The sudden death of a healthy young student from Cork in the middle of her Leaving Certificate exams last year may be linked to both a previously unknown genetic abnormality and an oral contraceptive pill, an inquest has heard.
A sitting of Dublin District Coroner’s Court heard that Sarah-Kate O’Meara had begun taking a common combined oral contraceptive, Ovreena, about a month before her death.
An inquest on Friday into her death heard the Glen Rovers camogie player would also have been at an increased risk of blood clots due to a previously unknown genetic condition as well as a period of relative inactivity while studying for exams.
An autopsy showed she died from a lack of oxygen to the brain which was due to blood clots in her right lung and in veins on the surface of her brain.
The 18-year-old student from Baker’s Rd, Gurranabraher, was rushed by ambulance to Cork University Hospital after becoming unwell at her home on the morning of June 10, 2024, just before she was due to sit a Leaving Certificate maths paper at Mount Mercy College.
Ms O’Meara was transferred to the Mater Misericordiae University Hospital in Dublin the following day for specialist care but her condition subsequently deteriorated and she died on June 17 — just four days after her 18th birthday.
The deceased’s mother, Diann O’Meara, told the inquest that her daughter — one of five children — was a healthy teenager who was very sporty by playing camogie, running, and going to the gym.
She said Sarah-Kate was “so health conscious” that she would give out to the rest of her family about putting salt and butter on their food.
Ms O’Meara recalled her daughter giving a small cough after coming into the kitchen at around 8.25am on June 10, 2024, with a study folder under her arm.
She told the inquest that Sarah-Kate then fell helplessly to the ground as if she had fainted.
Ms O’Meara said she screamed for her husband, Tony, to help before their daughter started speaking, although she still appeared somewhat disoriented.
After being moved to a couch, the teenager told her parents that she felt like something was stuck in her chest but was concerned about going to school for her exam.
Ms O’Meara said her daughter vomited shortly after she had given her some Lucozade and Calpol.
A short time later, they called an ambulance after her lips went blue and her skin turned grey and she went into convulsions.
Breaking down in tears at regular intervals as she recalled the tragic events, Ms O’Meara said her husband started CPR on their daughter and was later assisted by a pharmacist from a nearby chemist.
However, Sarah-Kate was unresponsive by the time that paramedics arrived at their home.
Ms O’Meara revealed that they decided to donate their daughter’s organs to help others after being informed by doctors at the Mater that the chances of her recovering were unlikely.
In reply to questions from the coroner, Clare Keane, she said there was nothing to suggest there was anything amiss with her daughter’s health in the days before her collapse.
Ms O’Meara outlined how Sarah-Kate had visited the Parklands Surgery in Cork the previous month to arrange to start taking a contraceptive pill.
The inquest heard she was on no other medication at the time of her death apart from an occasional protein supplement and had no history of blood clots.
Ms O’Meara said Sarah-Kate had suffered from migraine for a number of years but had no longer required treatment for it since 2017.
A Cork-based GP, Caroline Burke, gave evidence of prescribing Ovreena to the teenager following a detailed consultation on May 13, 2024.
Dr Burke said the teenager wanted to go on the pill to lighten her periods as well as for contraceptive purposes.
The doctor told the inquest that she went through the various options for contraception and a detailed set of questions that covered possible risk factors as well as checking the patient’s blood pressure and weight.
Dr Burke said she had discussed the patient’s previous history of migraine but was reassured that she had not suffered the specific type of migraine that posed a particular risk.
The inquest heard that Sarah-Kate was given a prescription for one month for Ovreena and had booked a follow-up check for one month later.
Dr Burke told the coroner that Ovreena was “the safest first line option” for the combined oral contraceptive pill.
A consultant cardiologist at CUH, Gerry Fahy, told the hearing that the teenager’s poor condition on arrival at the hospital had required her to be defibrillated 15 times over a 90-minute period.
Dr Fahy said doctors were not aware at the time of the underlying cause of what happened and originally believed it was due to inflammation of the heart muscle before it became clearer that it could be due to blood clots.
He explained that the patient developed disseminated intravascular coagulation — a rare condition where the blood is prone to both clotting and bleeding at the same time — which posed major challenges in providing regular treatment for clots.
A consultant intensivist and anaesthetist at the Mater, Deirdre Edgeworth, gave evidence that the patient was deemed suitable for treatment with the hospital’s ECMO machine — which diverts blood away from the lungs and heart — for patients with cardiac conditions that are considered reversible.
A consultant cardiologist at the Mater, Katie Murphy, said Sarah-Kate had no signs of any underlying cardiac condition.
Dr Murphy said the patient’s cardiac function had improved with the ECMO treatment but the neurological injuries she had suffered as a result of the cardiac event had proven fatal.
The cardiologist said she believed the cause of the blood clots were “multi-factorial” including the patient’s use of an oral contraceptive pill and not being as active as normal due to her studies.
Dr Murphy also revealed that testing had shown Sarah-Kate had a genetic abnormality known as Factor V Leiden which placed her at an increased risk of blood clots.
Recording a narrative verdict to reflect the complexity of the evidence, Dr Keane said she noted the significant finding in relation to Factor V Leiden.
The coroner also observed that there was a known increased risk of blood clots with the combined oral contraceptive pill.
Dr Keane reecorded that the potential side effects of the pill had been explained to the teenager and that it had been prescribed at a time when her genetic abnormality was unknown.
The inquest heard that the donation of the deceased’s kidneys had saved the lives of two other patients.
Offering her condolences to the student’s family, Dr Keane said she was so sorry “for the heartbreaking loss of your vibrant daughter.”
Ms O’Meara replied: “It’s the world’s loss — not just ours. She had so much to offer.”
Her family had originally sought an adjournment of the inquest after only receiving a copy of Dr Burke’s deposition just before the hearing which had left them “taken aback”.
However, they decided to allow the inquest to proceed after the coroner informed them they could ask questions about any evidence.
