Coroner's Finding: VONDERWALL Frederick Albert

66y · Male·hepatorenal failure and biliary sepsis complicating common bile duct obstruction

A 66-year-old man incarcerated in Port Lincoln Prison died from hepatorenal failure and biliary sepsis complicating common bile duct obstruction. He presented with progressive jaundice, dark urine, and signs of liver failure from February 2007. Transfer to Royal Adelaide Hospital ICU in April 2007 revealed probable biliary cancer. He underwent ERCP with stent insertion and required ICU support including mechanical ventilation and dialysis. After extubation on 18 April, he explicitly declined further aggressive treatment and life support. Care was appropriate and compassionate, with respect for his wishes and transition to palliative care. The death was natural, inevitable, and not preventable given disease severity.