Coroner's Finding: KILTIE Andrew
Deceased
Andrew Kiltie
Demographics
52y, male
Date of death
2007-12-26
Finding date
2011-05-12
Cause of death
clozapine toxicity
AI-generated summary
Andrew Kiltie, 52-year-old Aboriginal man, died from clozapine toxicity on 26 December 2007. He had been on clozapine 400mg daily for 5 years with significant clinical benefit for aggressive behaviour and psychosis, enabling community living. At autopsy, liver clozapine concentration (45mg/kg) was in the lethal range. Post-mortem findings showed cardiac failure with coronary artery disease, pulmonary oedema, and liver congestion. Evidence suggests heart failure caused hepatic impairment, reducing clozapine clearance. The coroner found clozapine administration was justified given substantial quality-of-life benefits and complex underlying cardiac/metabolic pathology. No medication overdose occurred. A carer slept during night shift but this was unlikely causative. The coroner made no recommendations and was not critical of care provided during the 5-year residence.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Drugs involved
Clinical conditions
Contributing factors
- cardiac failure with hepatic impairment impairing clozapine clearance
- hypertensive and ischaemic heart disease
- cardiomyopathy
- coronary artery atherosclerotic disease
- long-term clozapine therapy
- history of alcohol abuse
- history of petrol sniffing with lead toxicity
- type 2 diabetes
- chronic obstructive pulmonary disease
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