A woman “with a complex medical history” died of total organ failure after becoming ill while taking Ozempic for weight loss and a diabetes drug, an inquest has heard.
Breeda O’Donoghue (66), of West End, Carrigtwohill, Co Cork, died on December 9th, 2023, at Cork University Hospital (CUH) three days after being admitted, Cork Coroner’s Court heard.
Coroner Philip Comyn was told that Ms O’Donoghue joined Dr Sushil Ranga’s surgery in Carrigtwohill in 2017 after moving to the area.
In a report read into the record, Dr Ranga said Ms O’Donoghue was a type two diabetic and also had osteoarthritis, restless legs and hypertension. He said she had been prescribed the diabetes drug Metformin by her then GP in 2016 and the condition was well controlled when she became his patient.
In 2020, Dr Ranga said, Ms O’Donoghue had an osteoarthritis flare-up and while her pain settled over time, she started to gain weight. He said she then struggled to lose weight through diet and exercise and was “very self-conscious”.
He said Ms O’Donoghue, who was 5ft 3in tall, had a body mass index of 35.94 and weighed 92kg in 2023. He said she was, per protocol, prescribed Ozempic that September and the dosage was increased in October.
Ms O’Donoghue was examined a week later. She had lost almost 7kg since she started taking the drug, she was very happy and denied having any problems. The Ozempic dosage was then further increased.
On November 23rd, 2023, Dr Ranga said Ms O’Donoghue reported feeling nauseous, but was taking in plenty of fluids and eating well, so she was prescribed anti-nausea medication.
She was still feeling nauseous a week later and was advised to stop taking Ozempic and to come in for a review. However, he said she was not keen to attend but that she would at a later date if she did not improve.
Ms O’Donoghue’s husband called Dr Ranga on December 6th, 2023, to say his wife was not well and she came to the clinic to be examined. Dr Ranga said she was feeling weak, dehydrated and was generally unwell, so she was sent to CUH by ambulance for further management.
When she presented at hospital she told the registrar she had “multiple episodes of vomiting every day” having started on Ozempic three months earlier. She said she had been “unable to keep anything down” and her condition had worsened before her arrival in hospital.
Ms O’Donoghue died on December 9th, 2023, after various treatments failed to improve her condition.
Assistant State Pathologist Dr Margot Bolster carried out a postmortem. She said she tried to get laboratories in Ireland and abroad to test the level of Ozempic in Ms O’Donoghue’s blood, but none was able to do this.
She described what happened in the case as “very rare”.
Dr Bolster said she had read newspaper reports about deaths possibly linked to Ozempic but there was no “scientific literature on mortality rates” related to it.
She said the use of Metformin was “less likely” to have been an issue in the case but she was unable to rule it out. She said the benefits of both drugs are “well recognised” but every drug comes with a risk.
Dr Bolster said it was a “complex, multifactorial case”.
The cause of death was given as “total organ failure due to profound electrolyte abnormalities with a mixed high anion gap metabolic acidosis with lactic acidosis, hypochloraemia on Ozempic and Metformin.”
Mr Comyn said Ms O’Donoghue died of a “known complication of a prescribed medication” and there was “complex medical history” in the case. He emphasised that Ms O’Donoghue and her doctors followed the correct protocols regarding Ozempic.
He expressed concern about members of the public sourcing Ozempic outside GP settings. Dr Bolster agreed that doing so was dangerous.
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