Deceased
Alice Louise McTye
Demographics
34y, female
Date of death
1998-09-24
Finding date
2000-04-14
Cause of death
hypoxic brain damage complicating fresh water drowning
AI-generated summary
Alice Louise McTye, a 34-year-old woman with severe intellectual disability and epilepsy, died from hypoxic brain damage following fresh water drowning in a bath at a disability services residence. The coroner found she likely suffered a seizure while bathing unattended, despite therapeutic levels of anti-convulsant medication. Key clinical lessons include: (1) people with epilepsy bathing represents a high-risk situation requiring continuous observation (not more than 1 minute unattended); (2) medication omissions due to unclear shift handover protocols created gaps in seizure prophylaxis on preceding days; (3) absence of casenotes at handover prevented staff from knowing critical safety information; (4) seizures in epilepsy can occur without warning or audible signs, even when medication is therapeutic. Preventable deaths can be avoided through strict policies requiring continuous supervision during bathing, clear medication administration protocols at shift changes, and ensuring relevant clinical information is communicated at all handovers.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.
Specialties
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