Coroner's Finding: Brown, Sandra Anne

54y · Female·hypothermia, likely related to drug toxicity

Sandra Anne Brown, a 54-year-old woman with multiple chronic conditions including COPD, diabetes, bipolar disorder and epilepsy, died from hypothermia likely related to drug toxicity. She presented to the ED with breathing difficulties and COPD exacerbation but discharged herself against medical advice. She was found unresponsive at home two days later with a core temperature of 27.5°C. Autopsy revealed fluvoxamine at fatal range and amisulpride at toxic range. She had been socially isolated with inadequate community support despite declining functional capacity. Key clinical lessons: early recognition of medication toxicity risk in patients with polypharmacy and cognitive impairment; coordinated community care planning for vulnerable isolated patients; and appropriate escalation when patients with serious medical conditions self-discharge.