Coronial
VIChospital

Finding into death of Danielle Julie Kaye Thomson

Deceased

Danielle Julie Kaye Thomson

Demographics

41y, female

Date of death

2022-11-04

Finding date

2024-10-07

Cause of death

Neck compression and hanging

AI-generated summary

Danielle Thomson, a 41-year-old woman with complex medical and mental health conditions including cervical dystonia, bipolar disorder, borderline personality disorder, chronic pain, and alcohol use disorder, died by suicide on 4 November 2022. She presented to Ballarat Hospital ED with severe neck pain and anxiety about her condition while in a residential rehabilitation program at Windana. Triaged as Category 3 (semi-urgent), she waited in the ED but left before being seen, approximately 3 hours after arrival. She subsequently obtained an electrical cord and died by hanging. Expert review found care at the Geelong Clinic, Windana, and Ballarat Hospital to be generally reasonable. Key clinical lessons include: the high suicide risk in patients with concurrent chronic pain, mental illness, and substance abuse; the importance of integrated multidisciplinary care for this complex population; and recognition of the 'catch-22' that such patients often do not respond effectively to treatment until mental state is stabilised. The coroner identified no specific medical errors but highlighted systemic issues around integrated care coordination.

AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.

Contributing factors

  • chronic pain (cervical dystonia)
  • bipolar affective disorder
  • borderline personality disorder
  • depression and anxiety
  • alcohol use disorder
  • feelings of hopelessness regarding permanent nature of physical condition
  • prolonged wait in ED without being seen
  • ED access block
  • inadequate integrated care coordination across services
  • lack of family involvement in treatment planning

Coroner's recommendations

  1. The Suicide Prevention and Response Office of the Department of Health examine the relationship between chronic pain, mental illness, substance abuse and suicide to identify strategies to address the clinical dilemma facing clinicians treating people who experience chronic pain along with mental illness and substance abuse who often do not respond effectively to treatment of their chronic pain.
  2. The Suicide Prevention and Response Office liaise with the Commonwealth Department of Health and Aged Care regarding the National Strategic Action Plan for Pain Management to identify areas of mutual interest concerning the relationship between chronic pain, mental illness, substance abuse and suicide.
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