391 results for “psychiatric medication management”
23y · Male·Hanging whilst suffering acute mental illness, most likely a first episode delus…
… clinical handover when the assessing nurse left (9 May) without ensuring documented follow-up; lack of psychiatric medication despite first-episode psychosis; and failure to notify him of parole refusal. The coroner fo…
64y · Male·bronchopneumonia in a man receiving palliative care for terminal cancer of the r…
…d care were exemplary. The deceased refused cancer diagnosis, believing his symptoms were caused by his psychiatric treatment and the devil. He deteriorated rapidly from bowel obstruction on 20 March 2012 and died two d…
21y · Female·Multiple blunt trauma with acute alcohol toxicity as a significant contributing …
…ble Curyer) was working while suffering significant mental illness and depression, taking antidepressant medication, which impaired his judgment; police General Order D7 regarding domestic violence response was not unifo…
59y · Male·Suicide by hanging while suffering from a mood disorder in the nature of deliriu…
…ist unsuccessfully, ultimately seeing a different specialist. The coroner found DBS, in combination with medication, likely contributed to the mood disorder that increased impulsivity and suicide risk. Better informed co…
30y · Male·pulmonary thromboembolism in an overweight man with comorbidities (including rec…
…mbolism on 12 March 2023 while under Mental Health Act care. After two weeks of increasingly challenging management at Kalgoorlie Health Campus for acute psychotic exacerbation, he was transferred by RFDS to Fiona Stanle…
32y · Male·self-inflicted hanging
…rt, no consular assistance, and severe depression with anxiety. Top End Health Service provided minimal psychiatric care with brief consultations (3-31 minutes), insufficient history-taking, conflicting assessments of h…
34y · Male·ischaemic heart disease secondary to coronary atherosclerosis as an antecedent c…
…rosclerosis. During his 5-year imprisonment, his weight increased from 86kg to 162kg despite attempts at management. He received psychiatric care only 3 times over 8 months despite complex mental health needs. Critical g…
26y · Female·morphine toxicity complicated terminally by bronchopneumonia
…of large quantities of narcotics clinically inappropriate given her obvious drug dependency and complex psychiatric overlay. Earlier referral to specialist services (neurology, psychiatry, pain management) was not pursu…
62y · Male·Multiple sharp force injuries intentionally inflicted by client during home visi…
…etween his GP and the mental health service. The coroner made 13 recommendations focusing on structured psychiatric review post-CTO, shared care planning, appropriate staffing and caseloads, formal Safety Huddle procedu…
56y · Male·Multiple injuries sustained in a motor vehicle incident (driver)
…ook his own life. Frawley had been treated for depression since 2014 by Dr H., a psychiatrist. He ceased medication without consultation in late 2018 despite advice, initially declining further appointments. In August 20…
89y · Female·Aspiration pneumonia complicating electroconvulsive therapy for treatment of psy…
…teriorated in hospital with refusal to eat or drink due to psychotic beliefs. After initial conservative management, compulsory ECT was approved and administered. She subsequently developed aspiration pneumonia and died.…
28y · Male·hanging
… (TEMHS) in December 2008 with concerns about aggression and suicide/homicide risk. Despite initial case management, he disengaged by mid-2009. When re-engaged in late 2009, assessment identified paranoid delusional thin…
58y · Male·Heroin toxicity
…e following morning. Clinical lessons include: coordinating care between multiple prescribers (GPs, pain management, mental health) to prevent polypharmacy and drug-seeking behaviours; recognising that patients with esta…
50y · Male·hepatic encephalopathy secondary to liver cirrhosis with background of hepatitis…
…disease, ascites, and hepatic encephalopathy causing confusion and delirium. Despite appropriate medical management including fluid drainage, PICC line insertion for medication delivery, antibiotic treatment for peritoni…
45y · Male·bronchopneumonia and combined drug toxicity
…se in community settings without integrated long-term residential facilities; (2) documentation gaps in psychiatric assessments after August 2018 with no recorded face-to-face reviews; (3) limited therapeutic options av…
35y · Male·Gunshot wound to the head (self-inflicted)
…ound during a police siege. He had a history of substance-induced psychosis from ice use, with multiple psychiatric admissions in 2015-2016. Following discharge, he declined mental health follow-up and community treatme…
18y · Male·Sodium nitrite toxicity
…er intentionally consuming 30 grams of the substance. He had been under care at his GP with psychotropic medication (Zoloft) and had received psychology referrals, but faced significant waitlist delays (6 months) for spe…
47y · Female·risperidone toxicity
…ith delusional disorder, died from risperidone toxicity after ingesting an overdose of her antipsychotic medication. She had self-escalated her risperidone dose from 3mg to 6mg daily without medical advice. On 16 October…
Unknown·Multiple: Olanzapine toxicity, pulmonary thromboembolism, asphyxiation on food, …
…rrickville, between June 2009 and August 2010. All residents had schizophrenia on multiple antipsychotic medications and severe, untreated physical comorbidities (cardiac disease, COPD, obesity). The coroner found preven…
Multiple - hanging (2), unknown/unascertainable (1), multiple injuries from fall…
Five patients of Alma Street Centre's psychiatric unit died within 12 months (2011-2012). Three died by suicide within 24 hours of discharge; one disappe…
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