A Leaving Certificate student developed blood clots in her lungs which led to her death shortly after being prescribed the contraceptive pill, an inquest has heard.
Dublin District Coroner’s Court heard on Friday how Sarah-Kate O’Meara went into cardiac arrest on the morning she was due to sit a mathematics exam last year – three days after starting to take the oral contraceptive pill and three days before her 18th birthday.
Genetic testing following her death revealed she had a mutation called Factor V Leiden, unknown at the time of being prescribed the contraceptive pill, which placed her at a greater risk for blood clotting.
The inquest heard how the Mount Mercy pupil became ill at her home in Cork before she was due to go to a Leaving Cert exam on June 10th, 2024. She experienced chest tightness and disorientation and lost consciousness.
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She was taken by ambulance to Cork University Hospital and later transferred to the Mater Hospital in Dublin.
Her mother Dianne O’Meara, who was with Sarah-Kate when she started to feel unwell, told the inquest she was a very sporty and a “health-conscious” teenager. Sarah-Kate was an avid camogie player.
Ms O’Meara described how her daughter’s illness first presented with tightness “as if she had something stuck in her chest” and what appeared to be a fainting episode around 8.25am. Her condition quickly deteriorated and she appeared clammy and slightly disorientated, and vomited.
Minutes later she collapsed again and started convulsing, at which point an ambulance was called.
The inquest heard how Tony O’Meara tried to resuscitate his unresponsive daughter as the family waited on the ambulance to arrive. Ms O’Meara sought help from a local pharmacist.
She said her daughter had recently been prescribed the combined oral contraceptive pill, which she had started taking three days earlier, and that she had a history of migraines.
Sarah-Kate’s GP, Dr Caroline Burke, described their last consultation in which she prescribed the pill on May 13th, 2024. She had outlined the contraception options available and their associated risks.
She said she had questioned Sarah-Kate about her history of migraines and asked whether she had ever experienced “aura migraines”, which she had not. These are a specific type of migraine that would make put her at too high risk of blood clotting to be prescribed the combined oral contraceptive pill.
The hearing was told Sarah-Kate arrived to the Mater at about 1.20am on June 11th. She was pronounced dead on June 17th at 9.14pm.
Dr Katie Murphy, cardiology consultant at the Mater who assessed Sarah Kate, told the inquest that “multifactorial” respiratory pulmonary embolism, or clotting, was identified as the primary issue, pointing to the increased risk of clots posed by the pill and the “sedentary period” surrounding exams.
Dr Murphy said the results of genetic testing at the hospital showed Sarah-Kate had a previously unknown mutation called Factor V Leiden, which increased risk of clotting. The inquest heard how echocardiograms and CAT scans were performed throughout the duration of Sarah-Kate’s care.
In her closing statement, Coroner Clare Keane notedthe “increased risk of blood clots with the use of [the] combined hormonal contraceptive pill” and increased risk of blood clot formation due to the “significant condition” Factor V Leiden.
Dr Keane said the case “isn’t straightforward” and, given the complexity of Miss O’Meara’s death, a narrative verdict was most appropriate to reflect the evidence.
A letter received from Organ Donation Transplant Ireland said “Sarah-Kate has given new life to two patients through the donation of her kidneys”, the inquest heard.
