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VIChospital2025-07-28

Finding into death of Ann Williams

71y · Female·Aspiration pneumonia complicating dysphagia and status epilepticus

Ann Williams, a 71-year-old woman with severe intellectual disability and chronic dysphagia, died of aspiration pneumonia complicated by status epilepticus while residing in specialist disability …

emergency medicinerespiratory medicine
VIChospital2022-03-10

Finding into death of SMW

48y · Male·Aspiration Pneumonia in the setting of Fahr's Disease

A 48-year-old man with Fahr's disease, dysphagia, and multiple comorbidities died from aspiration pneumonia at Box Hill Hospital. He had significant disa…

respiratory medicineneurology
VIChospital2025-09-30

Finding into death of Richard Mark Ellis

64y · Male·Aspiration event obstruction in a man with oropharyngeal dysphagia and Parkinson…

…is, a 64-year-old man with intellectual disability, schizophrenia, Parkinson's disease and oropharyngeal dysphagia, died from aspiration obstruction following a witnessed choking episode while eating. He presented to th…

emergency medicinepsychiatryamisulpride
VIChospital2019-08-13

Finding into death of Johannes Gerhardus Jansen

66y · Male·Aspiration pneumonia complicating a seizure in a man with dysphagia and phenylke…

…ies must have robust medication management systems, particularly for patients with seizure disorders and dysphagia.

neurologyinfectious diseasesmedicationsystem
SAhospital2014-11-28

Coroner's Finding: HOGAN Constance Mary

73y · Female·general inanition due to dysphagia on a background of multiple neurological and …

…nasogastric feeding and intravenous hydration, she developed progressive neurological deterioration with dysphagia and eventually died from general inanition. The coroner found her treatment appropriate and detention la…

neurologypsychiatry
VIC2012-10-10

Finding into death of Christopher Barca

57y · Male·Aspiration of gastric content (due to choking on food)

…a Department of Human Services group home, died from aspiration of gastric content. He had oropharyngeal dysphagia, epilepsy, and a history of chest infections. While eating his evening meal on 21 May 2011, he began to …

speech pathologygeneral practice
VIChospital2024-10-15

Finding into death of Melissa Joanne Dibble

53y · Female·Bronchopneumonia on a background of cerebral palsy

…nchopneumonia in the context of cerebral palsy, spastic quadriplegia, cortical blindness and progressive dysphagia due to aspiration. She was admitted to The Alfred Hospital on 27 August 2023 with pneumonia, pleural eff…

respiratory medicinepalliative care
VICaged care2022-07-06

Finding into death of Catherine Ann Collier

51y · Female·Aspiration in the setting of end stage down syndrome

Catherine Ann Collier, a 51-year-old woman with Down syndrome, end-stage hydrocephalus, and severe dysphagia, died from aspiration pneumonia following a choking episode while eating. The Disability Services Commis…

neurologyspeech pathologysystemcommunicationsodium valproate
VIChospital2025-08-06

Finding into death of Mr B

60y · Male·End stage multiple system atrophy

…age multiple system atrophy, was admitted to Box Hill Hospital on 5 June 2025 with respiratory distress, dysphagia, and recent upper respiratory tract infection. His condition progressively deteriorated despite intraven…

general medicineneurologyantibiotics
VIChospital2024-10-24

Finding into death of Marina Norman

46y · Female·Aspiration pneumonia in a woman with multiple sclerosis

…auses. Clinically, this case highlights the inevitable complications of advanced multiple sclerosis with dysphagia and immobility, and the appropriate decision to transition to comfort care when active interventions pro…

neurologyinfectious diseases
VIChospital2024-08-21

Finding into death of Hayley Michelle Impey

50y · Female·Aspiration pneumonia, with epilepsy with frequent seizures as contributory cause

…ion was required. For clinicians, this case underscores the serious risks of aspiration in patients with dysphagia and seizure disorders, the importance of careful post-extubation monitoring, and the need for comprehens…

emergency medicineintensive careclonazepam
VIC2025-05-29

Finding into death of Gary Mayrhofer

54y · Male·Complications following an old prior cerebrovascular accident - aspiration pneum…

…ghlights the importance of appropriate swallowing assessment and management in post-stroke patients with dysphagia in supported care settings, and the need for coordinated interdisciplinary care between hospital, commun…

neurologydisability medicine
VICcommunity2026-04-13

Finding into death of David Evan Wild

61y · Male·Natural causes unascertained

…line with multiple comorbidities including recurrent urinary tract infections, aspiration pneumonia, and dysphagia. He was discharged from hospital on 14 April 2025 following aspiration pneumonia treatment and died unex…

geriatric medicineneurologyfluoxetine
VIChospital2013-05-09

Finding into death of Argyrios Carras

38y · Male·Aspiration pneumonia in the setting of cerebral palsy

… supported accommodation contributed to his death. Key clinical lesson: patients with cerebral palsy and dysphagia require careful monitoring for aspiration risk, and early recognition of respiratory decline is essentia…

respiratory medicineinfectious diseasesdiazepam
VICaged care2022-01-12

Finding into death of Diane Maree Pearse

51y · Female·Status epilepticus on a background of Lennox Gastaut syndrome and cerebral palsy

…d severe cerebral palsy, died from status epilepticus after prolonged deterioration. She had progressive dysphagia and recurrent seizures despite multiple anti-epileptic medications. A PEG tube was deemed too high-risk …

neurologypalliative careclonazepam
VIChospital2024-09-17

Finding into death of Hannah Gray

34y · Female·Aspiration pneumonia in a woman with cerebral palsy and Lennox-Gastaut syndrome

…ital staff. Her death resulted from natural causes related to her underlying neurological conditions and dysphagia.

neurologygeneral practicecannabidiol
VIChospital2023-10-16

Finding into death of Adam Richard Greaves

48y · Male·Aspiration pneumonia complicating progressive degenerative neurological disorder…

…, a 48-year-old man with progressive degenerative neurological disorder, frontotemporal dementia, severe dysphagia, and cerebral palsy, died from aspiration pneumonia after admission to hospital with acute breathing dif…

emergency medicineneurology
VIChospital2023-02-22

Finding into death of John Robert Clay

68y · Male·Stercoral perforation in a man with cerebral palsy

…g severe constipation and faecal impaction. He had multiple complex disabilities including quadriplegia, dysphagia, and epilepsy, managed by a multidisciplinary team with constipation/bowel management plans in place. In…

general practicegastroenterology
VICaged care2025-10-10

Finding into death of Christopher Kuric

52y · Male·Aspiration pneumonia in a man with end stage Huntington's disease

…ical lessons include: ensuring timely escalation of respiratory deterioration in high-risk patients with dysphagia; considering early hospital admission when oxygen saturation is borderline despite remote review; and ma…

neurologypalliative carepossibly_preventabledelay
VIChospital2021-03-26

Finding into death of Resel Juerchott

59y · Female·Aspiration pneumonia in the setting of Down's syndrome

A 59-year-old woman with Down's syndrome, advanced Alzheimer's dementia, dysphagia, epilepsy and blindness died from aspiration pneumonia. She was a resident of a group home requiring 24-…

geriatric medicineinfectious diseases

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