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SCMP Reporter

A 21-YEAR-OLD student who lost more than nine kilograms after taking anti-obesity drugs collapsed and died in class, the Coroner's Court heard yesterday.

  A jury sitting before Coroner Warner Banks returned a verdict of death by natural causes on Chan Yee-wai, a jewellery design student at Lee Wai Lee Technical Institute in Kowloon Tong.

   Her father and a lecturer said Chan had been well until her death during a class on September 25, 1991.

   Her father, Chan Wui-yuen, said after the hearing that he would have advised his only daughter not to take anti-obesity drugs if she had told him about them.

  The medical cause of death was a floppy mitral valve. The valve is between the left atrium and left ventricle of the heart.

  The court heard Chan weighed 73 kilograms when she first consulted Dr Mok Hing-yee at his clinic in Central on August 28, 1991, with a complaint of increasing appetite and being overweight.

  She was given drugs including Duromine (a trade name for an anti-obesity drug called Phentermine) and Vitamins B and C.

   Chan consulted Dr Mok on four other occasions and when she last visited him on September 24, 1991, she was 63 kilograms. She was given two other anti-obesity drugs, Fenfluramine and Diethylpropion, on that occasion.

   She had no history of heart disease.

   Questioned by coroner's officer Alan Lucas, Dr Mok said the drugs were commonly used for reducing a person's appetite.

   Mr Chan, who had 30 years of experience in the pharmacy business, queried whether his daughter's death might have been connected with the drugs.

   But forensic pathologist Dr Tso Chi-bun said there was no connection between the drugs and the development of the mitral valve which led to her death.

   Although he said anti-obesity drugs could stimulate heart activity, Dr Tso did not think the drugs had contributed to Chan's death.

   His view was supported by cardiologist Dr S. P. Wong.

  Dr Wong, chief of service of the Queen Elizabeth Hospital's Medical Department and a cardiologist, said the prolapse of the mitral valve was due to degeneration of tissue.

   Although the basic cause was not known, it was likely to be hereditary.

 He said a patient might develop a floppy mitral valve without displaying symptoms, adding Chan's heart condition must have been at least five years old.

   Asked whether the taking of obesity drugs could in any way contribute to the actual cause of death, Dr Wong said contribution of stress to the cause of death could not be excluded.

   ''Any kind of stress may precipitate or worsen the condition which the deceased suffered. But I don't think it had contributed to the immediate cause of death because of the absence of any drug detected in the post-mortem examination,'' he said.

 He said Chan stood the risk of sudden death in any event if untreated.

 Since she was not known to have heart disease, Dr Wong concluded that the prescription of weight-reducing drugs at the therapeutic dosage described was reasonable.

   But he said the use of such drugs should be avoided in subjects with cardiovascular diseases because of their side effects.

   Dr Wong said weight reduction was best conducted by a combination of exercise plus diet, and prescription of weight loss/appetite suppressant drugs was generally discouraged.

 ''A weight loss of up to two pounds each week is usually advised although more dramatic weight loss in grossly overweight subjects has been conducted safely and successfully under observation,'' he said.



Woman died after taking diet drugs