A CAIRNS nurse has told an inquest that she twice questioned a doctor about the largest amount of morphine she had seen before being told to administer the dose to a patient.

Margaret Ann Cahill, 61, died at Cairns Hospital on September 13, 2017 after she went into cardiac arrest in her Cairns home theday before and never regained consciousness.

Mrs Cahill was being treated for a nerve root compression in her neck by Dr Barbara Gynther in the McLeod Street Medical practice where Mrs Cahill also worked as a medical receptionist.

On Tuesday, an inquest at the Cairns Courthouse into her death heard Mrs Cahill's condition worsened in July 2017 and examined whether she may have overdosed on prescribed drugs. She was given Endone, Oxy­Norm, diazepam and Palexia (tapentadol) between July and August.

 

An inquest into the death of Margaret Ann Cahill found she was prescribed Endone, OxyNorm, diazepam and Palexia (tapentadol). Picture: iStock
An inquest into the death of Margaret Ann Cahill found she was prescribed Endone, OxyNorm, diazepam and Palexia (tapentadol). Picture: iStock

 

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The court heard the Cahills went to the practice on the morning of September 11 when Dr Gynther directed nurse Abigail Heath to inject 60mg into Mrs Cahill's right arm.

Ms Heath told the court the amount was "the largest I've seen at the practice" and asked Dr Gynther twice if it was correct because she was concerned about health reactions.

Ms Heath said the doctor responded: "Yes, we've got to nip this pain in the bud."

The nurse said she obtained verbal consent from the Cahills with Mrs Cahill saying "please just take the pain away".

During cross-examination by Dr Gynther's lawyer, Stephanie Gallagher, Ms Heath said Dr Gynther may have told her Mrs Cahill had a high morphine tolerance.

Dr Gynther is set to give evidence on Wednesday.

Earlier in the hearing, the inquest focused on the reliability of her husband's notebook about administering her Palexia.

Counsel coroner Joseph Crawfoot questioned Mr Cahill about his notebook, corrections made, and whether his administration was consistent with Dr Gynther's advice.

The court heard that overnight on September 10-11, when Mrs Cahill's condition deteriorated, she told Mr Cahill her pain "was like a knife in the back".

"That night was just horrendous," he said.

In his notebook, he reported he gave her 200mg of Palexia at 6.45pm, then another dose at 6.45am the next day before the morphine injection.

Later that evening at home, he found her to be unresponsive in bed and she later died at the hospital.

Treating doctors told Mr Cahill "there may have been an interaction between the Palexia and morphine to cause her to go into respiratory distress".

Originally published as 'Largest I've seen:' Nurse queries morphine shot at death inquest



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