Coroner's Finding: Free, Maxwell John

64y · Male·Multiple organ failure due to paracetamol toxicity

A 64-year-old man died from multiple organ failure due to chronic paracetamol toxicity after taking regular paracetamol 500mg four times daily for over 12 years for pain management. He presented with nonspecific symptoms (lethargy, falls, acute deterioration) that were misattributed to his known dementia and psychogenic polydipsia. By presentation to hospital on day of death, he had irreversible severe renal and hepatic failure. Chronic paracetamol toxicity is notoriously difficult to diagnose due to insidious, nonspecific symptoms. Risk factors for chronic toxicity—advanced age, dehydration, nutritional status, and concurrent medications—were present but not recognized. Clinicians should consider limiting long-term paracetamol use in elderly patients, particularly those with risk factors, and maintain heightened vigilance for signs of chronic toxicity.