Andrew Wilson, a 44-year-old man with intellectual disability, epilepsy, asthma, and severe scoliosis, died from aspiration in a community residential unit. He had been prescribed a laxative and enema for constipation after having faecal loading identified. He subsequently vomited twice and developed shallow, rapid breathing leading to respiratory distress and death. Autopsy revealed widespread aspiration pneumonia and significant faecal loading. While this was a natural death in a vulnerable adult with multiple comorbidities, the case highlights the importance of careful monitoring following bowel interventions in patients with swallowing difficulties and spastic quadriplegia, and consideration of safer medication timing and positioning in such high-risk patients.
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