Inquest into the death of Janelle Pamkal
Deceased
Janelle Pamkal
Demographics
35y, female
Date of death
2021-07-03
Finding date
2023-03-15
Cause of death
aortic dissection with associated acute aortitis
AI-generated summary
A 35-year-old Aboriginal woman with schizoaffective disorder presenting with acute psychosis and chest pain was appropriately referred for psychiatric assessment and retrieval. CareFlight transport was timely and the receiving ED team initiated appropriate chest pain investigation including troponin, ECG, CTPA and D-dimer testing. However, she suffered a rare Type A aortic dissection with acute aortitis, an extremely uncommon diagnosis in young women without typical risk factors. The coroner found that despite appropriate sequential diagnostic reasoning, the dissection extended and caused cardiac arrest before diagnosis could be made. Even if diagnosed that evening, transfer to Adelaide for cardiothoracic surgery (unavailable in Darwin) would not have been achievable in time. The coroner determined the death was unavoidable despite best efforts by all treating teams.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Drugs involved
Clinical conditions
Contributing factors
- Type A aortic dissection - rare presentation in young woman without typical risk factors
- acute aortitis with suppurative inflammation
- pericardial effusion with clotted blood causing cardiac tamponade
- absence of on-site cardiothoracic surgery service at Royal Darwin Hospital
- disease progression outpaced diagnostic process
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