Coronial
SAhospital

Coroner's Finding: MOUSTAKOS Erini

Deceased

Erini Moustakos

Demographics

53y, female

Date of death

2001-09-17

Finding date

2003-03-14

Cause of death

infarction of the transverse colon due to mesenteric/retroperitoneal haemorrhage and incisional abdominal hernia in the setting of anticoagulation

AI-generated summary

A 53-year-old woman with schizophrenia died from transverse colon infarction secondary to mesenteric/retroperitoneal haemorrhage and incisional abdominal hernia during anticoagulation therapy. She was admitted to hospital with delirium; an organic cause (UTI) was found and treated. A pulmonary embolism was diagnosed and anticoagulation commenced. She developed abdominal pain and imaging suggested small bowel obstruction managed conservatively. Warfarin levels became dangerously high (6-8 September) leading to internal haemorrhage. The coroner found no diagnostic error: strangulated colon was not clinically evident, and emergency surgery in her confused, non-compliant state would likely have been fatal. Clinical team performance was commended. Key issues identified were communication gaps with family and missing medication records, though these did not affect the cause of death.

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Specialties

psychiatrygeneral medicinesurgeryemergency medicine

Drugs involved

warfarinzuclopenthixolrisperidone

Clinical conditions

schizophreniadeliriumpulmonary embolismmesenteric haemorrhageretroperitoneal haemorrhagesmall bowel obstructionincisional abdominal herniaurinary tract infectiontransverse colon infarctionanticoagulation-related complication

Contributing factors

  • over-anticoagulation with warfarin (6-8 September 2001)
  • dangerously high warfarin levels on 6 and 8 September
  • pre-existing large incisional abdominal hernia
  • pulmonary embolism (diagnosed 24 August 2001)
  • small bowel obstruction
  • patient confusion and non-compliance limiting clinical assessment
  • obesity complicating surgical assessment
Full text

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