Her death was referred to the national coroner due to the fact she was taking the pill and had also recently received the Pfizer vaccine.
Coroner Janet Anderson found there “is no evidence available to me to suggest that the Pfizer vaccine had any role in her death”.
She did, however, say that Isabella’s death “is a reminder that widely used, and relatively safe, medications still have risks”.
Anderson went on to say in her report that even healthy young people, who appear to have no obvious risk factors, can be affected.
She said although nothing can be done to bring Isabella back, her tragic death highlights some important public health issues.
In her recommendations, Anderson suggested all prescribers of the combined oral contraceptive pill, and other hormone-related medications should ensure that they take a comprehensive clinical history and must inform patients about the risks of venous thromboembolism (VTE), the seriousness of the condition, and the symptoms to look out for.
The symptoms include leg pain or tenderness in the thigh or calf, leg swelling (oedema), skin that feels warm to the touch, and reddish discolouration and streaks.
Anderson also suggested patients be advised that when a DVT breaks free from a vein wall and blocks some of the blood supply to the lungs, this can cause a pulmonary embolism which can be fatal.
These symptoms include unexplained shortness of breath, rapid breathing, chest pain under the rib cage, fast heart rate and lightheadedness and passing out.
Isabella’s mother, Teresa Hura-O’Connor, told Newsroom her daughter initially obtained oral contraceptives from a friend, wanting to conceal this from her school.
After using the drug for a few months, Isabella experienced nausea and dizziness, even ending up in the hospital briefly. However, since she was trying to conceal her use of the pill, no medical professionals were aware of it and were proceeding as if she wasn’t taking it.
When her mother was finally aware, she told Newsroom that she was not allowed in the doctor’s appointment she sent her to because at that point she was already 16. Hura-O’Connor reminded her to discuss her hospital stay and health issues with the doctor, however, she could have forgotten to do so.
She caught the same cold as the rest of the family during a family vacation to Queenstown in April, and she also experienced coughing, nausea, and a sore leg, which she attributed to exercise.
Hura-O’Connor took Isabella to another city doctor when the cough persisted; this doctor found a mild heart murmur, which required Isabella to stay two nights in Auckland City Hospital for testing.
Hura-O’Connor researched the signs of a pill reaction three days before Isabella’s early-September collapse and took Isabella to her regular doctor’s office because she felt breathless, nauseated, and complained of sore legs. The doctor was aware that Hura-O’Connor was now using her own contraceptive pill, but he didn’t think Hura-O’Connor’s concerns about continuing to take the pill without menstruation were important.
Hura-O’Connor is now calling for easy online accessibility around medical histories for doctors in different settings with consent. She cited other nations with similarly sized populations as examples, such as Finland, where medical records are kept in a centralised register.
“I do not blame any doctor for what happened to Isabella. I would hate to have that responsibility for another person’s life resting on my decisions and they were all intelligent, caring members of our community,” Hura-Connor told Newsroom.
Hura-O’Connor also told Newsroom many of Isabella’s friends were shocked at newspaper reports saying she had died from an adverse reaction to a medication, as they didn’t consider the pill to be medication.
“They told me the range of reasons they take it - to avoid pregnancy, stop menstruation pain, clear up their skin or as a lifestyle drug to not menstruate because it is a nuisance,” she told Newsroom.
“Oral contraception has become so normalised in our daily life that the risks can almost feel non-existent.”
She said she wanted to see a poster on the wall of every GP practice warning of the possible symptoms of a blood clot for a start.
“Give the public the information they need to stay safe - it might just get the bell tinkling in a teenager’s head and keep them safe,” Hura-O’Connor said.
As for the genetic disorder Isabella was carrying, Factor V Leiden is carried by at least 5 per cent of the European population, which would amount to about 180,000 people in New Zealand. A blood test to determine whether a person has the disorder costs about $100.
Auckland District Health Board reported in 2019 that although a positive result on the test is common, there are only a limited number of scenarios in which it will change the way a person is treated.
The majority of these occur when a young person experiences spontaneous clotting or when a woman who has a history of venous thrombosis is pregnant or intends to become pregnant.
Hura-O’Connor told Newsroom she wants to see teenage girls funded for the Factor V Leiden test when they first are prescribed the pill, especially given an adult/guardian is not often present as was the case with her daughter.
“Asking a teenager for their family medical history is not good enough,” she said. “While researching this, I had to look up - what is a clot? So how is a teenage girl, with a good-looking boyfriend, going to know or even care about answering this question?” she told Newsroom.
“Imagine asking a 13-year-old girl this question, without a guardian present, and accepting the answer without referring to her medical history - this happens right now in New Zealand.”
