Inquest into the Death of Christine Pearl STRONER

AI-generated summary

Christine Pearl Stroner, 69, died of an unascertained cause on the evening of discharge following laparoscopic cholecystectomy and hiatus hernia repair at Fremantle Hospital. She was observed at 2pm with tachycardia (HR 111) and pain (10/10), given oxycodone, and reviewed by an unidentified doctor around 3pm with no recorded documentation. She was discharged to home at 4.10pm and died at 9.15pm the same day. While the coroner found the clinical decision to discharge was likely appropriate based on pain-related tachycardia responding to analgesia, significant concerns included the failure to document the pre-discharge doctor's assessment and inadequate investigations when tachycardia persisted. The coroner noted that while survival would have been marginally better if the patient remained hospitalised, this would have required continuous monitoring unlikely in standard ward settings. The care was ultimately found adequate, though documentation failures left the hospital open to suspicion.

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