Finding into death of Stewart Neil Padgham

57y · Male·aspiration pneumonia in an intellectually disabled man

Stewart Padgham, a 57-year-old man with severe intellectual disability, epilepsy, and multiple comorbidities, died from aspiration pneumonia. He presented with vomiting, difficulty swallowing, and respiratory symptoms on 14 September 2014. After initial admission and multidisciplinary review including speech pathology and dietetics assessment, a palliative care approach was agreed upon with family and carers. He was discharged but re-presented 30 minutes later with respiratory distress and was re-admitted for comfort measures. The coroner found medical management at Austin Hospital and community care were reasonable and appropriate. The case highlights challenges in managing complex, non-compliant intellectually disabled patients with swallowing difficulties and the difficult decision-making around escalation versus comfort-focused care in this population.