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Life-saving drug approved after heroin death

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Chris Spencer died in October 2012 after collapsing at home. The EMTs who attended the scene could not give Narcan, which can reverse heroin overdoses, because it could only be given intravenously after the approval of a doctor at King Edward VII Memorial Hospital (File photograph)

A life-saving drug used to reverse heroin overdoses can now be administered by all emergency medical technicians in Bermuda without a doctor’s approval after hospital chiefs acted on a coroner’s recommendation.

Bermuda Hospitals Board has changed its policy on the use of Narcan, or Naloxone, in “certain crisis situations” after an inquest into the death of 25-year-old Christopher Spencer this year.

Mr Spencer’s mother, Lynn, said yesterday she welcomed the decision and praised BHB, the coroner and her lawyer Saul Froomkin, who raised the question of why her son was not given Narcan at the inquest.

“I would like to say how important inquests are and how this is a huge example of what inquests can do,” Ms Spencer said. “I am so very grateful and believe lives will be saved because of these policy changes.

“There is nothing more than this that I could ever wish for, knowing that Chris’s death may save other lives.”

Mr Spencer, a former reporter at The Royal Gazette, was a heroin addict who died on October 27, 2012, after collapsing at the home he shared with his mother in Paget.

He was not given Narcan by the EMTs who attended the house after Ms Spencer called 911 — and Mr Froomkin questioned why at the inquest in February.

Senior coroner Juan Wolffe later ruled that the use of Narcan in Mr Spencer’s case “was unnecessary and ... in any event ... would have been ineffective”.

But he noted that the protocol for using the drug, according to evidence given by the two EMTs who attended the incident, meant it could only be given intravenously after approval from a doctor at King Edward VII Memorial Hospital.

He said “time was of the essence” in cases of suspected overdose and urged BHB to reconsider the protocol “so as to ensure that those suffering can receive help as soon as possible and immediately upon the arrival of the EMTs”.

Mr Wolffe said the board should consider whether the drug could be given by a nasal spray and whether EMTs could be trained to use it immediately without a doctor’s permission.

He made his recommendation “with the hope that we should continuously do all that we can to ensure that those afflicted with drug addiction can be saved”.

A BHB spokeswoman said the recommendation was taken on board and its processes regarding use of the drug were updated.

Emergency chief Edward Schultz added: “BHB has just approved a new Narcan policy that allows all EMTs employed by BHB and the Bermuda Fire and Rescue Service to administer intranasal Narcan.

“While it is preferred that there is an emergency department physician online to give direction, we have identified certain crisis situations where it can be administered without physician oversight.

“Training is planned for EMTs in the next few weeks.”

BHB told The Royal Gazette in October 2013 that the ten EMT-Intermediates (EMT-Is) on its full-time staff could administer Narcan.

The inquest heard evidence from EMT-Is Quincy Jones and Shirlene Furbert that Mr Spencer was without signs of life and had no pulse when they arrived at his home on October 27, 2012.

Mr Wolffe passed no criticism on the way they conducted themselves, adding: “I find that they did all that could have been done in the circumstances and that the use of Narcan would not have made a difference — it would not have saved the deceased.”

But the coroner said the two technicians, knowing that they were attending a potential overdose, should have “had or retrieved Narcan from the ambulance” in case it was needed for Mr Spencer, and could have asked a doctor for permission to use it “possibly even before they definitively established that the deceased had met his death”.

Mr Wolffe added: “There was no evidence at the inquest that the EMTs even canvassed the possible use of Narcan with the relevant doctor at KEMH.”

Ms Spencer said: “I am grateful for Dr Schultz’s decision to implement Narcan training and administration by all EMTs.

“Special thanks also go to the coroner for allowing the inquest to take place and putting these recommendations forward, and to Saul Froomkin for his invaluable help and belief that policies should be changed.”

Lynn Spencer, holding a photograph of her late son Chris, believes lives will be saved because of the policy change that means all EMTs can now give Narcan without a doctor’s approval (File photograph)