Finding into death of Hoi-Sam Lau
Deceased
Hoi-Sam Lau
Demographics
49y, male
Date of death
2016-11-26
Finding date
2018-11-09
Cause of death
acute asthma leading to hypoxic brain injury
AI-generated summary
Hoi-Sam Lau, 49, died from acute asthma leading to hypoxic brain injury during the unprecedented Melbourne thunderstorm asthma event of 21 November 2016. He had well-controlled asthma triggered by pollen and respiratory infections, but presented with cough to his GP on the day of the event. Despite receiving prescriptions for preventer medication and oral prednisolone, there is no record he filled them. He collapsed at home around 6.30pm and suffered cardiorespiratory arrest before paramedics arrived 29 minutes later. He was resuscitated and admitted to ICU but suffered severe hypoxic brain injury, dying five days later. The coroner found delay in ambulance dispatch was not inordinate given the unprecedented 2,332 call surge during the event. Key clinical lessons include: patients with seasonal hay fever and asthma require optimised preventer therapy; objective lung function testing improves outcomes; asthma action plans are underutilised; and community awareness of thunderstorm asthma risk is essential.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Specialties
Error types
Clinical conditions
Contributing factors
- thunderstorm asthma event with massive pollen concentration
- sensitisation to rye grass pollen
- suboptimal preventer medication use
- hay fever with seasonal asthma exacerbations
- delayed ambulance response due to unprecedented surge in demand
- possible exposure to Alternaria mould spores
- absence of asthma action plan
- no recent lung function testing
- allergic asthma inadequately managed in primary care
Coroner's recommendations
- Further research into meteorological, biological and aerobiological factors contributing to thunderstorm asthma to improve prediction and forecasting
- Continued verification and development of the thunderstorm asthma forecasting system
- Continuation of public awareness campaigns about thunderstorm asthma, hay fever and preventative therapy
- Further medical, allied health and community education encouraging hay fever sufferers to undergo allergy testing and develop management plans
- When thunderstorm asthma warnings issued, public advised to remain indoors with windows shut and evaporative cooling turned off
- Ongoing review of the effectiveness of new ambulance call-taking scripts and consideration of providing callers with estimated ambulance arrival times
- Continued cooperation between ESTA, Ambulance Victoria, DHHS and Bureau of Meteorology on surge preparedness and response capabilities
Further listening
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