Coroner's Finding: FISHER Judith Mary

62y · Female·ventricular fibrillation associated with congestive cardiomyopathy

A 62-year-old woman detained under the Mental Health Act for acute psychiatric deterioration (psychosis, confusion, paranoia) secondary to anxiety following cardiomyopathy diagnosis died from ventricular fibrillation associated with congestive cardiomyopathy. She collapsed at the Adelaide Clinic on 5 February 1999 and suffered severe anoxic encephalopathy before dying in ICU. Post-mortem revealed a grossly enlarged heart (1,042g, three times normal weight) consistent with decompensating congestive cardiomyopathy. The coroner found no grounds for concern about medical or psychiatric treatment quality. The cardiac cause of death was unrelated to her mental health detention. Key clinical lesson: recognition that acute psychiatric deterioration can occur secondary to serious medical illness; the importance of thorough cardiac assessment in patients presenting with anxiety and psychiatric symptoms, particularly when cardiac disease is known.