Mystery remains over woman's overdose death
The family of a woman who had double the lethal dose of a morphine-type drug in her system were told they would never find out what caused the overdose.
Dorothy Nappin had 4,889mg of tramadol per litre in her blood when she died – eight times above the therapeutic dose and twice as high as the lethal dose.
Known to everyone by her middle name Diane, the 65-year-old had been in constant pain as she was terminally ill with bowel cancer which had spread to several other organs including a kidney.
An inquest, held at Portsmouth Guildhall, heard how Mrs Nappin took a daily cocktail of drugs, administered by her husband Anthony Nappin, to manage her various health problems, which also included diabetes, high blood pressure and crippling back problems.
Mr Nappin had called for an out-of-hours doctor to come to their home in Kilmiston Drive, Portchester, shortly after midnight on November 17, 2007, as his wife was in extreme pain.
Duty doctor Dr Kevin Vernon said she could be given more oromorphin – one of the drugs she was already prescribed – but did not give her anything else.
After checking her over he called for a non-emergency ambulance to take her to hospital as he was still concerned. He left about 3am telling Mr Nappin the ambulance could take up to two hours.
Mr Nappin called their eldest daughter Tracy to help him on the ambulance run and she got to the house at about 3.15am.
But Mrs Nappin's condition began to deteriorate quickly and they called 999 at 4am.
Paramedics were swiftly on the scene but could do nothing to save her and she was pronounced dead minutes later. During that evening she had been alone for just a few minutes when Mr Nappin moved his car to make way for the ambulance.
But the inquest heard how the drugs were kept on her husband's side of the bed and she would not have been able to reach them without help.
A post-mortem report recorded cancer as a secondary cause of death.
Deputy coroner for Portsmouth and south east Hampshire Roger Stone said: 'The tramadol level was very high indeed, about eight times above the therapeutic dose.
Addressing Mr Nappin, Mrs Nappin's husband of 45 years, he said: 'It is possible there was a problem with your wife's kidneys which meant she was unable to get rid of the tramadol.'
He recorded a verdict of accidental death and added: 'I don't know what caused the overdose. I don't think anyone ever will.'
FAMILY CONCERNED BY WAIT FOR AMBULANCE
Before the inquest Diane Nappin's family had been concerned about the amount of time it took for an ambulance to arrive and felt it could have played a part in her death.
The call for a non-emergency ambulance to take her to the hospital had been categorised as an AS2 call, which is not urgent.
But the coroner was satisfied that even if the ambulance had come earlier it would not have changed the outcome, and when its status was upgraded to an emergency 999 call, the service arrived in a matter of minutes.
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