An inquest is examining the death of 73-year-old Caroline Savage, who developed severe abdominal pain after increasing her prescribed Mounjaro dose. She died from faecal peritonitis caused by a perforated sigmoid diverticulum hours after being discharged from hospital.
An inquest is investigating the circumstances surrounding the death of Caroline Savage, a 73-year-old woman from Wortwell in Norfolk who became seriously ill after a reported increase in her Mounjaro dose.()
Savage had been privately prescribed Mounjaro, also known as tirzepatide, for approximately four months. She was using the medicine to lose weight and ease symptoms associated with lipedema and lymphoedema.
The hearing is considering whether the medication may have contributed to her symptoms and whether healthcare professionals sufficiently investigated other possible causes of her severe abdominal pain.
However, no causal link between Mounjaro and her death has been established, and the coroner has not yet delivered a final conclusion.
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Severe Abdominal Pain Developed After Dose Escalation
Savage visited a private weight-management clinic in July 2024, when she reportedly weighed 128 kilograms and had a body mass index of 46.
By October, her weight had fallen to 114 kilograms. She told her prescribing doctor that she felt well and had not experienced significant side effects. She was advised to finish the remaining 7.5-milligram doses in her existing pen before increasing to 10 milligrams.
The inquest heard that she developed acute and constant abdominal pain on the morning of October 18. Her husband called an ambulance at approximately 1.30 p.m. after finding her doubled over in pain.()
Mounjaro commonly causes gastrointestinal effects such as nausea, vomiting, diarrhea and constipation. The UK’s Medicines and Healthcare products Regulatory Agency says these reactions may be more likely when treatment begins or following a recent dose increase.
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Normal Test Results Hid a Developing Medical Emergency
Savage arrived at Norfolk and Norwich University Hospital at about 2.45 p.m. but initially remained in an ambulance because the emergency department was busy.
A clinician’s initial concern was
Another clinician performed a focused ultrasound examination to exclude an abdominal
Savage was discharged at approximately 6.30 p.m. with pain relief and medical advice. Shortly after midnight, her husband heard a thud and found her unresponsive on the floor. He attempted cardiopulmonary resuscitation, but she could not be saved.()
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Post-Mortem Uncovered the Hidden Cause of Her Abdominal Pain
A post-mortem examination determined that Savage died from faecal peritonitis caused by a perforated sigmoid diverticulum.
The National Institute of Diabetes and Digestive and Kidney Diseases identifies perforation, intestinal obstruction and peritonitis as possible complications of diverticular disease.
The post-mortem findings did not establish that Mounjaro caused the bowel perforation. A family representative emphasized that the examination “did not establish a link between this and Mounjaro use.”
Did Mounjaro Play a Role? The Evidence Remains Unclear
Tirzepatide acts on GIP and GLP-1 receptors, helping regulate blood glucose, reduce appetite and support weight loss. It also delays gastric emptying, while constipation is among its recognized gastrointestinal side effects.
The inquest discussed whether constipation might theoretically increase pressure within the bowel of someone who already had undiagnosed diverticular disease. However, the hearing was told that any possible contribution from Mounjaro could not be quantified.
Research has found that gastrointestinal adverse events are more common with tirzepatide than with placebo. These effects are generally dose-related and commonly include nausea, diarrhea, vomiting, reduced appetite and constipation. This evidence does not, by itself, prove that tirzepatide causes diverticular perforation.
The timing of an adverse event following medication use can raise a safety question, but timing alone does not establish causation. Other medical conditions, risk factors and clinical findings must also be considered.
Family Questions Whether Drug Side Effects Anchored Diagnosis
Savage’s family argued that clinicians may have attributed her abdominal pain too readily to recognized Mounjaro side effects instead of investigating alternative explanations.
Their barrister questioned why she was discharged without CT imaging, a surgical review or a confirmed diagnosis. Concerns were also raised about clinical documentation, communication between staff and whether morphine affected assessments of the severity of her pain.
The hospital trust maintained that Savage’s observations, blood results and ultrasound findings were within normal limits when she was examined. A consultant told the inquest that diverticular perforation can be extremely difficult to predict and that the clinicians acted appropriately based on the information available at the time.
The case therefore concerns not only a possible medication reaction but also whether the presence of a plausible drug-related explanation may have reduced attention to another developing abdominal emergency.
Severe Abdominal Pain Requires Urgent Attention
People taking Mounjaro should seek urgent medical care for severe or persistent abdominal pain, particularly when accompanied by vomiting, bloating, worsening constipation, fever or an inability to pass stool or gas.
Patients should not change or stop treatment without medical guidance and should inform their prescriber about existing digestive, pancreatic or gallbladder conditions.
Coroner’s Final Conclusion Remains Pending
The family asked the coroner to consider whether Article 2 of the European Convention on Human Rights should apply because of alleged systemic problems involving communication, record-keeping and clinical decision-making.
Norfolk and Norwich University Hospitals NHS Foundation Trust argued that the death resulted from natural causes and that the threshold for an Article 2 investigation had not been met. Its representative acknowledged that record-keeping could have been better but maintained that appropriate clinical pathways were followed.
Area coroner Yvonne Blake adjourned the proceedings to consider the legal arguments. A narrative conclusion explaining the circumstances surrounding Savage’s death is expected later.
Until that conclusion is delivered, it would be inaccurate to state that Mounjaro caused her death or that the hospital’s actions were found to be negligent.
References:
- A GRANDMOTHER tragically passed away after developing severe stomach pain following an increase in her Mounjaro dose, an inquest has heard.- (https:www.thesun.co.uk/health/39963323/gran-dies-after-ae-sent-her-home/)
- Definition & Facts for Diverticular Disease- (https://www.niddk.nih.gov/health-information/digestive-diseases/diverticulosis-diverticulitis/definition-facts)
Source-Medindia