Finding into death of Hazel Angela Bampton
Deceased
Hazel Angela Bampton
Demographics
67y, female
Date of death
2011-12-28
Finding date
2015-07-20
Cause of death
Pulmonary thromboembolus secondary to deep vein thrombosis in the setting of convalescent phase left lower leg trauma
AI-generated summary
A 67-year-old woman with obesity (BMI 35.88), type 2 diabetes and hypercholesterolaemia fell from a ladder on 14 December 2011, sustaining a partial Achilles tendon rupture. She was immobilised in plaster and discharged home after physiotherapy and occupational assessment. She died suddenly on 28 December 2011 from a saddle pulmonary embolus secondary to deep vein thrombosis. The coroner found that while clinical management and discharge planning were reasonable, the case highlights an evidence gap regarding thromboprophylaxis for outpatients with obesity requiring limb immobilisation. Current NHMRC guidelines recommend low molecular weight heparin for hospitalised patients with cast immobilisation, but not for outpatients. Evidence suggests LMWH prevents deep vein thrombosis but not pulmonary embolism in this setting. The coroner recommended NHMRC commission guidelines for obese outpatients requiring immobilisation and suggested public education about VTE risk.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Error types
Contributing factors
- obesity (BMI 35.88)
- immobilisation of left leg in plaster cast
- age greater than 60 years
- pre-existing type 2 diabetes and hypercholesterolaemia
- prolonged sitting and resting post-discharge
- lack of thromboprophylaxis for outpatient with risk factors
Coroner's recommendations
- The National Health and Medical Research Council should consider commissioning a working group to collate and analyse evidence concerning thromboprophylaxis for outpatients who have a body mass index over 30, including those at increased risk of venous thrombo-embolism such as people with trauma requiring limb immobilisation, with a view to creating guidelines for hospitals and the health care system
- The Victorian Health Department should consider a public education campaign to raise awareness of the potential risk of venous thrombo-embolism and the importance of early mobilisation for people who have a body mass index over 30 and find themselves immobilised after discharge from hospital or for any other reason
Full text
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