Coroner's Finding: Jablanovic, Branko

AI-generated summary

A 61-year-old man with diabetes, obesity, and high cholesterol presented to his GP with shortness of breath for 4-5 days and tachycardia (HR 120). The GP diagnosed anxiety instead of cardiac failure, failed to ask critical discriminating questions (e.g., orthopnoea), and prescribed propranolol despite cardiac failure being a valid differential diagnosis and contraindicated per MIMS guidelines. The patient deteriorated one hour after taking propranolol and died of congestive cardiac failure. The coroner found the GP should have: obtained adequate history including orthopnoea status; maintained cardiac failure as a differential diagnosis; referred to hospital rather than prescribing propranolol; and not prescribed beta-blockers without first excluding cardiac failure. The temporal relationship between propranolol administration and clinical collapse, plus documented bradycardia during resuscitation, supported the opinion that propranolol contributed to the death. Key lesson: avoid anchoring bias to prior diagnoses (anxiety), maintain appropriate differentials in high-risk patients, and do not prescribe contraindicated medications while awaiting investigations.

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