Finding into death of Waisele Qalubau
Deceased
Waisele Qalubau
Demographics
39y, male
Date of death
2017-05-11
Finding date
2017-12-07
Cause of death
Complications of large bowel pseudo-obstruction
AI-generated summary
A 39-year-old man with schizo-affective illness, hepatic cirrhosis, and substance abuse history died from complications of large bowel pseudo-obstruction with aspiration pneumonia. He had been admitted involuntarily for acute psychosis and underwent manual rectal dis-impaction and enemas on 2 February 2017. He collapsed with faecal vomiting, aspiration, and bowel obstruction, requiring intubation and ICU care. Despite aggressive management including colonoscopy and laparotomy, he deteriorated from ischaemic bowel changes and multi-organ failure. The coroner found his medical care reasonable and appropriate. Clinical lessons include recognition that constipation can be a serious complication in patients on multiple antipsychotics, particularly those with cirrhosis; earlier recognition of bowel obstruction risk; and coordination between psychiatry and medical teams when managing patients with complex comorbidities requiring psychotropic medications with gastrointestinal side effects.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Clinical conditions
Contributing factors
- Severe faecal impaction in rectosigmoid colon
- Ischaemic changes throughout large bowel
- Aspiration pneumonia secondary to faecal vomiting
- Adult respiratory distress syndrome
- Acute renal failure and lactic acidosis
- Coagulopathy
- Possible intra-abdominal sepsis
- Multiple antipsychotic medications with constipation as side effect
- Hepatic cirrhosis and splenomegaly
- Neutropenia limiting clozapine use
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