Widow loses coroner cannabis challenge

oconcuc · 28-04-2010 7:45pm #1

http://www.irishtimes.com/newspaper/breaking/2010/0428/breaking65.html

"A widowed mother of six has lost her High Court challenge to a coroner’s finding that cannabis smoking contributed to the death of her young husband from a heart attack.
Fiona Byrne, wife of the late Paul Byrne (37), had claimed Dublin County Coroner, Dr Kieran Geraghty, was “perverse” in finding her husband’s death on November 9th 2005 was by misadventure due to coronary issues with cannabis use as a secondary cause.
Her husband was not a chronic user of cannabis but smoked it in an attempt to alleviate the constant pain he was suffering from, Ms Byrne claimed.
Ms Byrne, Glenshane Grove, Tallaght, Dublin, claimed Dr Geraghty failed to consider several matters, including research rejecting links between smoking cannabis and heart attacks.
Dr Geraghty denied the claims and said the “opinion” about cannabis use was not put before him at the inquest and he did not have an opportunity to consider it when making his decision.
He also argued Ms Byrne failed to put before the court sufficient evidence to say that his decision as to cannabis being a secondary cause of death was at variance with reason and common sense.
Dismissing Ms Byrne’s case today, Mr Justice John Hedigan found the coroner arrived at his decision on the basis of reliable and detailed evidence and had acted in the interests of Ms Byrne at all times.
He rejected Ms Byrne’s arguments the coroner did not seek further evidence or was ambivalent about the role of cannabis as a precipitant to a heart attack.
“It would be unreasonable to expect all contrary views to be accounted for in a coroner’s inquest”, he said.
The question of whether further information should be required or explored was within the discretion of the coroner, the judge said.
The coroner had a detailed report, based on first-hand examination by the pathologist and supported with toxicology results, along with other material, which allowed him to make an informed and reasonable decision, he added.
A coroner must be satisfied a misadventure verdict was based on the balance of probabilities and such a verdict, although broad in scope, suggested the cause of death in this case arose as an “unintended consequence of an otherwise innocuous activity”, the judge said.
That was not an unreasonable decision given the preceding state of affairs, he added.
The judge also rejected Ms Byrne’s claim the inquest should have been adjourned to facilitate an investigation into why there was a 40-minute delay in an ambulance arriving at her home on the day of her husband’s death.
The judge said Ms Byrne attended the inquest with her father-in-law and was present when her father-in-law had refused an adjournment.
An inquest is merely an inquisitorial process and must not encroach on establishing criminal or civil liability, the judge said.
In her action, Ms Byrne said the coroner failed to properly take into account Mr Byrne’s medical history, including his being treated for high cholesterol and waiting for about a month for an “urgent” appointment for an MRI scan following the discovery of a blood clot in his leg.
She challenged Dr Geraghty’s finding, based on a pathologist’s report, that traces of cannabis found in Mr Byrne’s system were sufficient to have induced and/or contributed to the onset of the heart attack."

For those of you who are not versed in the fundamentals of Judicial Review of administrative decisions, Irrelevant Considerations in the decision-making process are a justification for a court to overrule an administrative body or agent.

Given the fact that there is no evidence whatsoever, in this case or otherwise, to show that there is any link between heart attacks and cannabis use, it is difficult to see how this woman failed to succeed.

Not so unusual a decision from the High Court however. They are known for the deferential nature to public bodies in Judicial Review proceedings.

I hope this decision does not affect any life insurance payout the family might be seeking. Though I cannot see any other reason why she would put herself through the trauma of High Court proceedings purely on a matter of principle. However commendable that may be.

Another failure from out third branch of state power.

ChocolateSauce · 28-04-2010 10:07pm

That would make this the first ever death to be linked to cannabis use that I've ever heard of.

I find that highly unlikely.

Pete M. · 28-04-2010 11:43pm

This is quite unusual alright.
I mean did the Coroner check for other substances like caffeine or sugar or alcohol or salt? These could also have contibuted, as could the temperature or a number of other factors.

oconcuc · 28-04-2010 11:57pm

The judge noted that it was an "otherwise innocuous activity".

