Finding into death of James Michael Hoctor

93y · Male·Complications following colectomy for Clostridium difficile pancolitis in the setting of recent antibiotic therapy

A 93-year-old man with a history of antibiotic use for a neck abscess developed diarrhoea during hospitalisation. Despite testing negative for Clostridium difficile at St Vincent's Hospital, he was transferred to a rural district hospital where his ongoing diarrhoea and low-grade fevers were attributed to viral gastroenteritis and treated symptomatically. Clostridium difficile infection was not considered or investigated during several days of progressive symptoms. When he acutely deteriorated with sepsis, he was transferred back to the tertiary hospital where C. difficile pancolitis was diagnosed, requiring emergency colectomy. He died from post-operative complications. The coroner found no want of care, but noted that clinicians should have considered C. difficile in an elderly patient on prolonged antibiotics presenting with diarrhoea and fever, and recommended education for rural hospital staff on recognising this condition.