Coronial

77 results for small bowel obstruction

VIChome2014-03-17

Finding into death of Marcus Michael Christopher Charles

<1y · Male·Complications of small bowel obstruction due to post operative adhesions

Marcus Charles, a 3-month-old neonate, died from small bowel obstruction due to postoperative adhesions following earlier surgical repair of oesophageal atresia …

emergency medicineparamedicinediagnosticcommunicationranitidine
NSWhospital2020-06-12

Inquest into the death of Dat Nhieu HA

45y · Male·abdominal sepsis on a background of metastatic lung carcinoma

A 45-year-old man with advanced metastatic lung cancer died from abdominal sepsis secondary to bowel perforation while imprisoned. He presented with respiratory symptoms in January 2019, was diagnosed with t…

respiratory medicineoncology
VIChospital2020-05-25

Finding into death of Chris Perdios

42y · Male·Aspiration pneumonia in the setting of impacted large bowel in a man with intell…

…ability, autism, and chronic constipation, died from aspiration pneumonia complicated by an impacted large bowel. He was admitted to hospital on 12 October 2018 with acute pancreatitis and bowel obstruction, treated in …

intensive careemergency medicinecommunicationsystemquetiapine
NSW2026-08-07

Inquest into the death of Amanawel Ayai

23y · Male·complications of bowel obstruction by adhesions

… history; medical staff misdiagnosed the presentation as food poisoning or indigestion without considering bowel obstruction or exploring adequate differential diagnosis. On 8 January, when he collapsed, bowel obstructi…

correctional healthgeneral practicediagnosticcommunicationmetoclopramide
SAhospital2005-06-03

Coroner's Finding: SORENSEN Ruth Bengta Maria

69y · Female·faecal peritonitis due to small bowel obstruction and perforation due to periton…

…thout diagnosis. She deteriorated rapidly and died at home the next morning from faecal peritonitis due to small bowel obstruction and perforation from peritoneal adhesions. The coroner found the standard of care was se…

emergency medicinesurgerydiagnosticcommunicationprochlorperazine
QLDhospital2023-02-13

Hunter- Non-inquest findings

8y · Male·ischaemic bowel due to strangulated small bowel obstruction secondary to congeni…

An eight-year-old boy with autism spectrum disorder (level 1) died from ischaemic bowel due to strangulated small bowel obstruction from a rare congenital band adhesion. He presented to a region…

surgerypaediatricsdiagnosticcommunicationondansetron
QLDhospital2026-06-09

Inquest into the death of Rosemarie Campbell

62y · Female·Acute bacterial peritonitis and pneumonia

… findings and did not review her before discharge. Had she remained in hospital for proper assessment, the bowel obstruction would likely have been diagnosed and treated surgically, preventing death. The coroner identif…

bariatric surgeryanaesthesiadiagnosticproceduralesomeprazole
QLD2007-11-28

Tanner, Marjorie Joyce

Female·Coronary atherosclerosis with ischaemic small bowel and Alzheimer's disease

…h enema and laxatives, she was discharged then readmitted when symptoms persisted. At Hervey Bay Hospital, bowel obstruction was confirmed. Due to elevated lactate on arterial blood gas and lack of available ventilated …

general medicinesurgerydiagnosticsystemmetoclopramide
VIChospital2025-02-12

Finding into death of Alexander Cameron

40y · Male·Aspiration pneumonia

…ubation at Werribee Mercy Hospital. He presented with acute abdominal pain and vomiting, imaging suggested small bowel obstruction, and he became agitated during nasogastric tube insertion. Ketamine was administered for…

intensive caregeneral surgeryclozapine
QLDhospital2014-03-31

Platt, Christopher Robert Edmund - Non-inquest findings

69y · Male·Perforated bowel/septicaemia as a result of diverticulitis

…iagnosis of depression and constipation. He returned 2 days later critically unwell and died of perforated bowel and septicaemia secondary to diverticulitis. Critical failures included: missing early signs of serious in…

emergency medicinegeneral surgerydiagnosticcommunicationsodium citrate enema
NSW2023-10-04