The courts are reluctant to challenge decisions of expert bodies, particularly following the case of O'Keeffe v An Bord Pleanala, which set a particularly high standard of unreasonableness for decisions. So I can understand why the judge decided the way he did.

What is more frustrating is that this may seem to legitimise the authority of the coroner's report that minute traces of cannabis may have contributed or set off the deceased man's heart attack.

The coroner has done what hundreds of millions of dollars of research in the developed world has previously failed to do, in directly implicating cannabis as a cause of death.

Your queries regarding other factors are well made. Had the man eaten McDonald's that day, listened to Joe Duffy or read any of the tabloid media at any period over the previous few days. These, surely, are factors that are as relevant to the onset of a heart attack as small traces of cannabis.

GarlicBread · 29-04-2010 10:46am

The war on drugs being waged against dead bodies :eek:? A scary society we live in indeed with coroners like that walking about.

eoin5 · 29-04-2010 2:42pm

Given that its a coroner saying this shouldn't it be a massive worldwide type of discovery? Publications in medical journals, peer review etc.

DarkJager · 29-04-2010 3:09pm

Its pretty safe to say cannabis had absolutely nothing to do with his death, to even suggest it let alone take a court case to prove it is beyond ridiculous. It just sounds like clutching at straws to have something to blame.

seamus · 29-04-2010 3:18pm

Cannabis use was cited as a secondary cause, not the primary cause.

Since cannabis raises heart-rate (and also lower your blood pressure) in the short-term, it's not unreasonable to claim that someone with a known cardiac condition aggravated that condition by smoking cannabis. The potency of the cannabis would be a factor there.

Basically the ruling was the primary cause of death heart failure and the cannabis didn't help.

Very strange though that the coroner would even bother to cite it instead of just chalking it up to a heart attack.

Though if he had smoked a large amount of the good stuff, you could indeed call it death by misadventure.

DarkJager · 29-04-2010 3:44pm

seamus wrote: »

Cannabis use was cited as a secondary cause, not the primary cause.

Since cannabis raises heart-rate (and also lower your blood pressure) in the short-term, it's not unreasonable to claim that someone with a known cardiac condition aggravated that condition by smoking cannabis. The potency of the cannabis would be a factor there.

Basically the ruling was the primary cause of death heart failure and the cannabis didn't help.

Very strange though that the coroner would even bother to cite it instead of just chalking it up to a heart attack.

Though if he had smoked a large amount of the good stuff, you could indeed call it death by misadventure.

The potency would certainly be a factor, but to induce a cardiac arrest would require a massive dose of THC (a lot more than 1 joint and hours on end of constant consumption of it). Also:

Article wrote:

She challenged Dr Geraghty’s finding, based on a pathologist’s report, that traces of cannabis found in Mr Byrne’s system were sufficient to have induced and or contributed to the onset of the heart attack."

The wife said he was not a chronic user of cannabis, thus this suggestion by a supposed "medical professional" is complete nonsense. Unless the weed he was smoking was almost 100% pure THC and packed into a joint about a foot long, there is zero possibility of there being sufficient quantities to cause any ill effects.

IrishTonyO · 29-04-2010 3:48pm

seamus wrote: »

Cannabis use was cited as a secondary cause, not the primary cause.

Since cannabis raises heart-rate (and also lower your blood pressure) in the short-term, it's not unreasonable to claim that someone with a known cardiac condition aggravated that condition by smoking cannabis. The potency of the cannabis would be a factor there.

Basically the ruling was the primary cause of death heart failure and the cannabis didn't help.

Very strange though that the coroner would even bother to cite it instead of just chalking it up to a heart attack.

Though if he had smoked a large amount of the good stuff, you could indeed call it death by misadventure.

There has never been one death anywhere in the world linked with cannabis use/abuse. I doubt very much that this is a genuine first.

seamus · 29-04-2010 3:57pm

DarkJager wrote: »

The wife said he was not a chronic user of cannabis, thus this suggestion by a supposed "medical professional" is complete nonsense. Unless the weed he was smoking was almost 100% pure THC and packed into a joint about a foot long, there is zero possibility of there being sufficient quantities to cause any ill effects.

