Patricia Iliev, a 57-year-old woman, died from starvation after progressively restricting her food intake over months while immobilised by chronic back pain. She had a gastrointestinal stromal tumour and advanced lung disease from smoking. Her partner, Philip Adams, provided food and care as requested but did not intervene when she stopped eating entirely in her final week, despite her becoming unresponsive and incapacitated. The coroner found Adams' account of events unreliable and questioned whether Iliev retained decision-making capacity in her final days. Key clinical lessons: untreated chronic pain and mental health conditions can lead to fatal outcomes; patients with capacity must have documented advance directives; early medical intervention for treatable conditions could have prevented death; and caregivers have obligations to seek help when patients become unable to communicate or self-care.
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Specialties
general practicepsychiatrygeriatric medicinepathologyemergency medicine
Error types
systemdelay
Drugs involved
aspirin
Clinical conditions
starvationchronic back paingastrointestinal stromal tumouremphysemarespiratory bronchiolitispressure soresmalnutritionstarvation ketosishippocampal scarring
Contributing factors
chronic untreated back pain
gastrointestinal stromal tumour of stomach (stage 1A)
advanced lung disease caused by smoking (centriacinar emphysema and active respiratory bronchiolitis)
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