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Doctor's overdose death prompts warning over misuse of anaesthetics Doctor's overdose death prompts warning over misuse of anaesthetics Doctor's overdose death prompts warning over misuse of anaesthetics
(5 days later)
The overdose death of an aspiring surgeon has highlighted an “increasing trend” of doctors diverting and misusing the dangerous anaesthetic propofol, a NSW coroner has found.The overdose death of an aspiring surgeon has highlighted an “increasing trend” of doctors diverting and misusing the dangerous anaesthetic propofol, a NSW coroner has found.
Beata Vandeville, 46, who was training to be an obstetrician and gyneacologist in Sydney, died of an overdose in mid-January 2013.Beata Vandeville, 46, who was training to be an obstetrician and gyneacologist in Sydney, died of an overdose in mid-January 2013.
A search of Vandeville’s apartment revealed a large volume of restricted medications, including varying quantities of propofol, midazolam, lignocaine and lorazepam.A search of Vandeville’s apartment revealed a large volume of restricted medications, including varying quantities of propofol, midazolam, lignocaine and lorazepam.
A cocktail of drugs was found in her system, and Vandeville was found to have died of “acute multi-drug toxicity”.A cocktail of drugs was found in her system, and Vandeville was found to have died of “acute multi-drug toxicity”.
One drug, the anaesthetic propofol, was highlighted as being of “extreme risk” outside a hospital setting, because it temporarily stopped breathing and caused a rapid loss of consciousness after injection.One drug, the anaesthetic propofol, was highlighted as being of “extreme risk” outside a hospital setting, because it temporarily stopped breathing and caused a rapid loss of consciousness after injection.
The NSW deputy state coroner, Derek Lee, found on Thursday that Vandeville had self-administered the drugs, but that they had been diverted and supplied to her by her fiancee, who was an anaesthetist working at a series of hospitals.The NSW deputy state coroner, Derek Lee, found on Thursday that Vandeville had self-administered the drugs, but that they had been diverted and supplied to her by her fiancee, who was an anaesthetist working at a series of hospitals.
Her fiancee, Shammi Kabir, had denied supplying the drugs.Her fiancee, Shammi Kabir, had denied supplying the drugs.
Expert anaesthetist Dr Ross Macpherson gave evidence to the inquest that the abuse of propofol within the medical community had emerged as a “general problem” in recent years.Expert anaesthetist Dr Ross Macpherson gave evidence to the inquest that the abuse of propofol within the medical community had emerged as a “general problem” in recent years.
The coroner similarly found that it was “apparent that there is an increasing tendency for propofol to be diverted and misused”.The coroner similarly found that it was “apparent that there is an increasing tendency for propofol to be diverted and misused”.
“Both internationally and within Australia, propofol has increasingly become the agent of choice for abuse amongst anaesthetists, despite educational programs and increased vigilance,” Lee wrote.“Both internationally and within Australia, propofol has increasingly become the agent of choice for abuse amongst anaesthetists, despite educational programs and increased vigilance,” Lee wrote.
“On the surface, it would appear that tighter restrictions in relation to its storage and distribution within hospitals are called for.”“On the surface, it would appear that tighter restrictions in relation to its storage and distribution within hospitals are called for.”
But Lee stopped short of making that recommendation. He said the drug was often required urgently by hospital staff, and any delay to its access could put patients at risk.But Lee stopped short of making that recommendation. He said the drug was often required urgently by hospital staff, and any delay to its access could put patients at risk.
He said the Australian and New Zealand College of Anaesthetists guidelines already struck a good balance between restricting the drug and ensuring patient safety.He said the Australian and New Zealand College of Anaesthetists guidelines already struck a good balance between restricting the drug and ensuring patient safety.
But he called for health authorities and the college to give further consideration to how to limit the diversion of propofol “without compromising patient safety”.But he called for health authorities and the college to give further consideration to how to limit the diversion of propofol “without compromising patient safety”.