Multiple organ failure—cause not determined to requisite standard
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Robert John Ryan, a 35-year-old senior stockman, collapsed suddenly on 7 January 2015 at a farm gate near his workplace at Malahide in Tasmania, while driving his work utility during a normal workday. He presented with severe vomiting, profuse sweating, hypersalivation, and confusion. Despite aggressive medical treatment including atropine for suspected chemical poisoning, he developed multiorgan failure and died on 9 January 2015. Despite extensive investigation, inquest testimony from multiple expert toxicologists, pathologists, and treating clinicians over six years, no definitive cause could be determined. Hypotheses included organophosphate/carbamate poisoning, glyphosate or MCPA herbicide poisoning, doramectin toxicity, paroxetine-induced serotonin syndrome, and intentional self-poisoning. Toxicological testing failed to detect farm chemicals in blood samples; autopsy revealed multiorgan failure and oesophageal ulceration but no primary pathology. The coroner found the cause of death could not be determined to the requisite standard, though chemical poisoning remained considered possible by most experts.
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Specialties
toxicologyintensive caregeneral practiceemergency medicinepathologyoccupational and environmental health
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