At any potency though, it will raise your heart rate. You don't have to go to 200bpm to have a heart attack. Perhaps he was already stressed and his heart rate was up, he had a joint or two, which tipped it over the edge.

IrishTonyO wrote: »

There has never been one death anywhere in the world linked with cannabis use/abuse. I doubt very much that this is a genuine first.

But nowhere does it say that the coroner ruled that the cannabis killed him. The heart attack killed him, the cannabis was merely a contributory factor.

It's much the same if someone gets drunk and suffocates on their own vomit. The drink didn't killed them; they suffocated, but it will still be death by misadventure where alcohol was a contributory factor.

My point is that while you wouldn't say that smoking cannabis killed him, or was even likely to kill him that day, you also can't claim that he would have died anyway without having smoked that joint, because the possibility is there that it raised his heart rate sufficiently to cause the anset of cardiac arrest.

As I say, it's odd that the coroner would bother to mention it. If, in my example above, the guy was also stressed on the day, then surely that's a contributory factor too?

I'm also curious as to why his widow is so adamant to have the verdict changed. Perhaps it's just a matter of principle, or perhaps she's looking to pursue a compensation case against HSE?

MagicSean · 29-04-2010 4:03pm

DarkJager wrote: »

The potency would certainly be a factor, but to induce a cardiac arrest would require a massive dose of THC (a lot more than 1 joint and hours on end of constant consumption of it). Also:

The wife said he was not a chronic user of cannabis, thus this suggestion by a supposed "medical professional" is complete nonsense. Unless the weed he was smoking was almost 100% pure THC and packed into a joint about a foot long, there is zero possibility of there being sufficient quantities to cause any ill effects.

The wife could have been lying you know. It's not uncommon for relatives of deceased to downplay any vices of their loved ones in an attempt to preserve their reputation and assign blame away from them.

As someone already said, cannabis has an effect on the body and the heart and in the opinion of the coroner this contributed to bringing on the cardiac arrest. I don't see what is wrong with that verdict. He is not saying cannabis caused the death.

oconcuc · 29-04-2010 4:07pm

seamus wrote: »

Cannabis use was cited as a secondary cause, not the primary cause.

Since cannabis raises heart-rate (and also lower your blood pressure) in the short-term, it's not unreasonable to claim that someone with a known cardiac condition aggravated that condition by smoking cannabis. The potency of the cannabis would be a factor there.

Basically the ruling was the primary cause of death heart failure and the cannabis didn't help.

Very strange though that the coroner would even bother to cite it instead of just chalking it up to a heart attack.

Though if he had smoked a large amount of the good stuff, you could indeed call it death by misadventure.

The traces of cannabis were admitted by the coroner to be minimal. For the type of severe reaction that, admittedly, cannabis can and does cause, the user would have had to ingest a considerable amount, or else be a novice user whose metabolism had not adjusted.

The wife indicated that he was more than an infrequent user, using it to help alleviate pain, which would rule out that kind of severe reaction. The initial transcripts show that the coroner made no substantiated causal connection between the presence of cannabis in his system and the heart attack.

Unfortunately, as I outlined above, the standard of judicial review of administrative decisions in this state is woefully weak in Ireland. The coroner's final decision would rarely be questioned, and following the O'Keeffe case, substantive reasons don't really have to be given. Considering the courts will only assess the decision making process, overruling an administrative body never takes place.

Mrs. Byrne I would imagine would have been briefed on this state of affairs in Irish public law, so the reason she challenged is hard to fathom. She must have wanted to publicise the decision she doesn't like, though I cannot see how she would benefit from having her failure brought out in the open. It certainly is not to assist any cannabis moderation lobby group, as this decision is ample fodder for the right wing media, and prohibition fundamentalists like EURAD and Grainne Kenny.

I believe this may be related to a life insurance payout. If he died as the result of an illegal activity, perhaps this would affect such a payout? I am unfamiliar with such policies, anybody else know?

