Coroner's Finding: ABBOTT Raymond

70y · Male·chronic obstructive lung disease with emphysema on a background of advanced vascular dementia

Raymond Abbott, a 70-year-old man with chronic obstructive pulmonary disease, emphysema, vascular dementia, opioid addiction and alcohol abuse, died of COPD with emphysema at a residential care facility. He was admitted to hospital on 10 March 2015 with shortness of breath and chest pain, found to have a large left spontaneous pneumothorax requiring chest drain insertion. Despite drain placement, imaging on 23 March showed the pneumothorax had increased with persistent subcutaneous emphysema. His condition declined and he was returned to residential care on 25 March where palliative care was instituted. He received escalating doses of midazolam and endone before dying peacefully on 26 March. The case highlights management of pneumothorax complications in patients with severe underlying lung disease and appropriate transition to palliative care when recovery is unlikely.