231 results for “respiratory symptoms”
36y · Male·infective endocarditis
John Clive Anderson, a 36-year-old prisoner, died from infective endocarditis despite being evaluated 25 times by prison medical officer Dr P. between February and May 2009. Dr P. documented possible infective endocardit…
33y · Female·Hypoxic ischaemic encephalopathy complicating mixed drug toxicity
Jessica Higgins, a 33-year-old woman with chronic pain and opioid dependence, died from hypoxic ischaemic encephalopathy following mixed drug toxicity. She underwent a ketamine infusion with opioid rotation from oxycodon…
0y · Male·neonatal encephalopathy due to perinatal compromise
…SW Health guidelines. The commencement of morphine for comfort management was appropriately responsive to symptoms. The main learning opportunity identified was the potential value of specialised palliative care input an…
57y · Female·small bowel ischaemia; distal gastrectomy
57-year-old woman underwent distal gastrectomy and vagotomy for gastric outlet obstruction in August 2008. Coroner found she suffered an aberrant surgical reconstruction during the procedure, with abnormal bowel anatomy …
59y · Female·complications of abscesses following dental extraction, in a woman with cerebral…
…perative monitoring is essential after oral surgery in vulnerable populations; and prompt escalation of respiratory symptoms and new fever is critical. The inadequate record-keeping between 22 June and 5 July delayed re…
81y · Female·Aspiration pneumonia in an elderly lady
An 81-year-old woman with intellectual disability, phenylketonuria, and severe dysphagia died from aspiration pneumonia following repeated admissions for the same condition. She had been assessed as 'very high risk of as…
45y · Male·multi-drug toxicity from ingestion of methadone and amitriptyline
Terry Riordan, 45, died from multi-drug toxicity caused by ingesting amitriptyline and methadone in April 2015. He had complex medical and psychiatric comorbidities, substance abuse issues, and was under care of his GP D…
1y · Male·Complications of acute lymphoblastic leukaemia
…y recommending blood tests to exclude sepsis. The ED consultant diagnosed viral tonsillitis and ordered respiratory and urine tests, but not blood tests. Though the coroner acknowledged this was a finely balanced decisi…
45y · Male·focal coronary artery disease and cardiomegaly
…ertain medications. The coroner found medication selection was generally reasonable given his psychiatric symptoms, and some QT-prolonging drugs were appropriately avoided. However, the coroner identified one critical ga…
45y · Male·Natural causes - cardiac arrest, most likely secondary to severe tardive dyskine…
Mark Andrew Burnside, a 45-year-old man with intellectual disability and chronic mental illness, died of natural causes on 7 November 2001 at Royal Perth Hospital. He had been prescribed thioridazine (Mellaril) for appro…
44y · Male·Metastatic small cell neuroendocrine carcinoma of lung
… receiving compassionate parole. He had presented to PAH emergency department on 28 September 2010 with respiratory symptoms. A chest x-ray that day revealed a mediastinal density reported by radiology as possibly requi…
9y · Female·Streptococcus pneumoniae and Candida albicans pneumonia and empyema in a girl wi…
…ulcerative colitis on immunosuppressive therapy, presented to the emergency department with ear infection symptoms on 29 July 2022. She was triaged Category 4 and discharged with a diagnosis of otitis externa after a 40-…
31y · Male·Complications in association with intestinal volvulus
31-year-old Morgan Edwards with Smith-Magenis Syndrome, cerebral palsy and Crohn's disease was discharged from Fiona Stanley Hospital ED on 14 August 2018 without definitive diagnosis despite elevated respiration rate, u…
36y · Female·Global ischaemic injury following cardiorespiratory arrest in the immediate post…
Caroline Lovell, 36, died from postpartum haemorrhage following home birth of her second child. She had significant risk factors: prior PPH with first child and uterine fibroid, but these were not properly investigated b…
86y · Male·Acute Myocardial Ischaemia in an Elderly Man with Valvular and Ischaemic Heart D…
…emained undiagnosed in theatre despite intraoperative hypotension. Post-operatively, he developed acute respiratory distress attributed to bronchospasm and later aspiration, treated initially with bronchodilators and on…
37y · Male·Mixed Drug Toxicity (Oxycodone, Quetiapine, Pregabalin and Clonazepam)
… clonazepam) after ingesting unknown quantities of his own medications in an ED. He presented with trauma symptoms four days post-motor vehicle accident and was observed taking Targin (oxycodone/naloxone) at 9:50am. Desp…
0y · Female·acute necrotising pneumonia
…after 20 minutes wait without being seen. On her third presentation (5 October), despite clear signs of respiratory distress and a triage score of 3, she waited nearly two hours and was never formally assessed before he…
79y · Male·Urinary tract infection with E coli bacteraemia on a background of ischaemic hyp…
…gns (tachypnoea, tachycardia, low oxygen saturation, fever) and a history suggestive of sepsis (6-day UTI symptoms, rigors, confusion). The ED RMO assessed the patient as having a simple UTI and discharged him with oral …
76y · Male·Streptococcus pneumoniae sepsis in the setting of acute bronchopneumonia and ren…
Terence Michael Brooks, a 76-year-old man with dementia, vascular disease, and depression, died of streptococcal pneumoniae sepsis with acute bronchopneumonia and renal failure from obstructive uropathy at an aged care f…
50y · Female·septicaemia
…icaemia on 1 April 2011 at her home in Bundaberg. Over 4-5 days prior to death, she developed progressive symptoms including weakness, incontinence, diarrhoea/vomiting, shaking and cold extremities—consistent with system…
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