Coroner in antibiotics call after death of James (19)

James McMaster. INPT48
James McMaster. INPT48

A coroner investigating the death of Portadown teenager James McMaster in 2012 is to write to the Health Minister to raise awareness of the use of antibiotics.

Patrick McGurgan gave the assurance on Wednesday, the third day of an inquest into the death of the 19-year old civil engineering student.

James died in Craigavon Area Hospital’s intensive care unit on May 16 four years ago, just three days after his birthday.

The inquest heard that an adverse reaction to antibiotics was a likely cause of death.

James had been in hospital for five weeks, initially in the surgical and medical wards, before his condition deteriorated rapidly.

The former Portadown College pupil had just finished a memorable season at Portadown Rugby Club, having been voted the seconds’ Young Player of the Year just the month before.

Mr McGurgan, who heard the final submissions on Wednesday, will deliver his full findings this morning (Friday), after taking time to consider what he said was the “enormity of medical evidence” on a “very complex matter”.

However, he did say he will raise the issue of antibiotics with the Minister with a view to introducing an educational learning tool to raise awareness of their use.

He said, “It would mean that the consultants treating patients like James are asking questions of the right people.

“I think if this happens the family of James may feel there is something positive that has come out of this inquest.”

He was speaking after evidence from Dr Sara Hedderwick, a consultant in infectious diseases at the Royal in Belfast, who said that James’s death was likely to have been caused by DRESS Syndrome, a severe reaction to drugs, which many consultants are unaware of.

She said that even in her own hospital she sometimes had difficulty persuading clinicians to stop using antibiotics for infections, as it is a generally held view that they are the correct course of treatment.

When pressed by the coroner on rashes which James developed, she said that if anyone is on intravenous antibiotics and develops a rash “it is pretty clear it is the antibiotics and if you continue with that antibiotic, there will be a bad outcome, like this”.

The coroner also highlighted a perceived lack of communication between consultants and family members, saying it was accepted by a consultant that communication had been “reactive rather than pro-active”.

Mr McGurgan also pointed to a delay between James’s death and a meeting with the family in December.

Wednesday’s hearing also heard from Dr John Harty, a nephrologist with the Southern Health and Social Care Trust, who headed a Serious Adverse Incident (SAI) report into James’s death.

Dr Harty said he would add to his report a third recommendation, namely the role of DRESS Syndrome and greater recognition of the role of infectious diseases consultants.

The coroner added, “What matters now is how the trust moves forward and what it can learn from the evidence of the last three days.”

The hearing was attended by James’s parents Jim and Grace, sister Sarah and other family members. Speaking on Wednesday, Jim and Grace said the three-day inquest had been very difficult and “hard to listen to” and while they were still awaiting the coroner’s full findings, they hoped “lessons will be learned”.