Coroner's Finding: SNIECIKOWSKA Alicja

68y · Female·chronic obstructive pulmonary disease

Ms Sniecikowska, a 68-year-old Polish-speaking woman with severe COPD, chronic alcoholism, cognitive impairment, and significant social isolation, was admitted to hospital for acute COPD exacerbation on 29 August 2016. Despite multiple interventions including oxygen, nebulised medications, and trials of non-invasive ventilation (BiPAP), she demonstrated poor compliance, refused diagnostic imaging (CTPA), and became increasingly agitated. She was placed on a Level 1 Mental Health Inpatient Treatment Order after refusing escalation of care. Conservative management continued with palliative focus. She died of respiratory failure on 1 September 2016. The coroner found care appropriate and lawful. Clinical lessons include the challenges of managing non-compliant patients with language barriers, cognitive impairment from hypoxia, and the need for early palliative planning when invasive interventions are refused and prognosis is poor.