Coronial
VICmental health

Finding into death of Graziano Birgi

Deceased

Graziano Birgi

Demographics

86y, male

Date of death

2024-10-21

Finding date

2025-11-11

Cause of death

Oesophageal perforation

AI-generated summary

An 86-year-old man with treatment-resistant paranoid schizophrenia residing in a secure psychiatric unit died from oesophageal perforation. He experienced two unwitnessed falls on 20 October 2024 and declined post-fall medical assessment and observations. He had progressive frailty, poor oral intake, and recent palliative care discussions. Post-mortem imaging revealed oesophageal perforation with pleural effusion, likely secondary to underlying disease such as malignancy, chronic ulceration, or inflammation. The death was determined to be from natural causes. Clinical lessons include the importance of thorough post-fall assessment even when patients refuse evaluation, particularly in elderly frail individuals, and consideration of underlying pathology when patients present with declining oral intake and functional status.

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

Contributing factors

  • Progressive frailty over preceding 6 months
  • Poor oral intake of food and fluids in week prior to death
  • Two unwitnessed falls on 20 October 2024
  • Patient refusal of post-fall medical assessment and observations
  • Underlying oesophageal disease (likely malignancy, chronic ulceration or inflammation)
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