Deceased
Daniel LAHENGKING
Demographics
66y, male
Coroner
Coroner King
Date of death
2009-08-15
Finding date
2014-08-29
Cause of death
multiple organ failure associated with the combined effects of complications of methotrexate toxicity, vasculitis and atherosclerotic cardiovascular disease
AI-generated summary
Daniel Lahengking, a 66-year-old Indonesian visiting family in Esperance, was diagnosed with rheumatoid arthritis by locum GP Dr H. and prescribed methotrexate 5-10mg daily, a grossly excessive dose (normal: 7.5-20mg weekly). The pharmacist dispensed it without proper labelling after flagging concerns but failing to resolve them effectively. The patient developed severe toxicity with vomiting, diarrhoea and mouth ulcers. When he returned with symptoms, Dr H. misdiagnosed urinary tract infection and failed to investigate the methotrexate. He was later hospitalized with severe immunosuppression, triggering tuberculosis reactivation, gastrointestinal bleeding and sepsis. Although the immediate methotrexate toxicity resolved, subsequent complications including vasculitis and coronary artery disease led to his death. Clinical lessons include: always obtain baseline blood tests before methotrexate; consider medication toxicity in differential diagnosis; pharmacists must effectively escalate safety concerns about unusual prescriptions; and methotrexate carries serious toxicity risks requiring careful patient selection and monitoring.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.
Specialties
Error types
Drugs involved
Clinical conditions
Procedures
41y · Male·Ligature compression of the neck (hanging) and penetrating sharp force injury (s…
Corey Desmond Devree, aged 41, died by suicide in Bunbury Regional Prison on 14 October 2024 through ligature compression of the neck and a self-inflicted stab wound to the chest. Key clinical and systemic lessons includ…
1y · Male·Complications of acute lymphoblastic leukaemia
A 21-month-old boy died from sepsis secondary to pneumonia complicated by undiagnosed acute lymphoblastic leukaemia (ALL). He presented to ED on 22 March with a three-week history of intermittent fever, had seen three GP…
42y · Male·Ligature compression of the neck (hanging)
Brian Kealy, aged 42, died by hanging at Hakea Prison on 2 August 2024 while on remand. He had a complex psychiatric history including polysubstance use, personality disorders, and treatment-resistant psychotic symptoms.…
Source and disclaimer
This page reproduces or summarises information from publicly available findings published by Australian coroners' courts. Coronial is an independent educational resource and is not affiliated with, endorsed by, or acting on behalf of any coronial court or government body.
Content may be incomplete, reformatted, or summarised. Some material may have been redacted or restricted by court order or privacy requirements. Always refer to the original court publication for the authoritative record.
Copyright in original materials remains with the relevant government jurisdiction. AI-generated summaries and tagging are for educational purposes only, may contain inaccuracies, and must not be treated as legal documents. We welcome feedback for correction — report an inaccuracy here.