Coroner's Finding: Barry, Margaret Joan

80y · Female·Right haemothorax due to bleeding right pleural adhesion with contributing apixaban anticoagulant therapy for atrial fibrillation and aortic valve replacement

Margaret Joan Barry, 80, died from right haemothorax due to bleeding from a pleural adhesion while on apixaban anticoagulation therapy for atrial fibrillation. She was admitted to Royal Adelaide Hospital for psychiatric care under an Inpatient Treatment Order for mania following cessation of carbamazepine. On 24 April 2019, after slipping in the bathroom and experiencing dry retching, she developed massive intra-thoracic bleeding (1600ml) and died peacefully. The coroner found no concerns relating to her care. Her extreme fragility from multiple comorbidities (aortic valve replacement, pacemaker, immunoglobulin deficiency, Addison's disease, epilepsy) meant haemothorax could have occurred spontaneously even without the documented fall. The anticoagulation was appropriate and not criticised.