Rubana PATHAN · Prevention of Future Deaths report

On 25 November 2015, one of my assistant coroners, Richard Britain, commenced an investigation into the death of Rubana Pathan, aged 40 years. The investigation concluded at the end of the inquest earlier today. I made a determination as follows.

Ms Pathan was admitted to Homerton University Hospital on Thursday, 5 November 2015 and was immediately recognised to be potentially very unwell. Her breast reconstruction wound later grew staphylococcus aureus, she was found to be positive for the TSST-1 gene, and was diagnosed with toxic shock syndrome.

I recorded a medical cause of death of:

1a toxic shock syndrome
1b staphylococcus aureus infection
1c infected breast implant wound

Although Ms Pathan’s MENTOR breast implant was suspected as being the cause of her sepsis and was removed on the evening of Saturday, 7 November 2015, her surgeon told me at inquest that she still did not believe this to be the cause, because she found no pus or localised redness.

However, one of the treating microbiologists undertook a literature search after Ms Pathan’s death and discovered that the toxin found to be responsible for her illness can supress signs of local inflammation such as the production of pus.

Although this is a rare occurrence, it seems to me that the information could usefully be disseminated among those likely to be caring for patients who may be at risk of developing sepsis, both by the hospital and by the implant manufacturer.