DarkJager · 29-04-2010 4:17pm

seamus wrote: »

At any potency though, it will raise your heart rate. You don't have to go to 200bpm to have a heart attack. Perhaps he was already stressed and his heart rate was up, he had a joint or two, which tipped it over the edge.
But nowhere does it say that the coroner ruled that the cannabis killed him. The heart attack killed him, the cannabis was merely a contributory factor.

It's much the same if someone gets drunk and suffocates on their own vomit. The drink didn't killed them; they suffocated, but it will still be death by misadventure where alcohol was a contributory factor.

My point is that while you wouldn't say that smoking cannabis killed him, or was even likely to kill him that day, you also can't claim that he would have died anyway without having smoked that joint, because the possibility is there that it raised his heart rate sufficiently to cause the anset of cardiac arrest.

As I say, it's odd that the coroner would bother to mention it. If, in my example above, the guy was also stressed on the day, then surely that's a contributory factor too?

I'm also curious as to why his widow is so adamant to have the verdict changed. Perhaps it's just a matter of principle, or perhaps she's looking to pursue a compensation case against HSE?

Good points, but I'd think anything could have caused that heart attack. Walking up a flight of stairs or any prolonged physical activity could have triggered it just as easily.

seamus · 29-04-2010 4:22pm

DarkJager wrote: »

Good points, but I'd think anything could have caused that heart attack. Walking up a flight of stairs or any prolonged physical activity could have triggered it just as easily.

No argument here at all. Without any more information about the autopsy or the deceased's movements before his death, I wouldn't risk speculating any further on the coroner's motives for including cannabis in the verdict.

As oconcuc points out, the judiciary really only tends to overrule these kinds of things where undue weight is given to irrelevant considerations. I'm really just pointing out that cannabis doesn't automatically qualify as irrelevant in this case, even if it is a bit of a scapegoat.

oconcuc · 29-04-2010 4:23pm

seamus wrote: »

At any potency though, it will raise your heart rate. You don't have to go to 200bpm to have a heart attack. Perhaps he was already stressed and his heart rate was up, he had a joint or two, which tipped it over the edge.
But nowhere does it say that the coroner ruled that the cannabis killed him. The heart attack killed him, the cannabis was merely a contributory factor.

It's much the same if someone gets drunk and suffocates on their own vomit. The drink didn't killed them; they suffocated, but it will still be death by misadventure where alcohol was a contributory factor.

My point is that while you wouldn't say that smoking cannabis killed him, or was even likely to kill him that day, you also can't claim that he would have died anyway without having smoked that joint, because the possibility is there that it raised his heart rate sufficiently to cause the anset of cardiac arrest.

As I say, it's odd that the coroner would bother to mention it. If, in my example above, the guy was also stressed on the day, then surely that's a contributory factor too?

I'm also curious as to why his widow is so adamant to have the verdict changed. Perhaps it's just a matter of principle, or perhaps she's looking to pursue a compensation case against HSE?

You are correct in that if somebody choked on their own vomit due to excess alcohol in their system, it would be classed as death by misadventure. It is not difficult to make a direct causal link between an large amount of alcohol in their blood, and death by asphyxiation.

However it is something entirely different to infer a direct causal link between small traces of cannabis and heart failure.

While the coroner is saying the heart attack was the c.o.d, he is also saying that cannabis was the primary instigator of the heart attack. That would make it the intervening rogue element in his death, and the label of misadventure enforces the conclusion that cannabis use was the primary inducing factor.

Now I understand that overall his rational may seem justified. Cannabis in the blood, heart condition, effect of cannabis on someone with poor health...boom, we have a result. If I was working for a state authority that is undoubtedly poorly resourced, I would be looking for the obvious conclusions. But when there is a possibility that this may impact someones entitlements, which he would be well aware of, he should err on the side of caution.

Insurance companies will use the coroner's report as major part of their own decisions on payouts.

When you are making such decisions, I don't think it is unfair to expect a qualified and justified conclusion, which can show a clear causal link.

oconcuc · 29-04-2010 4:29pm

And just from a quick perusal of the internet on life insurance payouts, it looks like they would possibly not pay out if death was induced by use of an illicit substance. Though that may just be hard-nosed American Insurance firms.

