The cause of death of a Birmingham woman who had beaten breast cancer and MRSA remained a mystery yesterday after a coroner failed to discover how she died.
Deborah Yardley, who had a mastectomy at Selly Oak Hospital in June 2003, died less than 48 hours after undergoing reconstructive surgery at the hospital last August.
The 45-year-old, who lived in Quinton with husband David and their 21-year-old daughter Clare, had had a bilateral breast reconstruction on August 5, 2005, when she stopped breathing towards the end of the sixhour operation.
Mrs Yardley never regained consciousness and her lifesupport machine was switched off at 12.35pm on August 7.
The inquest heard how anaesthetist Dr Martin King had given her 375mg of anaesthetic bupivicaine during the operation, the maximum dose is 400mg within 24 hours, as well as 8mg of adrenaline as he attempted to resuscitate her.
He had been assisted by Dr Bradley Lawther, a trainee anaesthetist who was on his first day at the hospital, taking part in his first plastic surgery operation.
Coroner Aidan Cotter heard from several expert witnesses how Mrs Yardley may have suffered an unforeseen adverse reaction to the drugs, a pulmonary embolism or blood clot, a cardiac arrhythmia, or a laryngeal spasm - an involuntary closure of the airway.
Dr Thomas Clutton-Brock, consultant anaesthetist at University Hospital Birmingham NHS Foundation Trust - which runs both hospitals - reviewed this case.
He said: "We are still faced with a situation where a reasonably fit young woman, after a prolonged surgery, who has subsequently died. That clearly is a disaster for everybody involved. I have no doubt at all it was an episode of laryngeal spasm and I've heard evidence from a number of witnesses who have said that was the cause."
Summing up, Mr Cotter said: "There's no certainty in this case on what caused Mrs Yardley to die. What we've discovered is what did not cause her to die. Once you go beyond that there's no known cause.
" The operation lasted approximately six hours but was entirely uneventful and no difficulties were encountered either before or during this surgery.
"After Mrs Yardley had been moved from the operating table to the bed, ready to be moved to the recovery area, she experienced a laryngeal spasm.
"The anaesthetic team took the action which they considered appropriate but sadly Mrs Yardley later suffered a cardio-respiratory arrest.
"She was resuscitated after a significant period of time but she did not regain consciousness and tragically she died on August 7, 2005."
He recorded a narrative verdict, stating the cause of Mrs Yardley's death was "not known and remains speculative."
The family's solicitor Julie Lewis, of Birmingham law firm Irwin Mitchell, said: "Whilst the family accept that, for legal or technical reasons, the coroner has recorded that the cause of death is unascertainable, we are encouraged by evidence that has emerged over the last two days as to its likely cause.
"A number of possible causes have been discounted on evidence which suggest that the cause of death was acute brain hypoxia due to an airway obstructed by laryngeal spasm." She added: "We're still pursuing a civil claim against the trust."
A trust spokeswoman said: "We would like to express our sincere condolences to Mrs Yardley's family. The trust does not wish to comment any further."