Talia Evaniа Phillips · Prevention of Future Deaths report

On 4 August 2022 I commenced an investigation into the death of Talia Evanіa Phillips.
The investigation concluded at the end of the inquest on 9 March 2023.
The conclusion of the inquest was a narrative conclusion;

"Talia Evaniа Phillips died at 19.55 on 6 March 2022 on the B3266 opposite the main entrance to the Colquite Estate near Washaway Bodmin as a result of catastrophic head and neck injuries sustained when the vehicle she was driving was in head on collision with an oncoming vehicle. The Deceased had been driving in the direction of Washaway when it crossed over the white line into the Camelford bound lane. It is likely that the Deceased lost control of her vehicle when she suffered a cardiac event caused by a significantly elevated level of the drug Fluoxetine in her blood which had been prescribed to her. There is insufficient evidence evidence to establish why the drug was at such a high level . There is no evidence that the Deceased had any intention to harm herself"

The medical cause of death was 1a Head and neck injuries 1b Fluoxetine toxicity.

Talia Phillips died as a result of injuries sustained in a head on road traffic collision with an oncoming vehicle. It is likely that she lost control of her vehicle having suffered a cardiac event caused by a significantly elevated level of Fluoxetine in her blood.

Evidence from a toxicologist indicated that a chronically high level of fluoxetine may have led to arrhythmia in life and contributed to a collapse at the wheel.

Talia was prescribed Fluoxetine by her general practitioner on 22 December 2021 for anxiety. On 31 January 2022 Talia experienced an episode of palpitations and contacted her general practitioner who organised routine blood tests and an ECG. The tests and the ECG were reported as normal, save for slightly low iron levels. The routine tests did not test Fluoxetine levels.

During the course of the inquest I heard that guidance around the prescribing of Fluoxetine did not indicate that fluoxetine levels would should be routinely tested in a patient prescribed Fluoxetine in the event of an episode of palpitations. Such a test may have identified chronically high levels of Fluoxetine.

It is requested that guidance in relation to the prescribing of Fluoxetine and management of patients on Fluoxetine should be reviewed to consider in what circumstances a blood test to establish the level of Fluoxetine in the patient's blood would be advisable.