Amanda Crowston, 22 years old, died from aspiration of gastric contents after a weekend of heavy alcohol and drug use (amphetamines, methylamphetamine, MDMA, cannabis). She vomited while alone in bed and choked. The coroner found that while timely intervention by the person present could have prevented death, there was no inevitability or predictability that she would vomit that night warranting hospitalisation. The coroner noted death could occur rapidly following aspiration and that recovery position may have helped if she had been supervised. No criminal or civil liability findings were made. Key clinical lesson: recognition of aspiration risk in patients with altered consciousness from substance use, importance of supervision and recovery positioning, and the rapid deterioration possible with gastric aspiration.
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