Kathleen Smith, a 53-year-old podiatrist, disappeared on 15 July 2024 and is presumed to have drowned at Sorrento Back Beach. She was experiencing severe anxiety about upcoming foot surgery due to severe flatfoot deformity and osteoarthritis. Her GP recommended psychological counselling and prescribed sertraline and diazepam for anxiety management, but Smith declined initial antidepressant therapy. Critical clinical lessons include: recognising catastrophic thinking and functional limitations as suicide risk factors; ensuring anxious patients with medical conditions receive timely mental health intervention; following up on psychiatric referrals; and escalating concern when patients express suicidal ideation or make multiple visits to high-risk locations. Earlier psychiatric assessment and possible involuntary mental health intervention in mid-July 2024 might have prevented this death.
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Specialties
general practiceorthopaedic surgerypsychiatry
Error types
communicationdelay
Drugs involved
sertralinediazepam
Clinical conditions
severe osteoarthritis of the feetsevere flatfoot deformitylateral ligament instabilityperoneal tendon tearanxiety disorderdepressionsuicidal ideation
Contributing factors
Severe anxiety about upcoming foot surgery
Catastrophic thinking regarding post-operative mobility and functional limitations
Fear of foot amputation and loss of mobility
Declining mental health in weeks prior to disappearance
Suicidal ideation expressed to multiple acquaintances
Sport and fitness as primary source of identity and purpose
Functional limitations and inability to exercise due to foot condition
Unresolved psychological distress despite GP intervention
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