Girl refused transplant 'had signs of drug abuse'

A teenager who died from ecstasy-induced liver failure after being refused a transplant showed classic signs of adolescent drug abuse, a psychiatrist claimed in court yesterday.

But an inquiry into the death of Michelle Paul, 15, heard this "psychosocial" history was not the overriding reason for her being refused a new liver.

And doctors refused to bow to pressure from Michelle's family by listing her for transplant because it would have been a form of "appeasement".

Michelle, from Aberdeen, died in November 1995, 23 days after taking half a tablet of ecstasy at a rave near her home. She had been flown to the liver transplant unit at Edinburgh Royal Infirmary from Aberdeen Royal Infirmary. Her mother, Carolann, claimed a moral decision based on Michelle's background was taken by a surgeon at the unit, Dr Hilary Sanfey, to refuse a transplant. When she gave evidence, Dr Sanfey denied this, claiming the teenager had been too ill to undergo what was a very complicated operation. She had suffered irreversible brain damage.

George Masterton, 45, a consultant psychiatrist at the Edinburgh hospital, told the seventh day of the fatal accident inquiry at Aberdeen Sheriff Court that he had been asked to give advice on Michelle's background and any problems that might arise after a transplant.

Although he was unable to interview Michelle because she was unconscious, he said the problems she was having at school and at home were "classic signs of an adolescent drug abuser". However, he pointed out that her family background was very stable and described her mother's own history of drug abuse as a "red herring".

Dr James Garden, a surgeon at the liver transplant unit, told the inquiry: "The decision not to transplant was based on the medical factors."

The final witness to the inquiry, Professor Paul McMaster, director of the transplant unit at the Queen Elizabeth Hospital in Birmingham, said Michelle's case had raised major issues which would have to be discussed within the medical profession. He told the inquiry:"I see this fundamentally as a clinical, medical judgement rather than a moral one."