Coroner Calls for Anaphylaxis Warning on Steroid Injections After Patient Death

A coroner has called for all steroid injections to carry a warning about potentially fatal allergic reactions after a woman died following a routine jab at her general practitioner surgery. The call comes after Jane Turner, 77, received an injection commonly used to treat swollen or painful joints and muscle pain on September 12.

Turner reportedly returned to the surgery ten minutes after the injection complaining of shortness of breath. Five minutes later, she experienced a peri-arrest, a critical stage before cardiac arrest. Despite an ambulance being called, she died in hospital 16 days later. The cause of death was an injection-related allergic reaction that led to severe brain injury due to oxygen deprivation.

While the National Health Service acknowledges a 'rare' risk of complications, including anaphylaxis, from steroid injections, there is no current mandate for specific anaphylaxis warnings on all such treatments. Coroner Mary Hassell stated that this omission could contribute to a significant number of preventable deaths.

"There is Department of Health guidance regarding the risk of severe life threatening reactions after immunisation, but no guidance regarding the risk following steroid injections," Hassell noted in a prevention of future deaths report sent to the government. "This seems an omission."

Anaphylaxis following a steroid injection is considered rare, affecting fewer than one in 100 patients. These injections, also known as hydrocortisone injections, typically last for two to three months and are used for joint pain, inflammation, painful tendons, and arthritis. Potential side effects can include mood changes and adrenal gland issues, which may manifest as fever, sinus pain, confusion, extreme thirst, and breathlessness.

The Department of Health and Social Care offered its condolences to Turner's family. The UK's drug regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has announced that it will ensure all steroid injections carry an anaphylaxis warning. The MHRA plans to review product information for all steroid injection licenses by the end of the year to ensure consistent and appropriate presentation of anaphylaxis warnings.

The Resuscitation Council UK agreed that careful consideration is needed regarding consistent advice for patients on the risks of severe allergic reactions and the observation period post-injection. Annually, over 70,000 people in the UK receive at least one cortisone injection, with some receiving up to three, at an estimated annual cost to the NHS of around £40 million. Some experts have also raised concerns that these injections may exacerbate joint damage by accelerating cartilage breakdown, potentially leading to a higher likelihood of patients requiring knee or hip replacements.