BluePlanet · 29-04-2010 4:33pm

It's sounds like a politically-charged decision.
A bit worrying really.

oconcuc · 29-04-2010 4:38pm

BluePlanet wrote: »

It's sounds like a politically-charged decision.
A bit worrying really.

Though it would be nice to blame them for everything. I think, unfortunately, the coroner maybe wanted to get the hell outta the coldroom full of corpses and back to the family. While I understand it might have made sense at the time for the sake of completeness and balance to the days reports. It would have been just as easy to say, this dude had heart disease among other ailments, C.O.D HEART FAILURE. Nice and easy. And then he could have gone home to chill with his bitches.:cool:

seamus · 29-04-2010 4:41pm

oconcuc wrote: »

And just from a quick perusal of the internet on life insurance payouts, it looks like they would possibly not pay out if death was induced by use of an illicit substance. Though that may just be hard-nosed American Insurance firms.

Having had a look at a T&C booklet from Irish Life, they won't pay out on a life insurance policy

If the accidental death is self-inflicted or caused directly or indirectly by you taking alcohol or drugs.

This is probably why she's challenging the coroner's verdict, she's now been saddled with a mortgage and very little money.

Are there any other avenues she can pursue at this point? With the above knowledge in mind, it seems odd that they would stick with this verdict instead of making a judgement on the greater good. Could she appeal for a new autopsy or examination?

oconcuc · 29-04-2010 4:50pm

seamus wrote: »

Having had a look at a T&C booklet from Irish Life, they won't pay out on a life insurance policy
This is probably why she's challenging the coroner's verdict, she's now been saddled with a mortgage and very little money.

Are there any other avenues she can pursue at this point? With the above knowledge in mind, it seems odd that they would stick with this verdict instead of making a judgement on the greater good. Could she appeal for a new autopsy or examination?

Much obliged for your research.

Nope, as I said above, unless she wants to take a Supreme Court challenge, the High Court has the final say in the matter.

As regards a second opinion, the body is 5 years old now, I reckon not much left to examine. She could possibly make a plea to the Insurance company on compassionate grounds...though we know what the Insurance Federation of Ireland thinks about voluntary compassion.

The Supreme Court is it. I don't know how that would fare at the moment. There was a very recent decision in the Supreme Court that has relaxed the O'Keeffe case I mentioned which was the original high bar for Judicial Review.

http://www.irishtimes.com/newspaper/ireland/2010/0122/1224262844026.html

The decision was centred around the administrative decisions effects on Ms. Meadows fundamental rights. An insurance payout would be difficult to construe as a fundamental right under Article 40 of the Constitution. But hell, if she has a good lawyer who knows what is possible.

The Supreme Court is very conservative at the moment. She would need a favourable draw on the bench. Denham and Fennelly for sure.

That info puts a very sad spin on this for me. I am now less sympathetic to the position of the coroner.

oconcuc · 29-04-2010 4:55pm

If anyone is wondering what O'Keeffe is, check out the link for the Times above and the article does an excellent job of explaining its effects.

This is relevant to everyone in the country. Any of us might have to take such a challenge against a public body.

Judicial Review is the only binding authority on public bodies. The ombudsman, while excellent at uncovering dodgy activities and behaviors within the public sector, can only issue recommendations to the Oireachtas.

The courts are the only real place you can get justice if you have been badly treated by the state or its bodies.:)

MagicSean · 29-04-2010 5:12pm

Surely she wouldn't have to get the coroners report changed if it was just about insurance. Could she not still take a civil action against the insurance company for failing to pay? In that case the coroners report would be used as evidence but could be open to interpretation on the extent to which the illicit substance was a factor?

oconcuc · 29-04-2010 5:19pm

k_mac wrote: »

Surely she wouldn't have to get the coroners report changed if it was just about insurance. Could she not still take a civil action against the insurance company for failing to pay? In that case the coroners report would be used as evidence but could be open to interpretation on the extent to which the illicit substance was a factor?

