Death of woman (64) from anaphylactic shock unforeseeable, inquest hears

The death of a 64-year-old woman who suffered fatal anaphylactic reaction in her home almost four years ago was “completely unforeseeable”, given the deceased and her family were unaware of her food allergy, an inquest has heard.

A sitting of Dublin District Coroner’s Court heard on Thursday that Deirdre Keville, late of Emerald Square, Dublin 8 went into cardiac arrest on the evening of July 3rd, 2020, after suffering an allergic reaction to a pre-packaged chicken and wild mushroom pie. Ms Keville later died at St James’s Hospital on July 14th, 2020.

The court heard that on the evening of July 3rd, Ms Keville was at home with her husband Joseph Keville. Mr Keville had prepared the pie for his wife, whom he described to the court as being in “good form”.

After consuming the pie, Ms Keville complained of having itchy hands. About 30 minutes after eating, Ms Keville began sweating and “gasping for air”, the court heard.

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With Ms Keville unable to “get a breath”, Mr Keville attempted to aid his wife – who had a history of asthma and COPD – with inhalers and a nebuliser. Ms Keville later collapsed.

After calling for an ambulance, Mr Keville was instructed to commence CPR on his wife. He told the court that he pleaded with his wife not to die.

“I said, ‘She’s dying in front of me’,” he said.

The ambulance crew took over resuscitation attempts on Ms Keville when they arrived at the residence and managed to restart her pulse following the administration of a dose of adrenaline.

Ms Keville was then transferred to St James’s Hospital. Subsequent scans showed that Ms Keville had suffered “devastating” damage to her brain on account of “prolonged” cerebral hypoxia – a medical term for when the brain is starved of oxygen – during resuscitation efforts.

Doctors determined that Ms Keville would be unable to make a good neurological recovery, and on July 14th, she died at St James’s Hospital.

A report prepared by consultant immunologist Dr Conleth Feighery found that it was likely that Ms Keville had an allergic reaction to the chicken and wild mushroom pie she consumed shortly before suffering a cardiac arrest. In making this observation, Dr Feighery’s report cited tests carried out on Ms Keville to determine her tryptase levels, a method used to confirm an anaphylactic reaction.

The court heard that Ms Keville had no known history of food allergies. She had previously been prescribed Cetirizine, a type of antihistamine used to treat hay fever.

Coroner Dr Clare Keane said that, based on the evidence before the court, the cause of death was “certainly” anaphylaxis caused by a food allergen. Dr Keane said it was not possible to narrow down what precise food allergen had caused Ms Keville’s allergic reaction.

The coroner said she was satisfied that Ms Keville had received a dose of adrenaline in a timely manner. She noted that early administration of adrenaline was the best form of intervention when treating anaphylaxis.

Speaking generally about treating anaphylaxis in the community, Dr Keane said there was “very little down side” to administering adrenaline early. “If in doubt, give it,” she said.

Dr Keane recorded a narrative verdict into Ms Keville’s death, given that the deceased had no knowledge of the allergy. The cause of death was recorded as cerebral hypoxia, secondary to cardiac arrest, secondary to anaphylaxis.

Dr Keane noted that Ms Keville’s death was “completely unforeseeable, unfortunately”, and that “everything that could have been done was done”.

She sympathised with Ms Keville’s family members, a number of whom were present in court. “I understand that the loss is devastating,” she said.

Mr Keville said he and his wife had enjoyed “a great life together”.

“She was great to us, she was always there,” he said. “She should be still here with us.”

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