Fit and healthy woman, 23, collapsed and died from blood clot five months after being prescribed the contraceptive pill
She went into cardiac arrest at her work and was rushed to hospital
A HEALTHY young woman collapsed at work and died from a blood clot five months after she was prescribed a contraceptive pill, an inquest heard.
Charlotte Foster went into cardiac arrest after a thrombosis - thought to have arisen in her pelvis or leg - caused an embolism in her lungs.
Three days after collapsed at her work, dairy firm Muller, Charlotte died in hospital.
The inquest at Shropshire Coroner's Court heard that Charlotte had been seen by a GP three weeks before she died, and no signs of deep vein thrombosis were recorded.
It also heard she should not have been given the medication following previous medical tests.
Charlotte had been given a three-month prescription of Dianette as a contraceptive and to combat acne in August last year, having told her GP of a family history of pulmonary embolism and breast cancer.
Shropshire Coroners Court heard the brand of pill she was given is known to double your chance of a blood clot and Charlotte was advised to see her surgery immediately if she suffered shortness of breath.
She visited her doctor three weeks before she collapsed and her mum Cecilia, 60, claims her daughter then complained of shortness of breath but nothing was done.
Dr Sarah Cumberlidge prescribed Dianette to Charlotte when she first moved to Seven Fields Health Village practice, in Shrewsbury, Shrops.
Today the GP told the hearing: "I was aware that she had tried a variety of treatments for her acne, including tropical cream and antibiotics, but they had been unsuccessful.
"She requested a combined oral contraceptive pill and I discussed the side effects with her.
"I prescribed a three month course and advised if there were any problems such as shortness of breath or chest pains she should contact the surgery."
The court heard a MET risk assessment of the contraception pill was carried out, where category one shows there is "no restriction for the use of contraception".
Category two says "the advantage of using the contraceptive outweighs the risk" and category three where "theoretical risk usually outweigh benefits of using the medication".
A previous test carried out in 2011 at Wellington Road Surgery, in Newport, found Charlotte was a category three - but Dr Cumberlidge found she was a category one or two.
She added: "I don't know how they would have come to that conclusion, and I stand by what I found.
"Although her mother had suffered two pulmonary embolisms, these were when she was over 45.
"Her blood pressure and oxygen saturation were healthy."
She then returned to see a different GP at her surgery in Newport in October last year, and was given a continuing prescription for Dianette after reporting no side effects.
The Shropshire Coroner, John Ellery, heard evidence that Charlotte went back to the surgery on January 4 with pain in her lower back, extending down to her knee.
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The court heard Charlotte told Dr Sunil Simon she was suffering from shortness of breath when she visited him in January.He told the hearing: "I don't specifically recall it, but it may have been mentioned.
"When I suspect pulmonary embolism there has to be serious clinical symptoms.
"When I observed Charlotte I did not observe that she had shortness of breath.
"This is what GPs do do every day, day in day out, and I didn't notice any respiratory distress.
"The cause of her back pain was mechanical."
Consultant anaesthetist Dr Nigel Tuft gave the cause of death as "hypoxic brain damage due to a pulmonary embolism due to taking the oral contraceptive pill".
The court heard CT scans had shown she was not suffering from any tumours, which may have caused the embolism.
After she died on January 25, Dr Tuft concluded the only risk factor was that she was taking the oral contraceptive pill.
Dr Tuft told the inquest: "The most likely site for the pulmonary embolism to arise is in the veins of the pelvis and the upper leg.
"These can cause no symptoms whatsoever or they can cause symptoms or deep vein thrombosis."
Dr Tuft added: "On January 26 we were aware that Charlotte's parents desired for her to be an organ donor and a second set of tests were carried out to determine if her organs were damaged.
"We discussed information to put together reasons why Charlotte may have suffered a pulmonary embolism.
"One recent factor was that she was taking the oral contraceptive pill Dianette
"When speaking to the coroner I explained on balance of probabilities Charlotte died from hypoxic brain damage due to a pulmonary embolism due to taking the oral contraceptive pill.
"I imagine the most likely start of the embolism was in the veins on the pelvis or upper leg.
"This can cause absolutely no symptoms, or it can show itself through chest pain, shortness of breath or coughing up blood.
"We would expect the clot to have formed in the order of weeks, perhaps 10 days, before the pulmonary embolism, but it is hard to say for sure.
"Since the 1970s there has been some evidence the contraceptive pill could lead to an increase in blood clots.
"Normally there is a one in 10,000 risk of blood clots in normal women. That raises to two in 10,000 if you are on a number of contraceptive medication.
"If you are on Dianette it raises to four in 10,000, which in turn increases your risk of a pulmonary embolism.
"Health regulators have found that despite its risk of pulmonary embolisms, Dianette is still a legitimate drug to use to treat acne, but not to use as a contraceptive pill."
Charlotte attended Shrewsbury High School before going to the University of Liverpool where she studied Business Studies and graduated in 2004.
She joined Muller in June last year where she had been working as a Customer Category Executive for just over six months.
The hearing continues.
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