Finding into death of Colleen Elizabeth Fermanian

45y · Female·Blunt force trauma to the head

Colleen Fermanian, 45, died from blunt force trauma to the head sustained on 24-25 March 2017. She had a history of heavy alcohol use and advanced liver disease. The circumstances of her injury remain unclear—it could have resulted from a fall or assault. Clinical lessons include: the importance of thorough assessment of altered consciousness (she was found extremely intoxicated with head injury); recognition that patients with liver disease and alcohol use disorder are at high risk of falls and intracranial bleeding; and the need for careful documentation of mechanism of injury when patients present with unexplained trauma. No medical errors were identified, but her presentation highlighted the vulnerability of patients with chronic liver disease and alcohol dependence.