Coroner's Finding: ISSACSON David Jacob

52y · Male·disseminated carcinoma of the gallbladder

David Issacson, 52 years old, died from disseminated gallbladder carcinoma at Royal Adelaide Hospital while detained under the Mental Health Act. He presented on 2 April with abdominal pain and was initially discharged from ED with a diagnosis of constipation, then re-presented on 3 April and was admitted. Advanced cancer with metastases was diagnosed on 8 April; he died the following day. The coroner found his treatment was appropriate and made no recommendations. Clinical lessons include the importance of thorough assessment of abdominal pain in patients with risk factors (obesity, diabetes, hepatitis C), and the challenge of distinguishing psychiatric from medical presentations when symptoms overlap.