The tragic death of 14-year-old Emma Sloan two years ago next week was the focus of intense media interest and highlighted the life-threatening challenges faced by some people with nut allergy.
It also prompted an investigation by gardaí and by the regulator for the pharmacy sector, the Pharmaceutical Society of Ireland (PSI). The latter inquiry was prompted by allegations made by Emma's mother, Caroline Sloan, about her unsuccessful efforts to buy an EpiPen from a Dublin city-centre pharmacy.
Emma had mistakenly eaten satay sauce, containing peanut, in a Chinese buffet and was beginning to experience an allergic reaction. The family decided to go to Temple Street hospital, but stopped on the way at the Hamilton Long pharmacy on O'Connell Street, where her mother attempted to buy an EpiPen.
What happened inside the shop is disputed. Ms Sloan says she asked for the EpiPen for her daughter, who was outside. Staff, including the pharmacist David Murphy, who was the subject of the PSI hearing this week, says she did not refer to any particular person. There were also differences over whether the calling of an ambulance was suggested.
In the event, Ms Sloan left and headed north to a car park, but her daughter’s condition worsened quickly and she died shortly afterwards.
Rules
Strict rules govern the dispensing of medication by pharmacists. Generally, they are not allowed to dispense prescription items without a prescription, especially to customers who haven’t been in their store before. They are also required by law to stay in the store while on duty.
Mr Murphy’s conversation with Ms Sloan was brief and limited. In the view of an expert witness, he should have asked more questions to establish the situation, and should have seen the patient, even if she was outside. But did this amount to poor professional performance? The standard of proof required in these inquiries is a criminal one – that is, beyond reasonable doubt – and given the conflicts of evidence and the legal framework, it was hard to see how such a finding could be sustained in this case.
No medical witnesses were called at the hearing, so no evidence was provided about the causes of death.
The case highlights the way that there are no winners from these inquiries. Ms Sloan has lost a young daughter, a nightmare she relives daily; Mr Murphy has endured a lengthy investigation process and waves of verbal abuse, even death threats.
The only good is that, arising from the publicity in the case, and through Ms Sloan’s campaigning, the law on the availability of EpiPens has been liberalised. It is now possible for non-medical people with training to use these devices and, hopefully, to avert tragedies of this type.