Currie, Sheldon Douglas

18y · Male·Hypoglycaemic hypoxic-ischaemic encephalopathy, due to massive liver necrosis, due to Hepatitis B and C infection

An 18-year-old remand prisoner died from acute liver failure secondary to Hepatitis B and C infection. He presented with fever and malaise on 15 February but was assessed only for boils and not thoroughly evaluated. Clinical staff did not obtain collateral information from correctional officers about the severity or duration of symptoms. He was found in a hypoglycaemic coma the next morning and transferred to hospital where he died four days later from massive hepatic necrosis. Key clinical lessons: the diagnosis of acute viral hepatitis can present atypically and rapidly progress; confirmation bias (focusing on obvious diagnosis of boils) prevented broader assessment; communication gaps between custodial and medical staff compromised clinical information; earlier transfer to hospital for diagnostic evaluation was delayed, though unlikely to have altered outcome. Systemic failures included failure to order liver function tests when hepatitis diagnosed, lack of structured assessment protocols for antiviral treatment eligibility, and inadequate medical record-keeping.