Finding into death of Robert James Wright
Deceased
Robert James Wright
Demographics
63y, male
Date of death
2017-07-08
Finding date
2018-09-03
Cause of death
Bronchopneumonia in a man with cholangitis due to choledocholithiasis
AI-generated summary
Robert James Wright, a 63-year-old man with intellectual disability living in supported accommodation, died from bronchopneumonia complicated by cholangitis due to gallstone obstruction. He presented with weight loss and underwent CT imaging showing gallstones, followed by ERCP on 26 June. Despite initial apparent recovery, he deteriorated on 30 June with sepsis and was admitted to Box Hill Hospital. Conservative treatment with antibiotics was chosen over repeat ERCP. He developed multi-organ failure and died on 8 July. The clinical lesson concerns recognizing early signs of sepsis in vulnerable patients with limited communication ability, ensuring appropriate escalation of care, and considering whether repeat intervention (ERCP) should have been performed earlier when sepsis developed rather than relying solely on conservative management.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Error types
Drugs involved
Clinical conditions
Procedures
Contributing factors
- Gallstone obstruction of bile duct
- Sepsis following ERCP
- Multi-organ failure
- Vulnerable patient with intellectual disability and limited communication ability
- Difficulty in early recognition of deterioration
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