Inquest finds Cork grandmother died of total organ failure three months after starting on Ozempic
Breeda O’Donoghue of West End in Carrigtwohill, Co Cork died on December 9, 2023 at Cork University Hospital (CUH) having been hospitalised three days earlier.
A Cork mother-of-two died from total organ failure less than three months after starting the weight-loss drug Ozempic.
Breeda O’Donoghue, aged 66, suffered “profound vomiting” after increasing her Ozempic dose in line with her prescription which interfered with her blood pH level so profoundly that she suffered organ failure and died.
The family of the much-loved mother and grandmother have called for more awareness around the potential side-effects of the popular but relatively new drug.
Ms O’Donoghue had gained weight after becoming “very down” following three family deaths in one year and found exercise difficult due to pain with osteoarthritis.
She was “struggling to lose weight and was very self-conscious and suffering with low moods” and after going to her GP, Dr Sushil Ranga, for medical help was prescribed the diabetes and weight-loss drug Ozempic on September 19, 2023.
Ms O’Donoghue, of 29 West End, Carrigtwohill, had type 2 diabetes — a condition Ozempic is prescribed for — but this was well controlled with medication and diet and her use of Ozempic was for weight control, Cork City Coroner’s Court heard.
She was started on Ozempic 0.25mg on September 19, 2023, and after four weeks her dose was increased to 0.5mg on October 19. When reviewed by Dr Ranga on October 26, 2023, she had lost weight and said she was “happy” and managing well on the drug and “denied any problems”.
On October 26, 2023, her dose was increased to 1.0mg. She was reviewed on November 7, 2023 and was again “happy with the results” and denied any problems, Dr Ranga reported.
But on November 23, 2023, she reported nausea and was prescribed anti-nausea medication. One week later, she was still suffering nausea and was advised to stop Ozempic and review with her GP.
Her husband rang Dr Ranga on December 6, 2023, saying she was not well. Dr Ranga saw her and found her “weak, dehydrated and generally unwell”. She was taken by ambulance to Cork University Hospital and was later admitted to the Intensive Care Unit suffering “metabolic disarray” and acute kidney injury.
A report from Professor Joseph Eustace in Cork University Hospital said that Ms O’Donoghue had “apparently been vomiting on a frequent basis over the past two to three months since starting treatment with Semaglutide [the drug sold as Ozempic].”
“Gastrointestinal side-effects are a well-recognised problem of Semaglutide,” he said.
The other medications she was taking for her conditions would also have increased her susceptibility to acute kidney injury, he said. She had started on Ozempic on September 19, 2023, but only reported nausea after increasing to 1mg on November 23, 2023. She died in hospital on December 9, 2023.
Cork City Coroner Philip Comyn said that Ms Donoghue died due to a known complication of a prescribed medication on a background of a complex medical history.
Pathologist Dr Margot Bolster said that Ms O’Donoghue died of total organ failure due to profound electrolyte abnormalities with a mixed anion gap metabolic acidosis with lactic acidosis, hypochloraemia on Ozempic and Metformin [another diabetes medication Ms O’Donoghue had been taking since 2016].
But neither the State laboratory, nor any other laboratories contacted, could check Ozempic levels in the blood following her death because the drug was still relatively new, Dr Bolster said. The body has a very precise pH level to maintain — a balance between acid and alkaline — for cells to function, Dr Bolster said.
Vomiting profusely changes the pH level in the blood and cells then cannot function properly, she told Cork City Coroner’s Court. And when the pH changes too much, a patient suffers complete organ failure and this is what happened to Ms O’Donoghue, she said.
Ms O’Donoghue had suffered “profound electrolyte abnormalities” with profuse vomiting and renal failure, she said. Her death should be referred to the Health Products Regulatory Authority (HPRA), she said.
Every drug has a risk versus benefit analysis and the benefits of both Ozempic and Metformin were well-publicized, Dr Bolster said. What Ms O’Donoghue suffered was “extremely rare” she said.
Ms O’Donoghue had been taking Metformin with “no obvious ill effects” since 2016, Mr Comyn noted. Dr Bolster said that Ms O’Donoghue’s “whole problem” seemed to start when Ozempic was added to her prescription. And gastrointestinal issues were a well-known potential side-effect of the drug.
Mr Comyn noted that the drug was prescribed for Ms O’Donoghue “with protocols in existence” and she was monitored by her GP. But Ozempic can be bought online from unregulated sources, he said. Dr Bolster said that this was “very dangerous”.
Dr Bolster said that lots of people were now taking Ozempic on prescription and it was not a dangerous drug at all for many people. But the drug was relatively new and there was no scientific literature yet regarding mortality rates or long-term use, she said.
Mr Comyn extended his sympathies to Ms O’Donoghue’s family on her tragic death and said that he would refer her case to the HPRA.
Semaglutide, sold as Ozempic, has become widely used for weight loss. It is a diabetes medication that lowers blood sugar level in type 2 diabetes. It is also used to reduce the risk of major cardiovascular events and chronic kidney disease.
It was granted FDA approval on December 5, 2017, and it has been lauded as a ‘wonder-drug’ by many since, with demand so high that there have been worldwide shortages of the drug.
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