Coroner's Finding: Allie, Sue Denise

63y · Female·unable to determine; possibly mirtazapine toxicity, cardiac disease, or injection of unknown substance

Sue Denise Allie, aged 63, died at home in July 2015. She had presented to hospital in May 2015 with superwarfarin (brodifacoum) poisoning from rat poison, which she attributed to handling contaminated material. Medical review suggests she had undiagnosed factitious disorder (Munchausen syndrome), deliberately ingesting rat poison and later overdosing on mirtazapine. Treating doctors noted she was unconcerned about poison origin, reluctant to comply with treatment, and attempted to deceive nursing staff. The coroner could not determine the immediate cause of death but concluded it was not the rat poison exposure. Clinically, this case highlights the importance of recognising factitious disorder in patients with unusual presentations, non-compliance, and incongruent affect. Mental health assessment occurred but factitious disorder was not identified during treatment. Enhanced collaboration between medical and psychiatric teams, and awareness of this disorder's presentations, may have enabled earlier recognition and appropriate management.