Coroner's Finding: Phillips, Helen Lynette

77y · Female·intracranial haemorrhage (subdural, intraventricular and brainstem)

A 77-year-old woman fell from a ladder on 12 December 2022, suffering loss of consciousness and rib fractures. No brain CT scan was performed at Mersey Community Hospital despite the mechanism of injury and unconsciousness suggesting head trauma risk. Eight days later, she suffered a STEMI and received thrombolysis based on standard protocols. However, she likely had a small intracranial haemorrhage from the initial fall. Thrombolysis is contraindicated with prior ICH. The clot-dissolving therapy caused expansion of the existing bleed, leading to fatal subdural, intraventricular, and brainstem haemorrhages. The critical clinical lesson: elderly patients with significant falls and loss of consciousness warrant brain imaging regardless of absent neurological signs, as ICH symptoms may be silent and imaging results would have prevented fatal thrombolysis.