Aaron John Peter McCaffrey · Prevention of Future Deaths report

On the 20th January 2017 an investigation was commenced into the death of Aaron John Peter McCaffrey. An inquest was opened on the 20th January 2017 and concluded on the 31st May 2017. The medical cause of death was:

1a Hypoxic brain injury
b Multiple cardiac arrests
c Loperamide overdose

The Coroner's Conclusion was: “drug-related” death.

Mr McCaffrey had a history of taking large quantities of loperamide medication. This is a medication that is available “over-the-counter” and is often referred to under the brand name “Imodium”. Mr McCaffrey had a history of addiction to opiate medications, which dated back a number of years. This included addiction to medications such as co-codamol. However, he later developed an addiction to loperamide medication and – in the years prior to his death – he was known to regularly take in the region of 150 tablets per day. Mr McCaffrey’s ex-partner explained in evidence that this was the amount that Mr McCaffrey would admit to taking but she suspected that he took more than this on occasion. It was clear that the history of addiction was part of the reason for the relationship breakdown, although ████████ remained in close contact with Mr McCaffrey, as they had young children together. Loperamide medication contains a low level of opiate. Mr McCaffrey was known to suffer from anxiety, although he kept any mental health concerns mainly to himself. He told ████████ that he took large amounts of loperamide medication because it made him feel better.

On the 13th January 2017 Mr McCaffrey took in the region of 250 loperamide tablets. He collapsed in the toilets at the Tesco Store in Droylsden, Manchester and was taken by ambulance to Tameside General Hospital. His condition deteriorated in hospital (despite medical treatment) and he died on the 19th January 2017. The Conclusion was recorded as: “drug-related death”. Mr McCaffrey did not intent to end his own life. His death was an unintended consequence of consuming the large amount of loperamide medication.

Mr McCaffrey’s ex-partner gave evidence that Mr McCaffrey would regularly purchase large quantities of loperamide medication. Following the incident on the 13th January 2017, she counted 250 tablets that had been taken (the empty packets were in the back-pack in his possession). The receipts were also present within the bag. She advised that he had purchased large amounts of this medication from a budget store as well as smaller quantities from a supermarket and a chemist. It was clear that Mr McCaffrey would frequently buy large amounts of this medication from a single store.

The concern is that there is no apparent limit on the amount of loperamide medication that can be purchased from a single store. This makes the medication easier to purchase in large quantities. I am concerned that action should be taken to limit the amount of loperamide medication that can be purchased from a single store, due to the fact that it is apparently being used (on occasion) to fuel addiction and due to the risk of overdose and death.