Coronial
QLDother

Rasmussen, Hayward

Deceased

Hayward Rasmussen

Demographics

45y, male

Coroner

Ryan

Date of death

2019-08-28

Finding date

2023-03-10

Cause of death

Intra-abdominal haemorrhage due to ruptured spleen due to splenomegaly due to cirrhosis due to Hepatitis C

AI-generated summary

Hayward Rasmussen, a 45-year-old man with cirrhosis and severe splenomegaly, died from intra-abdominal haemorrhage due to ruptured spleen while in custody. He collapsed in prison after sustaining possible rib injuries from boxing/exercise days earlier. The splenic rupture was either spontaneous or a secondary delayed rupture from minor/silent injury. Expert review found his acute medical care appropriate. Key clinical lessons: prisoners with cirrhosis and splenomegaly require regular monitoring; contact sports risk stratification should be discussed; clearer pathways for accessing specialist medical history in correctional settings are needed. System improvements implemented post-inquest include iMER access for prison health staff and planned education on contact sport risks in patients with liver disease.

AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.

Specialties

emergency medicinegastroenterologyhepatologyhaematologytrauma surgerycardiologycorrectional health

Error types

communicationsystem

Drugs involved

tramadolparacetamoltapentadolvenlafaxinequetiapinenaloxonefentanyl

Clinical conditions

cirrhosishepatitis Cportal hypertensionsplenomegalyoesophageal variceshypersplenismpancytopeniacardiomyopathyinfective endocarditispulmonary hypertensionsplenic ruptureintra-abdominal haemorrhagehypovolaemic shock

Contributing factors

  • severe splenomegaly from portal hypertension secondary to cirrhosis
  • cirrhosis from chronic Hepatitis C
  • cardiomyopathy
  • possible minor or silent splenic injury from contact sport (boxing) in days prior
  • lack of clearer pathway to transmit known serious medical history to Offender Health Services
  • lack of regular medical review of liver disease and associated complications
  • risk of contact sports in patients with splenomegaly not discussed with prisoner

Coroner's recommendations

  1. West Moreton Health to create an information sheet detailing risks associated with contact sports such as boxing for individuals with conditions including liver disease and splenomegaly, to be provided at reception screening and through BBV screening program
  2. Continue implementation of read-only access to ieMR for all prison health services staff, enabling access to discharge summaries and specialist appointment records
  3. Ensure recruitment and deployment of Nurse Practitioners specialising in blood-borne viruses including Hepatitis C and liver cirrhosis, with supporting Clinical Nurse roles for patient review, education and care application
  4. Implement regular medical review protocols for prisoners with cirrhosis and associated complications (at least every six months)
  5. Establish clearer pathways for transmission of known serious medical history from community specialists to Offender Health Services
Full text
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