Coroner's Finding: Biermann, Hans
Deceased
Hans Biermann
Demographics
92y, male
Date of death
2023-03-01
Finding date
2026-08-21
Cause of death
respiratory failure secondary to bilateral pleural effusions on a background of rib fractures and Alzheimer's dementia
AI-generated summary
Hans Biermann, aged 92, died on 1 March 2023 following respiratory failure secondary to bilateral pleural effusions and rib fractures sustained in a fall at Regis Playford aged care facility on 23 February 2023. Mr Biermann had Alzheimer's dementia and was subject to guardianship detention with a documented history of being a very high falls risk. The coroner found the facility made appropriate efforts to manage his falls risk, including physiotherapy assessment, provision of a walker, and ordering sensor mats within 48 hours of admission. The fall was unwitnessed as staff attended to another resident. Following the fall, he was transferred to hospital, deteriorated, and discharged for end-of-life care on 27 February 2023. The coroner found care provided at Lyell McEwin Hospital and Regis Playford entirely appropriate and made no recommendations.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Contributing factors
- Fall at aged care facility
- Bilateral rib fractures
- Bilateral pleural effusions
- Pneumothorax
- Alzheimer's dementia with cognitive impairment and lack of insight into own safety
- Not using four-wheeled walker at time of fall
- Pre-existing chronic pleural effusions
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