83 results for “general anaesthesia and intubation”
66y · Female·Hypoxic-ischaemic encephalopathy
A 66-year-old woman with COPD, obstructive sleep apnoea, and obesity underwent routine knee surgery at Royal Darwin Hospital. Post-operative care was inadequate. Despit…
8y · Male·acute exacerbation of chronic asthma
…ation. Initial assessment underestimated severity. Despite initial improvement with salbutamol, ipratropium and prednisolone, he deteriorated over 48 hours. On 2-3 July, nursing and medical staff misdiagnosed severe res…
56y · Male·Hypoxia and cardiac arrest with contributing conditions of Ischaemic Heart Disea…
A 56-year-old man with diabetes, ischaemic heart disease, morbid obesity, and an implanted defibrillator underwent minor toe debridement surgery. The anaesthetist failed to conduct an a…
0y · Female·Perinatal asphyxia
…different antenatal care including diabetes management, glucose monitoring, possible additional ultrasound, and continuous CTG monitoring during labour, likely changing labour management decisions. However, an expert ob…
76y · Female·Undetermined (natural causes)
HJ, a 76-year-old woman with chronic psychotic disorder and paranoid delusions, presented with abdominal pain, vomiting, and small bowel obstruction. Imaging revealed …
2y · Male·Hypoxic-ischaemic encephalopathy
…fe support, Baby M suffered irreversible hypoxic-ischaemic encephalopathy from prolonged oxygen deprivation and aspiration, and died on 29 November 2008. The clinical lesson is that unrecognised pregnancy can occur even…
29y · Male·Bronchopneumonia complicating neck injuries sustained in a fall, with Coffin-Low…
…n injury, delaying ambulance notification. The rare syndrome, characterized by profound developmental delay and muscle abnormalities, masked the severity of his condition. Ambulance paramedics, without first-hand inform…
36y · Female·Complications of pneumonia and pulmonary emphysema with bullae formation; respir…
A 36-year-old woman with congenital chest wall abnormality, scoliosis, and difficult intubation history presented to a rural hospital with community-acquired pneumonia and sepsis. Sh…
59y · Female·Asphyxial aspiration with upper airways obstruction by vomitus
…completed on 14 September 2021 by locum registrar Dr S. that designated her as 'not for resuscitation or intubation', implemented without Ms Prenc's informed consent (she had delirium), without family consultation, and c…
61y · Female·Diffuse alveolar damage in a woman with restrictive lung disease following catar…
A 61-year-old woman with severe restrictive lung disease, obesity, cardiac failure, and diabetes underwent cataract surgery at a private day surgery centre on 13 August 2018. She was unable to li…
16y · Male·transection of the liver and laceration of the inferior vena cava sustained in a…
A 16-year-old male died from transection of the liver and inferior vena cava laceration sustained in a quad bike accident. He was riding a single-rider ATV with a pi…
24y · Male·Hypoxic-ischaemic encephalopathy, due to or as a consequence of cardiac arrest, …
…aged 24, died on 5 September 2014 after contracting a leg infection (Chromobacterium violaceum) on Manus Island while in immigration detention. His death was preventable and resulted from multiple compounding errors: fa…
60y · Female·Peritonitis due to anastomotic leak following subtotal colectomy for treatment o…
…ultiple clinicians failed to recognize deterioration or escalate appropriately; ICU involvement was delayed and poorly communicated. Expert review criticized surgical technique (side-to-side vs end-to-end anastomosis), …
0y · Female·Cerebral hypoxia due to placental abruption
…an section. Gestational diabetes indicated planned induction at term. At 2050 hours, antepartum haemorrhage and pathological CTG changes occurred. Critical delay occurred in decision-making and theatre availability: the…
34y · Male·Air embolism and severe haemorrhage due to perforation of the right subclavian v…
…subclavian vein, causing massive haemorrhage. Despite aggressive resuscitation including blood products, intubation, and CPR, the patient deteriorated and an air embolism was eventually diagnosed post-mortem. The coroner…
66y · Female·Multi-organ failure associated with haemorrhage and sepsis following cholecystec…
…al clips applied to the cystic artery during surgery were inadequately secured using a multi-use applicator and subsequently displaced, causing significant bleeding. Critical clinical lessons: profound hypotension at 3.…
Female·Combination of liver failure, blood loss and shock following needle biopsy
…nfant, died from hemorrhage following a liver biopsy at Monash Medical Centre. She had persistent jaundice, and biopsy was undertaken to investigate potential biliary atresia. Post-operatively, nursing staff could not o…
54y · Male·aspiration pneumonia caused by multiple drug toxicity
…ted from a prescribing error where anaesthetist Dr K. inadvertently prescribed a 100mcg/hour Fentanyl patch and Fentanyl PCA intended for another patient (GS) to Paul's chart. This critical error was not detected by hos…
10y · Female·Head injuries due to fall from a bunk bed
Elise Neville, aged 10, fell from a non-compliant bunk bed and sustained a head injury. At her first ED presentation to Caloundra Hospital at 3:25am, Dr D.—a junior house…
4y · Male·Complications of T-cell lymphoma
Nghi Pham was a 4-year-old admitted to Sunshine Hospital with facial swelling, stridor, and upper respiratory symptoms. He was examined by emergency and ENT teams, diagnosed with adenoiditis and sinu…
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