Woman at drug rehab centre died of overdose

SINGAPORE - A female inmate who died at a drug rehabilitation centre had been prescribed 19 times the recommended amount of anti-depressants, an inquest heard yesterday.

Lian Huizuan, 27, was killed by a probable overdose after taking way above the therapeutic level of medication such as amitriptyline.

The mother of two was sent to Changi Women's Prison for abusing drugs in May 2010, the court heard.

There, she was treated by doctors, nurses and psychiatrists provided by Raffles Medical Group.

On March 2 last year, about a month before her detention order was due to end, she complained of aching legs during a drill session with other inmates in the yard.

She stumbled when marching and was later seen climbing at an unusually slow pace up the stairs to her cell. When she reached the third floor, she sat in a corner and leaned against the wall.

Staff tried to give her water, but she was unable to drink. A nurse could hardly detect her pulse. When they failed to revive her, she was taken to Changi General Hospital, where she was pronounced dead.

Associate Professor Teo Eng Swee, who carried out the autopsy, concluded that the high levels of amitriptyline in her blood could only have been caused by a slow increase over a long period of time.

He added that the overdose could have occurred for one of several reasons. The drugs could have been packed or supplied incorrectly, or given to her without authorisation.

She also could have hoarded the tablets. But the senior consultant forensic pathologist said that this was unlikely as she was in prison, where doses of medication were controlled.

He added that Lian did seem to have shown possible signs of an adverse reaction to amitriptyline because she fell frequently and suffered from urine retention.

The toxins in her body could also have been due to her history of narcotics abuse.

Lian had three theft convictions and had been sent to drug supervision and treatment centres six times before since 1998, the court heard. She also had a history of glue sniffing and abusing Subutex and Dormicum.

The former factory operator had been treated in the past for asthma, hepatitis C and depression. She had undergone three caesarean sections and had been on psychiatric drugs since 1997.

The court heard the overdose damaged her heart, which caused it to beat abnormally.

Lian's father, Mr Lian Hock Kwee, was at yesterday's inquest. The 59-year-old cabby is represented by lawyers Raphael Louis and Mathew Kurian.

The inquiry continues.

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