Deceased
Silin Wang
Demographics
25y, female
Date of death
2021-01-31
Finding date
2023-05-23
Cause of death
multiple injuries
AI-generated summary
A 25-year-old woman with newly diagnosed metastatic gastro-oesophageal cancer and depression died by suicide on hospital grounds. She was admitted on 30 January 2021 after imaging showed cancer progression. Her sister disclosed suicidal ideation (interest in voluntary assisted dying, previous mention of jumping). Psychiatry referral was made but review was deferred to next morning. No documented suicide risk assessment occurred on the morning of death, and the patient was permitted unaccompanied access to a rooftop café with a scalable glass balustrade. Key preventive opportunity: failure to conduct mental health handover and suicide risk assessment before allowing unaccompanied ward leave, and inadequate environmental safety barriers on the rooftop garden accessible to at-risk patients.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Error types
Drugs involved
Clinical conditions
Procedures
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