82y · Male·Complications of large bowel obstruction in a man with diverticular disease and …
…ICU teams deemed him too high-risk due to extensive comorbidities including heart failure, chronic kidney disease, atrial fibrillation, and peripheral vascular disease. Following discussion with the patient and family, …
90y · Female·abdominal sepsis complicating perforated diverticular abscess of the sigmoid col…
…e Ogilvy, a 90-year-old woman from rural Victoria, died from abdominal sepsis complicating a perforated diverticular abscess. She presented with bowel obstruction requiring laparotomy on 21 October 2019, was discharged o…
86y · Male·Sepsis associated with a pericolic abscess, complicated by terminal large intest…
…parent stability; managing patients who refuse standard treatments (he refused BiPAP); recognising that diverticular disease can lead to pericolic abscess and sepsis; and understanding that palliative care was ultimately…
50y · Male·gastrointestinal haemorrhage; haemorrhage from cystic artery post laparoscopic c…
… of MET calls when systolic BP fell below 90 on three separate occasions; misattribution of bleeding to diverticular disease rather than post-operative complications; inadequate investigation of suspected upper gastroint…
94y · Female·Sepsis complicating management of vulval carcinoma in an elderly woman with seve…
A 94-year-old woman with vulval carcinoma underwent suprapubic catheter insertion at a private hospital on 14 May 2014. She appeared well post-procedure with normal observations. The following day, she was transferred by…
75y · Male·Effects of fire
Mr B, aged 75, killed his wife Mrs A by striking her to the head and asphyxiating her with a ligature, then set their house on fire resulting in his own death. Evidence indicates Mr B was experiencing undiagnosed mental …
65y · Female·Unascertained (Natural Causes)
…ed natural causes with minimal autopsy findings (small pelvic fluid, small bowel fluid levels, probable diverticular disease). The coroner found no prevention opportunities and concluded the death resulted from natural c…
61y · Male·Multiorgan failure, due to, or as a consequence of metastatic lung cancer (suspi…
…ed that even earlier diagnosis would not have changed prognosis given the aggressive nature of metastatic disease. Care was appropriately transitioned to palliative management based on his wishes and in consultation wit…
62y · Male·Multi-organ failure following surgical repair of ruptured abdominal aortic aneur…
…ul Rodda, a 62-year-old long-term prisoner with extensive medical comorbidities including ischaemic heart disease, COPD, and a known abdominal aortic aneurysm (AAA), presented with chest pain in September 2015. Imaging …
80y · Female·sudden cardiac arrest due to multiple post-operative complications including myo…
An 80-year-old woman died from multiple post-operative complications following reversal of a Hartmann's procedure for diverticulitis. She had undergone a complex 8-hour surgery complicated by extensive adhesions (frozen …
85y · Female·Coronary artery disease and heat exposure
An 85-year-old woman with coronary artery disease was admitted to a low-care supported residential service following bowel surgery. She was frail, hard of …
60y · Female·haemorrhagic shock and respiratory failure due to right-sided haemothorax compli…
A 60-year-old woman with metastatic breast cancer and COAD died from haemorrhagic shock due to right-sided haemothorax complicating thoracentesis. The procedure was appropriately performed to drain a pleural effusion on …
67y · Female·Intra-abdominal sepsis complicating an anastomotic leak following elective surge…
A 67-year-old woman died from intra-abdominal sepsis following an anastomotic leak from elective colorectal surgery to repair a vesico-colic fistula. The initial surgery on 1 November 2017 was appropriately performed, an…
75y · Female·hypovolaemic shock from excessive blood loss
Lorraine McDonald, age 75, died from hypovolaemic shock due to massive intraoperative bleeding during an anterior resection for rectosigmoid adenocarcinoma. Critical deficiencies included: no pre-admission clinic assessm…
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