The 2023 death of Ellen Mercer, a 24-year-old student from Gerrards Cross, Buckinghamshire, England, has highlighted the dangers of nitrous oxide abuse. Known as “laughing gas,” nitrous oxide is commonly misused for its euphoric effects but can have deadly consequences. Mercer’s death has prompted a coroner to issue a warning to the National Health Service (NHS) about the need for timely medical assessments in emergency departments.
Mercer had been inhaling two to three large bottles of nitrous oxide every day, leading to the development of a blood clot. She complained of back, and leg pain; she found herself unable to walk and would fall over if she tried. Her condition deteriorated rapidly with her not being able to walk and falling over if she tried. Despite being admitted to the emergency department, she did not receive a formal blood clot risk assessment during her 24-hour stay.
Heidi Connor, the senior coroner for Berkshire, conducted an inquest into Mercer’s death that concluded in April 2024. She expressed concern that current NHS policies only require blood clot risk assessments within 24 hours of admission to a ward, not considering long waits in emergency departments. Connor stated, “The policy needs to reflect the reality of long A&E waits, ensuring patients are assessed as soon as they arrive.”
The postmortem report found that the cause of death was bilateral pulmonary thromboembolism, deep vein thrombosis and “long-term complications of nitrous oxide use”.
Mercer’s friends remembered her as a “truly beautiful and gentle soul.” Her mother, Sharon Cook, shared a heartfelt warning after her daughter’s passing. “If there is one more life that could be saved from your report, then it is all worth it,” Cook told The Sun. She emphasized that Ellen was unaware of the dangers of nitrous oxide, believing it to be safe because it was legal.
Nitrous oxide often referred to as “hippy crack,” was recently classified as a Class C drug in the UK due to its associated risks. It can cause a range of health issues, including dizziness, nausea, disorientation, and severe nerve damage from vitamin B12 deficiency. In extreme cases, as with Mercer, it can lead to fatal blood clots.
Mercer’s death has drawn attention to the need for better public awareness of the dangers of nitrous oxide. Many young people misuse the gas without understanding the potential consequences. Dr. David Green, a toxicologist, noted, “There’s a misconception that because nitrous oxide is legal, it’s harmless. This couldn’t be further from the truth.”
Coroner Connor’s Prevention of Future Deaths report has been sent to the Frimley Health NHS Foundation Trust, the National Institute of Clinical Excellence, and NHS England. The report highlights the need for immediate changes in blood clot risk assessments. Connor urged that policies be updated to ensure evaluations are performed as soon as patients enter the emergency department.
Ellen Mercer’s story reminds us of the hidden dangers of seemingly harmless substances. Her mother’s plea and the coroner’s report aim to prevent similar tragedies by raising awareness and prompting changes in hospital protocols.