After a four-year-old boy died, his blood and urine samples were found to contain traces of nitrazepam, a type of sleeping pill. This could have contributed to the death of Muhammad Irfan Salam, who was diagnosed with epilepsy when he was three months old, a police investigation officer (IO) told a coroner's inquiry yesterday.
Inspector Sabrina Wong said forensic pathologist Dr Marian Wang from the Health Sciences Authority (HSA) had certified the cause of death as infantile epilepsy.
Dr Wang's autopsy report said Irfan was taking two other drugs, carbamazepine and lorazepam, to control his seizures at the time.
Insp Wong said that if all three drugs were taken together without appropriate medical supervision, they could increase their common side effects of central nervous system depression, "causing excessive drowsiness and, in some instances, death".
The IO added that while Dr Wang felt that Irfan had died primarily of epilepsy-related complications, she could not "conclusively exclude the possibility of adverse mixed drug interaction brought on by the apparently unsupervised consumption of nitrazepam".
Irfan was found lying motionless in his home at around 7am on April 7.
Paramedics who went to the flat in Block 149, Lorong 1 Toa Payoh, pronounced him dead about 30 minutes later.
Irfan's father and sole care provider, Mr Salam Mohammed, 41, told the authorities that he had not given nitrazepam to his son. Insp Wong said that a foil packaging containing a powdery substance and a slab of tablets were seized from a kitchen dustbin in the flat. They were found to contain nitrazepam.
She told State Coroner Marvin Bay that the packaging looked as if someone had chewed on it.
Mr Bay asked it to be examined by the HSA for traces of saliva.
Mr Salam denied owning the powdery substance and tablets and said he had no idea why they were in the dustbin.
He was later arrested for drug-related offences. His urine was found to have traces of cannabis and nitrazepam.
Insp Wong said Irfan, who had been trained to walk around the flat by himself, used to help himself to food and drinks inside the refrigerator. He had a habit of biting and eating things that he could get his hands on and was able to reach the kitchen tabletop with ease. He would also throw things into the kitchen dustbin.
Irfan lived with his father as his parents were getting divorced.
"It is noteworthy that (Irfan) was left alone in the (flat) for approximately 1.5 hours in the evening of (April 6) and was again left unattended when his father fell asleep before him at around midnight," said Insp Wong.
The case has been adjourned on Nov 6.
This article was first published on October 17, 2014.
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