Inquest into the death of Melville Schrader

76y · Male·small bowel obstruction in the setting of terminal metastatic neuro-endocrine tu…

A 76-year-old Aboriginal man died of small bowel obstruction from metastatic neuro-endocrine tumour after spending nearly two years requesting medica…

oncologygastroenterologydiagnosticsystempsyllium
NSWhospital2022-06-09

Inquest into the death of Steve FESUS

60y · Male·metastatic atrial sarcomatoid tumour

Steve Fesus, aged 60, died in custody at Prince of Wales Hospital from metastatic atrial sarcomatoid tumour. He had been diagnosed with cardiac cancer in 2016, underwent surgery, and was in remission until metastases wer…

oncologycardiologypazopanib
VIChospital2025-10-17

Finding into death of Raymond Charles Levy

75y · Male·Aspiration pneumonia in the setting of epilepsy and cerebral palsy

Raymond Charles Levy, a 75-year-old man with cerebral palsy and epilepsy living in supported disability accommodation, died from aspiration pneumonia. He presented to hospital with fatigue, fever and cough on 18 October …

general medicineemergency medicineceftriaxone
QLDhospital2015-08-28

Wright, Verris Dawn; Carter, Jasmyn Louise

Female·Verris Dawn Wright: septic shock due to small bowel ischaemia secondary to small…

…scalate when she deteriorated over four hours. No doctor reviewed her before she died of septic shock from bowel obstruction. Communication failures and an uncharged doctor's mobile phone prevented escalation. Jasmyn Ca…

emergency medicinegeneral practicediagnosticcommunication
NSW2018-10-26

Inquest into the death of Mahmoud Houri

27y · Male·multiple organ failure due to the consequences of multiple gunshot wounds to the…

…t 2008 when he presented with vomiting and abdominal pain, which led to emergency surgery revealing a rare small bowel volvulus requiring total bowel resection. Expert evidence established that this volvulus was excepti…

general surgerygastroenterologymetoclopramide
QLDhospital2016-07-08

Talbot, James Patrick

87y · Male·Strangulated small bowel due to adhesions from previous abdominal surgery

…n. Within 24 hours, nursing staff observed a distended abdomen and bile-stained vomiting—clinical signs of bowel obstruction. Despite these findings being documented and communicated verbally at handover, the informatio…

general medicinenephrologydiagnosticcommunicationondansetron
SAhospital2006-05-18

Coroner's Finding: PAHL-CADMAN Emma Rose

20y · Female·cardiac dysrhythmia/arrest in a 20 year old Down's Syndrome female following abd…

…isenmenger syndrome (cyanotic heart disease with ventricular septal defect) was admitted with abdominal obstruction. After appropriate diagnostic workup, laparotomy was performed for small bowel obstruction caused by a …

general surgeryanaesthesiadiagnosticcommunication
NThospital2018-09-21

Inquest into the death of David Fensom

67y · Male·multi-organ failure due to septic shock consequent on faecal peritonitis due to …

…d abdominal pain post-operatively. A laparoscopy on 8 October misinterpreted findings and missed ischaemic bowel—a critical diagnostic error. The expert review identified a 48-hour delay before appropriate laparotomy on…

general surgeryemergency medicinediagnosticcommunicationfentanyl
QLDaged care2025-04-17

Non-inquest findings into the death of Mr H.

89y · Male·combination of biochemical consequences of colonic pseudo-obstruction and faecal…

…rcoral colitis. He resided in a residential aged care facility (RACF) where staff failed to recognize that small bowel movements represented faecal overflow rather than normal bowel function. Despite bowel charts docume…

geriatric medicinegeneral practicediagnosticcommunicationmacrogol
VIChospital2023-05-30

Finding into death of Thelma Annie Ogilvy

90y · Female·abdominal sepsis complicating perforated diverticular abscess of the sigmoid col…

…al Victoria, died from abdominal sepsis complicating a perforated diverticular abscess. She presented with bowel obstruction requiring laparotomy on 21 October 2019, was discharged on 30 October appearing recovered, the…

general surgerycolorectal surgeryapixaban

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