113 results for “acute liver failure”
31y · Male·Hanging
…ion about preparations for death was not effectively communicated to treating teams. Complex assessment of acute suicide risk in chronic BPD presents ongoing clinical challenges.
48y · Male·Coronary atherosclerosis with acute cardiac event
…ironmental factors affecting patient safety—Mr Hobbs was required to walk 4 metres to an ambulance despite acute decompensation and severe exercise intolerance due to absence of a ramp. The coroner found medical care ap…
45y · Female·haemorrhage due to traumatic rupture of the liver
…med again hours later. That evening she left the flat; hours later she was struck by a train and died from liver rupture. The coroner found inadequate mental state assessment, failure to recognize suicide risk despite p…
59y · Male·ischaemic heart disease in the setting of chronic ethanol use
Robert Spencer, 59, called 000 at 4:27 am reporting weakness and inability to mobilise following a fall. He was triaged as Code 3 (non-urgent) and underwent secondary triage call-back attempts without success. An ambulan…
31y · Female·Ruptured splenic artery aneurysm with extensive retroperitoneal and intraperiton…
…re but recognised pregnancy complication. The coroner found her initial assessment was appropriate and no failure to diagnose represents medical deficiency, given the condition's extreme rarity. However, communication b…
Bearham: hypoxic brain injury from hanging; Fisher: asphyxiation from hanging by…
…s between January 2015 and November 2016: three by hanging and one by jumping. The coroner found systemic failures including inadequate ligature risk mitigation, poor observation procedures, failure to properly search f…
37y · Male·acute heart failure caused by multiple drug toxicity (methadone and alprazolam)
Richard Mark Kiel, a 37-year-old with chronic opioid addiction, died from acute heart failure caused by lethally high levels of methadone and alprazolam, likely consumed on 9 September 2…
72y · Female·Intrathecal toxicity of bupivacaine and morphine
…tending epidural administration but the line was intrathecal. These doses were excessive for intrathecal delivery. The patient collapsed within 35 minutes, with profound hypotension (56/32) and respiratory depression. S…
37y · Male·Sudden unexpected death in epilepsy (SUDEP) in the setting of acquired brain inj…
Kieran McGuinness, 37, died of sudden unexpected death in epilepsy (SUDEP) following acquired brain injury with post-traumatic epilepsy. He was found unresponsive on his apartment floor on 11 September 2022, having been …
15y · Male·Multiple organ failure associated with hyperthermia (heat stroke)
A 15-year-old rugby league player died from heat stroke during training on an extremely hot Perth summer evening (44.4°C). The coaching staff appropriately applied NRL heat guidelines in deciding to proceed with modified…
66y · Male·Complications of metastatic lung adenocarcinoma, with terminal palliative care, …
…ut identified issues: (1) delayed dental treatment despite identified need and multiple requests, and (2) failure to complete an External Movement Risk Assessment before emergency transfer, resulting in unnecessary rest…
41y · Female·intra-abdominal haemorrhage caused by a ruptured spleen due to blunt force traum…
… conducting any inquiries about her safety or assessing the boyfriend's fitness to care for her. Critical failures included: ignoring domestic violence protocols, failing to follow up on information from neighbours abou…
55y · Male·Head injury from a fall, contributed to by chronic alcoholism and cirrhosis, res…
John Henry Colbert, a 55-year-old man with chronic alcoholism, Wernicke's encephalitis and cirrhosis, was admitted to Royal Darwin Hospital's ICU following a seizure. He was transferred to Ward 4A on 14 October 2002 and …
50y · Male·Multi-organ failure caused by low flow ischaemia of coeliac artery and superior …
Adrian Van Die, a 50-year-old with severe ischaemic cardiomyopathy, underwent coronary artery bypass grafting with intra-aortic balloon pump (IABP) support. The first IABP ruptured intraoperatively and was replaced. The …
45y · Male·unascertained
…ed cause, earlier documentation and reassessment of monitoring protocols may have been warranted after the acute incident.
19y · Female·Meningococcal septicaemia
Emma McGrath, a 19-year-old nursing student, died from meningococcal septicaemia caused by the W strain after presenting to the ED with a 12-hour history of vomiting, diarrhoea, abdominal pain and fever. The atypical pre…
40y · Male·Acute hepatic and renal failure in the setting of postoperative haemorrhage foll…
A 40-year-old man with obesity, COPD, diabetes and hypertension died from acute hepatic and renal failure following postoperative haemorrhage after left radical nephrectomy for a 10cm re…
49y · Male·Unascertained - cardiac arrhythmia with terminal aspiration in an overweight man…
…ic patient at Bentley Mental Health Services. He presented to Royal Perth Hospital ED on 15 July 2020 with acute manic psychosis requiring sedation with ketamine and zuclopenthixol acetate (Acuphase). After transfer to …
77y · Male·Stroke; cardiogenic shock; severe aortic stenosis with three vessel coronary art…
…identified include: inadequate transfer of vascular disease severity and imaging from referring hospital; failure of the proceduralist to review available prior angiographic/ultrasound imaging; and importantly, a 9-hour…
11y · Male·complications of bowel obstruction in the setting of chronic constipation
… impaction, megacolon, and hypoganglionosis. Despite surgery and intensive care, he died from multi-organ failure and uncontrollable bleeding. Key preventable factors included: failure to refer to Wadja Aboriginal suppo…
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