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Coroner's Finding: SWINGLER Yvonne Mary

Deceased

Yvonne Mary Swingler

Demographics

86y, female

Date of death

2017-12-02

Finding date

2020-07-02

Cause of death

multi-organ failure due to sepsis

AI-generated summary

An 86-year-old woman with dementia, recent stroke, and multiple comorbidities was admitted with acute delirium and paranoia, subsequently placed on an Inpatient Treatment Order. She developed sepsis secondary to staphylococcal salivary gland infection, likely triggered by her refusal to eat or drink due to paranoid beliefs. Despite intravenous hydration, antibiotics, and attempted feeding tube placement, her condition deteriorated rapidly. Given her frailty, advanced age, and multiple comorbidities, a 'not for resuscitation' decision was made in consultation with her son. She died from multi-organ failure due to sepsis. The coroner found her care was appropriate and lawful, with no preventable issues identified. Clinical lesson: early recognition of delirium in elderly patients post-stroke, consideration of underlying medical causes (infection), and early nutritional support are important, though in this case her combative presentation and refusal made intervention challenging.

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

Specialties

psychiatryemergency medicineinfectious diseasesgeriatric medicine

Drugs involved

morphineantibiotics

Clinical conditions

sepsisstaphylococcal infectionsalivary gland infectiondeliriumdementiastrokehypertensionmulti-organ failure

Procedures

intravenous drip insertionCT scanfeeding tube placement

Contributing factors

  • refusal to eat and drink due to paranoid delusions
  • staphylococcal bacterial infection
  • salivary gland inflammation
  • delirium and acute confusion post-stroke
  • advanced age
  • multiple comorbidities including dementia and previous strokes
  • combative behaviour limiting treatment options
Full text

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