A Cambridge University student who fell from a plane in Madagascar had suffered a “psychotic event” after taking antimalarial drugs, a coroner has said.
Alana Cutland, 19, died after she broke open the door of a light aircraft and jumped from a height of around 3,700ft.
Following an inquest into her death, Alana’s family said they were shocked to hear that the side effects of doxycycline – an antimalarial drug – were “virtually undocumented”.
A senior coroner has ordered an investigation into the drug after he found that Alana – a second-year natural sciences student – had suffered a “psychotic/delirium event” after taking doxycycline, which led to her death.
Alana was taking the antimalarial medication while staying in a remote lodge in Ananlalava, Madagascar, where she was doing a conservation project studying crabs in July 2019.
However, the Robinson College student suffered a number of “paranoia attacks” while on the trip, which was meant to last six weeks but she decided to cut short just eight days in.
Tom Osbourne, senior coroner for Milton Keynes, has told the government’s medicine regulator there was a direct link between doxycycline and Alana’s death.
“It was quite apparent from the evidence that she had a psychotic reaction as a result of taking the drug and yet there is nothing on the drug information leaflet that either highlights or mentions this possibility,” he says in a letter to the Medicines and Healthcare Products Regulatory Agency.
He adds that Alana’s death could have been avoided if she or her parents had been aware of the possible side effects of doxycycline.
Alana’s family described her as a “a bright, independent young woman, who was loved and admired by all those that knew her”.
“She was always so kind and supportive to her family and friends, which resulted in her having a very special connection with a wide network of people from all walks of her life, who we know will miss her dearly.
“Alana grasped every opportunity that was offered to her with enthusiasm and a sense of adventure, always seeking to extend her knowledge and experience in the best ways possible,” they said.
Cédric Martin, the general manager of the luxury Anjajavy Le Lodge hotel, which runs the conservation project Alana was working on, claimed she was “excited” when she arrived at the resort on July 16.
But within days her health worsened.
Hours before the flight, Mr Martin said Alana had been found “sitting on a chair and staring into space”.
He added: “Her eyes were vacant and she did not seem to have slept. She did not speak, but she was watching us. We found the tablet of sleeping pills not used on the table.”
The student from Milton Keynes had told Mr Martin she feared she would be put in prison if she didn’t complete her research.
Mr Martin said Alana had refused to eat an evening meal the night before, but did sit down in a restaurant to eat a fruit salad before the flight.
On July 25, 2019, she boarded a Cessna C168 aircraft from Anjajavy to Antananarivo with two others onboard – fellow volunteer Ruth Johnson and the pilot.
Local police chief Sinola Nomenjahary told the Sun: “After 10 minutes of flight, Alana undid her seatbelt and unlocked the right door of the plane and tried to get out.
“Ms Johnson fought for five minutes trying to hold her, but when she was exhausted and out of breath she let go.
“Alana then intentionally fell from an aircraft at 1,130 meters above sea level.”
Alana’s parents Neil and Alison Cutland told the BBC in a statement it was “tragic” that Alana’s death was “essentially caused by the side effects of doxycycline”.
They added: “We realise that such drugs have an important role to play, but it shocked us to discover that such a severe side effect could be virtually undocumented.”
The UK medicines regulator told the BBC a review of the suspected association between the drug and psychotic reactions was ongoing.