic equivalent, Ranceph and Mybulen. Her mother rushed Heloïse back to the pharmacy after she developed respiratory problems to the medication. It was no ordinary emergency, but a desperate crisis situation, the Magistrate said. Everything happened very fast, her condition was deteriorating with every passing minute and time was of an essence. "Mr Engelbrecht said in trying to resuscitate the girl, both Dr. Eloff and the pharmacist, Dirk had done everything they could in such an emergency. The pharmacist was not trained in CPR, but gave her an andrenaline injection - which most pharmacists would not have done", while the doctor also gave her an injection and CPR. It was argued that oxygen could've saved her life, he said, but a specialist who treated her in hospital said oxygen was useless without an open airway, and that the brain, if deprived of oxygen, within four minutes would suffer irreversible damage. Even if the first ambulance had arrived with oxygen it would not have made a difference, he said. "The crux of the matter is what her chances of survival would have been in optimal circumstances where oxygen was available and she had got to hospital quickly. Prof. Izak Loftus, a forensic pathologist gave a good answer, when he testified that even proper treatment would not ensure that the patient would have survived. The question has also been asked if a tracheotomy could have saved her life, but the specialist testified that few people, even he himself in hospital, were proficient to perform such an incision." The Magistrate said he only had the mother's testimony to support her allegations and would then have to discount the testimonies of the doctor's receptionist, the two doctors, the pharmacist and also two former family doctors, who had no record of a penicillin allergy on her patient records. There was also evidence that antibiotics previously prescribed to Heloïse had no allergic reaction. She also had not worn any allergy disc or bracelet, apparently for aesthetic reasons. Dr. Johann Eloff's lawyer Suzette van der Merwe, said it was a fair and well deliberated judgement. "It remains a tragedy - there are no winners," she said.
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