Coroner's Finding: LA BELLA Claudia
Deceased
Claudia La Bella
Demographics
28y, female
Date of death
2014-06-29
Finding date
2018-05-23
Cause of death
aspiration of gastric contents complicating laxative abuse
AI-generated summary
A 28-year-old woman died from aspiration of gastric contents complicating severe laxative abuse. She fabricated a terminal cancer diagnosis to conceal anorexia nervosa and factitious disorder. During a RAH admission, a CT scan revealed dozens of tablets in her stomach, but staff accepted her explanation (pain medication). The diagnosis of eating disorder was not pursued despite severe weight loss, dehydration, and clinical suspicion. She discharged against medical advice and died days later. Key failures included: failure to obtain psychiatric liaison despite clinical suspicion; inadequate communication between hospital and GP about eating disorder concerns; lack of escalation when patient insisted on discharge; and pharmacy staff selling excessive laxative quantities without appropriate safeguards. Earlier psychiatric assessment, detention under Mental Health Act, and mandatory interdisciplinary communication could have prevented death.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Error types
Drugs involved
Clinical conditions
Procedures
Contributing factors
- failure to diagnose eating disorder despite clinical suspicion and severe weight loss
- failure to obtain psychiatric liaison consultation
- failure to detain patient under Mental Health Act when indicating wish to discharge
- inadequate communication between hospital team and general practitioner regarding eating disorder suspicion
- CT scan finding of tablets in stomach not investigated as potential laxative abuse
- patient's refusal to allow family communication not respected as red flag
- delayed discharge summary communication to GP
- pharmacy staff selling excessive quantities of laxatives without appropriate safeguards
- absence of formal written discharge instructions to GP regarding psychiatric concerns
Coroner's recommendations
- In hospital presentations or admissions involving cases of severe weight loss where there is any suspicion of an eating disorder, there must be a referral to the Psychiatric Liaison Service and that must be triggered as a matter of urgency if the patient wishes to self-discharge
- Where a patient is discharged from hospital against medical advice, but with an expectation that they will be treated by their general practitioner in the community, a personal discussion between a member of the treating team and the general practitioner is mandatory before the patient leaves the hospital
- Dulcolax and like medications be classed as pharmacist only medications, the safe use of which requires professional advice. They should not be available for self-selection from pharmacy shelves or online stores and purchases should only be made following consultation with the pharmacist
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