Deceased
Sebastian Nicholas Pelle
Demographics
20y, male
Coroner
Coroner Boss
Date of death
2016-07-26
Finding date
2019-08-22
Cause of death
sudden unexplained death in epilepsy (SUDEP); right frontal lobe epidermal cyst a significant contributing condition
AI-generated summary
A 20-year-old man with a history of seizures and a previously resected frontal lobe cyst presented to hospital with severe headaches. Despite his significant medical history of epilepsy and prior neurosurgery, he was discharged the same day without neuroimaging (CT/MRI scan), given only analgesia and paracetamol-codeine. He died of sudden unexplained death in epilepsy (SUDEP) the following morning. Expert review by a neurologist concluded that a non-contrast CT scan should have been performed, hospital admission was warranted based on his clinical features and history, and the failure to scan was outside accepted medical practice. While death could not have been predicted, hospitalization might have enabled prompt seizure management and resuscitation, potentially preventing a fatal outcome.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.
Specialties
Error types
Drugs involved
Clinical conditions
Procedures
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