Coronial
WAprison

Inquest into the Death of Marshall Ruben EDGILL

Deceased

Marshall Ruben EDGILL

Demographics

38y, male

Coroner

Coroner Urquhart

Date of death

2017-05-07

Finding date

2021-09-06

Cause of death

combined effects of acute-on-chronic respiratory disease and cardiomegaly

AI-generated summary

Marshall Ruben Edgill, a 38-year-old Indigenous man, died in custody from acute-on-chronic respiratory disease and cardiomegaly. He had longstanding obstructive sleep apnoea (OSA), obesity, asthma, and hypertension. Critical missed opportunities included: failure to formally diagnose OSA despite multiple hospital admissions documenting suspected OSA since 2000; absence of prison medical officer assessment during his final two incarceration periods despite policy requiring assessment within 28 days; failure to offer pneumococcal vaccination despite being Indigenous with chronic lung disease; and inadequate documentation and follow-up of three separate presentations with cardiac symptoms (palpitations, chest tightness, missing heartbeat). While OSA was not directly diagnosed via sleep study, expert evidence indicates CPAP therapy may have prevented death by reducing cardiac failure risk. The coroner found the Department failed him on the issue of missing medical assessments but commended subsequent systemic improvements in OSA screening, cardiovascular risk assessment protocols, and immunisation procedures.

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

Specialties

respiratory medicinecardiologygeneral practicecorrectional healthemergency medicine

Error types

diagnosticdelaysystemcommunication

Clinical conditions

obstructive sleep apnoeaobesityhypertensionasthmacardiomegalypneumoniadyslipidaemiaproteinuriaacute pulmonary oedema

Procedures

cardiopulmonary resuscitationintubationdefibrillation

Contributing factors

  • undiagnosed obstructive sleep apnoea
  • obesity (BMI 42.3)
  • untreated hypertension
  • asthma
  • cardiac enlargement
  • pneumonia
  • failure to obtain formal sleep study despite multiple hospital admissions documenting OSA
  • missed cardiac symptom presentations without appropriate investigation
  • absence of prison medical officer assessment at final two periods of incarceration
  • lack of pneumococcal vaccination despite being Indigenous with chronic lung disease
Full text

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