carbon monoxide poisoning due to inhalation of exhaust gases from a lawn mower
AI-generated summary
Paul William Green, a 66-year-old retired engineer with longstanding depression, anxiety, PTSD, and chronic alcohol abuse, died by intentional carbon monoxide poisoning from a lawn mower exhaust. He had a prior suicide attempt in 2016 and was taken into protective custody in April 2017 after expressing fear of incarceration related to breach-of-order charges. He was discharged with community mental health follow-up but received inadequate ongoing support. Key clinical lessons include: (1) older males with multiple psychiatric comorbidities, physical health issues, social isolation, and substance abuse require intensive, coordinated mental health intervention; (2) information sharing between police, mental health services, and primary care improves suicide risk assessment; (3) follow-up after protective custody admissions must be robust, not minimal; (4) fear of incarceration in vulnerable individuals warrants immediate escalation of mental health support.
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