Duncan John Hancott, aged 56, died in Mount Gambier Prison from urosepsis secondary to urinary tract infection caused by E. coli. He had significant comorbidities including hepatic cirrhosis, portal hypertension, and history of hepatocellular carcinoma. On 17 February 2019, he fell from a bunk and was found faecally incontinent. Prison nurse assessment at 11:45am noted he seemed well with only minor wounds. By 6:30pm he was critically unwell with respiratory distress, slurred speech, and shallow breathing. He died despite resuscitation attempts. The coroner found medical care was appropriate throughout imprisonment and no concerns arose from specialist management or SAPHS treatment. The clinical lesson involves recognising that seemingly stable patients with advanced liver disease can deteriorate rapidly from sepsis, and that faecal incontinence in this context may indicate serious underlying pathology warranting urgent investigation rather than reassurance.
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infectious diseaseshepatologypsychiatrycorrectional health
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