Coronial
SAhospital

Coroner's Finding: MITTA Wilhelmina

Deceased

Wilhelmina Mitta

Demographics

88y, female

Date of death

2001-07-02

Finding date

2002-05-17

Cause of death

sepsis of unknown origin

AI-generated summary

An 88-year-old woman with multi-infarct dementia and behavioural disturbance was detained under the Mental Health Act following assault of her GP. She presented with abdominal symptoms and deteriorating vital signs, transferred to hospital with sepsis of unknown origin (possibly perforated bowel, diverticulitis, colitis, or ischaemic bowel). Clinical lesson: early recognition of physical illness in elderly patients with dementia and behavioural problems is challenging but critical. The patient had complained of abdominal symptoms for months at the aged care facility. Difficulty examining agitated patients should trigger alternative diagnostic approaches (imaging, blood work despite non-cooperation). Family preference for comfort care was documented. The coroner found care appropriate and made no recommendations.

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

Specialties

geriatric medicinepsychiatrygeneral practiceemergency medicine

Error types

diagnostic

Drugs involved

anti-psychotic medicationblood pressure medication

Clinical conditions

multi-infarct dementiasepsisseptic shockurinary tract infectionpossible perforated boweldiverticulitiscolitisischaemic bowelgastroenteritisneutrophilia

Contributing factors

  • multi-infarct dementia with behavioural disturbance obscuring physical examination
  • chronic abdominal symptoms not fully investigated prior to acute deterioration
  • difficult patient cooperation preventing thorough initial assessment
  • faecal incontinence with contamination potentially leading to urinary tract infection
  • rapid deterioration of vital signs (pulse and blood pressure drop)
  • advanced age and debilitation
Full text

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