Medication could not be excluded as contributory factor in man's death, inquest finds

By Louise Roseingrave

A toxic level of an anti-psychotic medication may have contributed to the sudden death of a 58-year-old man, an inquest heard.

Otto Auerbach, of Dolphin Park, Rialto, Dublin 8 had a toxic level of Clozapine in his system when he died on April 20, 2016.

Mr Auerbach had visited his local community centre and was making his way home when he collapsed, Dublin Coroner’s Court heard. He was well known and highly respected in the area, a local community worker said.

Neighbours rushed to help him after his collapse and performed cardio pulmonary resuscitation at the scene. He was rushed to St James’s Hospital where he was pronounced dead.

A postmortem examination revealed he died due to a cardiac arrhythmia due to coronary heart disease.

A toxicology screening revealed he had a toxic level of the anti-psychotic drug Clozapine in his system.

Mr Auerbach had been on the medication for many years and his dose had not changed, the inquest heard.

He had responded well to the medication and settled well into his surroundings, according to a doctors report. He visited an outpatients clinic every two months and had monthly blood tests, the court heard.

Clozapine is therapeutic between 0.35 and 0.6 micrograms per mil and toxic from 0.8 to 1.3 micrograms per mil. Mr Auerbach had a level of 1.6 micrograms per mil in his system at postmortem.

Coroner Dr Myra Cullinane noted that the screening can return slightly higher results after death.

The coroner returned an open verdict, because the contribution of Clozapine as a factor in his death could not be excluded.

"This was a death due to a cardiac arrhythmia, or a cardiac arrest in the context of hardening of the coronary arteries. The pathologist doesn’t confirm or otherwise exclude the contribution of Clozapine. In those circumstances we record an open verdict," Dr Cullinane said.

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