Civil action on what grounds?

The clause would be a condition of the agreement, if it does have that clause, though I suspect that Seamus's reference would be the norm in the industry.

To take a civil action the insurance company would have to be at fault.

It would be the coroner's fault, and she has failed in her challenge against them.

Because the coroner's evidence will be the only evidence on this issue, it would be taken as the primary burden of proof in favor of the insurance companies rejection of a claim.

The only thing she could and did do was challenge the evidence in the report. Since she has failed in that endeavour, she is tragically f**ked, it would appear.
:mad:

MagicSean · 29-04-2010 5:30pm

oconcuc wrote: »

Civil action on what grounds?

The clause would be a condition of the agreement, if it does have that clause, though I suspect that Seamus's reference would be the norm in the industry.

To take a civil action the insurance company would have to be at fault.

It would be the coroner's fault, and she has failed in her challenge against them.

Because the coroner's evidence will be the only evidence on this issue, it would be taken as the primary burden of proof in favor of the insurance companies rejection of a claim.

The only thing she could and did do was challenge the evidence in the report. Since she has failed in that endeavour, she is tragically f**ked, it would appear.
:mad:

Breach of contract? Depending on the actual wording of the clause of course.

oconcuc · 29-04-2010 5:43pm

k_mac wrote: »

Breach of contract? Depending on the actual wording of the clause of course.

The deceased is the one who is in breach. If the Contract for the Insurance had a clearly expressed condition that it would not pay out if the death was caused due to drug use, then they do not have to honour the agreement, as a condition on the other party has not been met.

It sucks, but these tend to be standard Ts & Cs of these agreements, and a court is never going to remove such terms due to unfairness, nor will they imply a term to conflict with the express wording.

seamus · 30-04-2010 9:23am

oconcuc wrote: »

It sucks, but these tend to be standard Ts & Cs of these agreements, and a court is never going to remove such terms due to unfairness, nor will they imply a term to conflict with the express wording.

With this particular clause, there would be massive ramifications if a court were to deem it unfair and void it, as I am sure there are a large number of families who've lost someone due to misadventure from drink or drug use and subsequently never got a payment from the insurance company.

If this clause were to suddenly become unfair, a lot of claims would have to be reopened and re-examined.

oconcuc · 30-04-2010 10:18am

seamus wrote: »

With this particular clause, there would be massive ramifications if a court were to deem it unfair and void it, as I am sure there are a large number of families who've lost someone due to misadventure from drink or drug use and subsequently never got a payment from the insurance company.

If this clause were to suddenly become unfair, a lot of claims would have to be reopened and re-examined.

The courts don't remove terms unless they are illegal. If they unfair, from an objective standard (I doubt they would deem that particular clause unfair given their track record on such issues), all that is required of the insurance company is that they draw adequate attention to it. So the more unreasonable the term, the greater the onus is on the party enforcing it to emphasise it before conclusion of agreement.

Unfortunately, insurance companies are used to being in court, and their policy documents are well drafted so as to avoid any possible legal implications.

To be fair to the Insurance companies, it is not unreasonable for them to exclude certain liability if a person is reckless with their own life.

But a more nuanced approach to the level of culpability the deceased might have in their own death would be more appropriate.

So here, even from the coroner's report, he is not laying much of the blame at the feet of the deceased and his actions.

But the get out clause for the insurance doesn't include any degrees of fault scale for a deceased. It is quite simplistic.

I don't see any court anywhere in Europe finding life insurance as a fundamental right that would be worthy of European Convention on Human Rights protection. But even if it were to succeed, the remedies available to similar parties would be minimal. The ECHR Court has no jurisdiction to compel anyone to do anything. All they say is if you are wrong or right...and maybe a few quid compo, but nothing like you could get in a domestic court settlement.

The best bet is a Supreme Court challenge here. They might find that such a simple approach on the part of the insurance companies is unethical and unconscionable...though this is unlikely. The only real way for this to work for her is if they strike down the coroner's findings as unreasonable.

And given the history on the matter...they would not do so.

Widow loses coroner cannabis challenge

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