Finding into death of Anthony John Toscano

45y · Male·small bowel obstruction due to plastic bag bezoar

Anthony Toscano, a 45-year-old man with intellectual disability residing in supported accommodation, died from small bowel obstruction caused by a plastic bag bezoar. He presented with vomiting on 20 August 2015 and was assessed by a GP the next day who diagnosed gastroenteritis based on findings of moist mucosa and soft, non-tender abdomen with no reported pain. The GP advised symptomatic management without further investigation. Anthony's condition deteriorated overnight with continued vomiting and he was found unresponsive on 22 August. The coroner found care provided was reasonable and appropriate. The case highlights the diagnostic challenge of distinguishing gastroenteritis from mechanical obstruction in patients with intellectual disability who may have difficulty communicating symptoms, and the importance of considering bezoar risk in this population.