Robert Fennell, a 77-year-old man serving an 18-year prison sentence, died of complications from metastatic colorectal carcinoma in Long Bay Correctional Hospital's Medical Sub-Acute Unit on 27 October 2020. He had an extensive medical history including systemic lupus erythematosus, COPD, and cardiac failure. Following diagnosis of incurable advanced colorectal cancer with less than 12 months prognosis in December 2019, he declined chemotherapy and opted for palliative care. His death from natural causes occurred during end-of-life care following his informed decisions and advance care directive. The coroner found no evidence that any aspect of medical or custodial care contributed to his death. The key clinical lesson concerns ensuring proactive chaplaincy and psychosocial support engagement for frail patients in palliative care settings.
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Specialties
palliative careoncologyhaematologygeneral medicinecorrectional health
right hemicolectomypalliative radiotherapycolonoscopy
Contributing factors
advanced metastatic colorectal cancer
poor performance status
multiple serious comorbidities
frail elderly patient in end-of-life care
Coroner's recommendations
Initiate strong partnership between Justice Health palliative care team and Corrective Services NSW Chaplaincy services to provide holistic care to inmates receiving palliative care
Establish formal procedures and policies regarding proactive access to chaplaincy services for inmate patients in palliative care, rather than relying on self-referral
Ensure vulnerable and unwell palliative care patients in custody receive offered support services proactively
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