Woodbridge: Poppy’s legacy to ‘benefit millions’
12:00 13 June 2014
Mark Palmer Photography
Poppy Harvey’s ambition was always to help other people. At 19, she had gained a place at Brighton and Sussex Medical School and dreamt of one day saving lives with international medical humanitarian charity, Médecins Sans Frontières.
She was fit and healthy but had been diagnosed with a severe allergy to eggs and nuts at a young age and always carried adrenaline used for first aid treatment of anaphylaxis.
In the year before her studies, she had been working full-time at Woodbridge’s Grove Court care home, where she unwittingly ate a piece of cake containing peanuts and suffered the reaction which led to her death on June 20, 2010.
After injecting herself with adrenaline from two injector pens, she showed improvement and decided to return to work, but her condition seriously deteriorated and she fell into a deep coma, dying within three hours of first recognising the reaction.
A pathologist’s report suggested the needles had failed to penetrate Poppy’s muscle, and had instead delivered adrenaline into the subcutaneous layer beneath her skin, which can slow down its effect.
Following an inquest, Poppy’s family called for clearer advice to be given to acute sufferers. They could find no robust evidence that the pens delivered adrenaline into the muscle of all users; they felt the information provided in patient instructions and on the devices was “deficient”, and they believed advice given by doctors to patients was “inadequate”.
Coroner Dr Peter Dean’s inquiry led to an admission from Ipswich Hospital, where Poppy eventually died, that there had been a failure between paramedics and Emergency Department staff to communicate the urgency of her condition, despite a pre-alert being sent en route to the Heath Road site.
Dr Dean said there needed to be greater clarity about where injector pens should most effectively be applied on the body, he wanted clearer advice about emergency calls following the first injection and had concerns over needle length and conflicting advice on positioning casualties.
Although the inquest could not find conclusive evidence to support the pathologist’s report – that the needles had failed to penetrate Poppy’s muscle –an in-depth review of all adrenaline auto-injectors followed, leading to the Government’s Medicines and Healthcare Products Regulatory Agency (MHRA) to revise guidance for the prescription and use of auto-injectors.
Now, sufferers who have been prescribed a pen will be told to carry two at all times for emergency use.
After every use, an ambulance should be called, even if symptoms are improving, and the sufferer should lie down with their legs raised and not be left alone.
Poppy’s parents, Steve and Marci Harvey, who wrote to the Chief Medical Officer for England directly, detailing their concerns regarding adrenaline auto-injectors, said: “We are delighted that Dame Sally Davies (the CMO) listened to us.
“It was a phenomenal relief.
“She thanked us for our time, effort and dedication, expressing gratitude for bringing these issues to her attention and directed the MHRA to perform a review.
“We have been impressed by the diligence and thoroughness of the MHRA, who invited us to meetings to contribute. It is immensely satisfying that each and every one of our recommendations has been heeded and included.
“It’s been a long, exhausting, painful and extremely lonely journey.
“We frequently felt that those purporting to support those at risk of anaphylaxis were unwilling to seek answers to the difficult questions which Poppy’s death forced us to ask.
“Whilst we wouldn’t have wished to be anywhere other than by Poppy’s side, we were haunted by images of the last tortuous moments of her life, which ran on a relentless loop through our tormented minds. It was a terrifying, horrific, agonising death.
“Poppy’s sister Sunshine also suffers from the same potentially life-threatening allergy to nuts.
“Given the facts that we gleaned, our consciences drove us to prevent future death and distress and now at last we’ve achieved our aim.
“The MHRA guidance to patients and doctors will already be helping save lives and the EMA review will result in putting auto-injector design on an evidence-based, scientific footing.
“It has required considerable determination and resilience on our part.
“Focusing so intently and unremittingly on Poppy’s death has been excruciating and severely taken its toll.
“We are not interested in attributing blame. We seek neither retribution nor compensation. They will not bring our beloved daughter back but would serve to drain precious time, energy and resources away from achieving our one and only burning desire – to ensure greater protection for others at risk of anaphylaxis.
“Poppy wouldn’t wish us to point fingers having successfully accomplished our mission. Behind her legendary, dazzling smile lay an inspirational generosity of spirit. The past is behind us, what we have is now – we hope we’ve lived up to her positive, loving example in making the safety of others our absolute priority.
“Poppy had gained a place at Brighton and Sussex Medical School. Whilst she didn’t live to fulfil her dream of becoming a doctor, in death she has helped millions.
“Our job now is done. We can all finally rest in peace.”