A teenager died from suspected anaphylaxis at the Whittington Hospital after her Epi pen “didn’t work” and the ambulance took almost an hour to arrive, a court heard today.
Shante Turay-Thomas, 18, may have had an allergic reaction after consuming hazelnuts at her home in Wood Green on September 14 - she died in hospital hours later.
Shante struggled to breath and said: "I am going to die" before she collapsed, while her mother Emma repeatedly called 111.
The incident was initially rated as category 3 (urgent two hour response time) and one ambulance was mistakenly sent to the wrong address six-miles away in Enfield, according to Leigh Day Law firm, which is representing Shante's mother Emma Turay.
At a preliminary hearing last week the coroner heard evidence that the NHS 999 system categorises anaphylaxis as category 1 (life threatening 7 minute response time) but that NHS 111 categorises the same condition as category 2 (emergency 18 minute response time).
It's alleged Shante tried to use her Emerade adrenaline auto-injector pen (AAI) but said it "didn't work".
The inquest into Shante's death started at St Pancras Coroner's Court today, where Dr Liina Palm, of Great Ormond Street Hospital, said she couldn't find a needle puncture mark during her post-mortem examination.
Summarising her findings, Ms Palm told the court: "I cannot confirm that she had anaphylaxis based on the absence of further findings, these include the relatively normal mast cell trypaste [MCT] levels."
Ms Palm said there was "some evidence of asthma related change" but this was not significant, and said she was unable to rule out other causes of death like heart-related arrythmia (irregular heartbeat).
She gave the "cause of death as unascertained", but clarified to senior coroner Mary Hassell she couldn't rule out anaphylaxis.
But, relaying the notes of Dr Adam Fox, Clodagh Bradley, representing the family, said: "He pointed to the fact Shante had a known history of severe allergies, he says: 'Known to have potentially life-threatening nut allergies."
Ms Bradley asked if combination of asthma and allergy could have increased the risk of anaphylaxis, and Ms Palm said: "Yes, absolutely."
Ms Bradley said Shante experienced "difficulty breathing, wheezing, itchy throat, sensation of face swelling" on the night she died.
If the court were to accept these symptoms, then Ms Palm agreed anaphylaxis was the most likely cause of death.
In June, Baush & Lomb, which manufactures Emerade AAIs - including Shante's device - divulged some needles were blocking and not releasing adrenaline. It confirmed about two in every 1,000 Epi pens were affected.
No batches were recalled but the Medicines and Healthcare Products Regulatory Agency advised all patients to carry two injectors.
Geraint Webbe QC, for Baush & Lomb, said to Ms Palm: "Although you didn't see any needle or puncture mark you can't say if you missed a mark. It's simply not possible to say whether a needle mark punctured the skin." She agreed.
The inquest is listed until Wednesday.
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