On 25 July 2020, 19 year old Cambridge University Student Alana Cutland, struggled against a fellow passenger holding her back, and eventually managed to open the door of the small aircraft she was flying in over swamp and jungle in Madagascar. Delirious, she stepped out into mid air and plunged over 1km to her death.
Coroner Tom Osborne found that the psychotic episode was a side effect of the anti malarial drug Alana was taking, Doxycycline.
Doxyclycline has been administered for over 50 years as an anti malarial drug and is also used to treat skin infections. There appears to have been no warning of the possible side effects to the drug suffered by Alana.
Alana's parents Neil and Alison Cutland said it was "tragic" that Alana's death was "essentially caused by the side effects of doxycycline".
"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," they said in a statement, reported by the BBC.
Local police chief Sinola Nomenjahary said: “The Cessna C168 aircraft was taking off from Anjajavy with three people aboard, including Johnson, Alana and the pilot. 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 metres above sea level.”
Pilot Mahefa Tahina Rantoanina, 33, told how Alana stayed eerily silent as he fought to stop her jumping but eventually "had to let her go". He told The Sun: “I had just taken off and I was still climbing when all of a sudden there was a rush of wind and Ruth started screaming. “I turned round and saw Alana hanging out of my plane. “I immediately levelled the aircraft to try and keep us on course, then I reached over and held the door. “I was trying to pull it shut while Ruth was holding on to Alana’s leg. “The plane stayed level, there was no rocking but it was very noisy from the wind. “I was trying to fly and stop her from falling at the same time. I was absolutely terrified, we all were.
Alana had taken anti malarial drugs previously without suffering side effects.
In a statement released through the Foreign Office, her family paid tribute to Cutland, saying she “grasped every opportunity that was offered to her with enthusiasm and a sense of adventure”. It added: “We are heartbroken at the loss of our wonderful, beautiful daughter, who lit up every room she walk into, and made people smile just by being there.”
The BBC reports Alana's parents are now raising funds for two causes "in memory of our beloved Alana".
They said on the fundraising page: "We want to directly help the villagers of Anjajavy and the surrounding area. This is an extremely poor region, and for the villagers to leave their farms and spend 10 days searching for Alana was extraordinarily generous. They are hoping to be able to pay for a new classroom at the local school which would mean children do not need to have lessons outside. "
In addition, a bursary will be established "at Alana's university home, Robinson College Cambridge - this will be specifically for the benefit of female students, something that we know Alana would have thoroughly approved of", they wrote on the fundraising page.
The Coroner's report into preventable deaths, sent to Medicines and Healthcare Products Regulatory Agency states:
"The deceased was prescribed doxycycline as an antimalarial medication for used whilst in Madagascar. 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. If she or her parents have been aware of this possible side-effect they may have been able to intervene earlier to avoid her death. In my view the information sent out with the drug should be reviewed."
The coroner's report concluded:
"In my opinion action should be taken to prevent future deaths and I believe you (and/or your organisation) have the power to take such action." The MHPRA is investigating the matter.