A Salmon Arm woman is questioning why the B.C. Coroners Service did not investigate the potential links between the sudden death of her sister and the birth control pill she was prescribed.
When 36-year-old Rhonda Bergen died suddenly from blood clots in hospital this past December, the coroner refused to investigate, saying she had died from natural causes.
But the family decided to pay for their own autopsy to find out what really caused her death.
Critics say it's another example of the coroners service not doing its job.
Bergen was overweight and suffered from poly cystic ovarian syndrome, her sister Lorelei Holden told CBC News, and Bergen was particularly troubled with one of the side effects of the illness.
"She really struggled with extra hair growth. Because of the syndrome you have extra male hormones in your body," said Holden.
Prescribed birth control pills for condition
Six weeks before her death, Bergen's doctor put her on a prescription for Yasmin, a birth control pill to treat the condition.
After five weeks on Yasmin, Bergen suddenly developed breathing problems and went to a walk-in clinic where the doctor told her she was likely suffering from the flu.
"'We'll put you on amoxicillan and order a chest X-ray,'" Holden recalls her sister was told.
Four days later, Bergen's breathing had worsened and she checked in to the emergency room at the hospital in Salmon Arm.
But the emergency room doctor told her that her chest X-ray was clear and she was sent home once again.
Eight hours later she returned, this time in an ambulance. Doctors soon determined she had a life-threatening condition: huge blood clots had developed in her lungs.
"They did a CT scan and found pulmonary embolisms," said Holden. "She told me that she was scared and she asked me not to leave and I told her I wouldn't leave," said Holden.
But Bergen didn't last another hour. She died on Dec. 16.
Yasmin linked to increased risk
Both the US Food and Drug Administration and the Health Canada warn the hormone in Yasmin increases the risk of clots by as much as three times, when compared with older birth control pills.
Studies show that on average one in 10,000 women on older birth control pills will develop blood clots, but as many as three in 10,000 will develop clots on newer pills like Yasmin.
In Salmon Arm, Bergen's family had suspicions about the role Yasmin may have played in her death.
When the coroner ruled she had died of natural causes and refused to order an autopsy, they decided to pay for one themselves.
"We asked for an autopsy and the end result was our family paid for her autopsy," said Holden.
It cost $1,200 and the pathologist who did it listed Yasmin and Bergen's morbid obesity as risk factors for blood clots.
Natural causes not investigated
B.C. Coroners Service spokesperson Barb McLintock says the coroners service is doing fewer autopsies these days.
"Everybody in the provincial government is trying to find every dollar they can, so we are applying our autopsy policy more carefully than we have in the past," said McLintock.
Critics say a change in mandate that came in 2007 has also reduced the numbers.
But in the case of Bergen's death, McLintock maintains the service didn't have the authority to investigate.
"The coroner does not have jurisdiction over anyone who dies of natural disease process while under the care of a physician," said McLintock.
But former B.C. coroner Dr. Robert Crossland says that when a woman dies suddenly after starting a drug, that is the coroner's business.
"I think it's hiding underneath a rock to say this is natural, therefore we should not become involved," said Crossland.
"All they're saying is the cause of death is natural, but why they died, why that cause occurred, that's a good reason to investigate."
Only the Interior Health Authority is still investigating the death.
Bergen's family is getting legal advice to join many others in suing the makers of Yasmin.