Elderly woman died of allergic reaction to gout medication: Coroner

SINGAPORE - A 77-year-old woman who suffered joint pain was given a medicine known as allopurinol to treat her gout and she started consuming the drug on Oct 27 last year.

But Madam Tian Lay Choo developed an allergic reaction to it and died in Tan Tock Seng Hospital (TTSH) on Jan 18.

In an inquiry into her death on Wednesday (Dec 27), Coroner Marvin Bay found her death to be an "unfortunate medical misadventure". He said she died of toxic epidermal necrolysis, a more severe form of Stevens-Johnson Syndrome (SJS).

The Straits Times has reported that every year, more than 100 people here suffer from the painful and severe skin condition which is a serious allergic reaction to certain types of medication. The adverse reaction causes skin cells to die and the skin to blister badly.

In rare cases, SJS leads to toxic epidermal necrolysis, in which large pieces of the skin die and fall away, leaving the person vulnerable to life-threatening infections.

On Wednesday, Coroner Bay said: "It is therefore essential for medical professionals, patients and their carers to work in close coordination to give and heed medical advice, and be vigilant for the onset of adverse symptoms such as rashes that may signal that an individual is especially susceptible to the medication prescribed."

He added that the patient can then stop taking the medication and seek medical attention before his condition gets worse.

Coroner Bay said that according to Madam Tian's son, his wheelchair-bound mother complained of knee pain in October last year and was taken to TTSH for treatment.

She asked for medication to ease her pain and her son recalled that a doctor had made reference to its possible side effects. However, her son could not remember the specific details of the discussion and advice.

He noted that his mother became weaker after taking the medication for about two months. The skin around her lips was also peeling.

Coroner Bay said: "He originally believed this to be from dehydration as Madam Tian had been on fluid restriction, as a result of complications by her diabetes and chronic kidney disease."

Madam Tian later asked to go to TTSH and was warded on Dec 31 last year. She also stopped taking her medication that day.

Coroner Bay said that she had rashes on her body which got worse over time. She was diagnosed with toxic epidermal necrolysis on Jan 16 and died two days later.