Inquest into the death of William MacDONALD

90y · Male·Complications arising from a gastrointestinal obstruction; incarcerated inguinal hernia as an antecedent cause

William MacDonald, a 90-year-old prisoner, died from complications of gastrointestinal obstruction caused by an incarcerated inguinal hernia. He presented to Prince of Wales Hospital with severe abdominal pain, nausea, and vomiting on 11 May 2015. Surgical consultation determined his condition was not survivable and operative management was not appropriate. A 'No CPR' resuscitation plan was implemented based on clinical judgment that CPR would offer negligible benefit, consistent with NSW Health guidelines. This decision was made in consultation with multiple doctors and was properly documented. Palliative care was initiated and the patient died the following morning. The coroner found the care and treatment received was appropriate, the decision-making regarding resuscitation complied with policy, and the death was of natural causes. No preventable errors or systemic failures were identified.