56y · Male·urosepsis
…mingly stable patients with advanced liver disease can deteriorate rapidly from sepsis, and that faecal incontinence in this context may indicate serious underlying pathology warranting urgent investigation rather than r…
75y · Male·Probable drowning
… approximately 12 nautical miles offshore without him. Investigation revealed he had experienced faecal incontinence, removed his clothing and personal flotation device, and entered the water to clean himself. The vessel…
58y · Male·Cardiomegaly and severe single vessel coronary artery atherosclerosis in a man w…
…galy and severe single vessel coronary artery atherosclerosis. Investigation focused on whether urinary incontinence represented a new symptom requiring investigation versus pre-existing chronic incontinence. Although me…
76y · Male·General inanition due to end stage Parkinson's disease
…e had been diagnosed with Parkinson's in 2005 and presented with advanced disease including immobility, incontinence, cognitive impairment, and dysphasia. The inquest was held because he was subject to a guardianship ord…
79y · Male·cardiovascular degeneration
John Alfred Beasley, aged 79, died of cardiovascular degeneration at Resthaven aged care facility on 16 August 2012. He had multiple chronic conditions including Type 2 diabetes, hypertension, cerebrovascular disease wit…
80y · Male·aspiration pneumonia complicating inanition of dementia
Arthur Smith, an 80-year-old man with advanced Alzheimer's dementia, died from aspiration pneumonia complicated by inanition (malnutrition/dehydration) at an aged care facility. He had cognitive decline from 2011, with p…
75y · Female·organ failure due to sepsis, likely from infected pressure sores, in the context…
…ion, and the deceased's progressive refusal to mobilise despite repeated nursing advice. The deceased's incontinence and faecal contamination accelerated wound deterioration. While KinCare had systemic failures in suppli…
88y · Female·Complications of a stage 3 sacral pressure ulcer in a woman with dementia
Margaret Alice Cook, an 88-year-old woman with end-stage dementia, died from complications of a stage 3 sacral pressure ulcer at a palliative care unit. She had resided at Crofton House Supported Residential Services (SR…
45y · Male·Bronchopneumonia
…ronchopneumonia. He experienced rapid functional decline from January 2008, including loss of mobility, incontinence, and development of infected pressure ulcers. An MRI in May 2008 confirmed severe cervical myelopathy u…
81y · Male·pneumonia complicating surgery for left hip fracture on a background of ischaemi…
…m pneumonia following hip fracture surgery. He fell while hip protectors were being cleaned after bowel incontinence. Post-operatively he developed hospital-acquired pneumonia and was appropriately managed with palliativ…
68y · Female·Terminal palliation in the setting of ischaemic liver and bronchopneumonia
…nia. From late 2019, her health deteriorated significantly with neurological symptoms including urinary incontinence, poor mobility, and food refusal. Her GP suspected normal pressure hydrocephalus and sought neurologica…
86y · Male·Sepsis with septic shock, due to urinary tract infection, pyelonephritis (kidney…
…ritis and prostatic infection. He presented to his GP in March 2015 with dizziness and reported urinary incontinence and nocturia, suggesting bladder neck obstruction. This diagnosis was missed by the GP and subsequently…
83y · Female·meningitis with sepsis with the likely source of infection being a large and dee…
Dorothy Jean Atkins, aged 83, died on 9 July 2017 from meningitis and sepsis secondary to a large stage 4 sacral decubitus ulcer. Autopsy revealed severe malnutrition (24.5kg, BMI 13), poor hygiene with faecal soiling un…
10y · Female·Ischaemic large bowel; large bowel obstruction secondary to chronic constipation
Child W, aged 10, died from ischaemic large bowel secondary to chronic constipation and faecal impaction. She had lifelong constipation and encopresis (soiling) from infancy, presenting to her GP twice (2008, 2010) with …
64y · Male·Complications of advanced rectal carcinoma
David Ronald Thompson, a 64-year-old man with severe intellectual disability and complex medical needs, died from complications of advanced rectal carcinoma. He resided in specialist disability accommodation and had been…
77y · Female·general inanition on a background of dementia, chronic subdural haematoma and ri…
Mrs Ann Perkins, aged 77, died from general inanition with dementia, chronic subdural haematoma, and fractured neck of femur as contributing factors. She sustained an unwitnessed fall at her aged care facility in Decembe…
7y · Female·cardiac tamponade due to total parenteral nutrition fluid leakage into the peric…
A 7-year-old girl with spina bifida died from cardiac tamponade caused by total parenteral nutrition (TPN) fluid leaking into the pericardial sac via a central venous line inserted during bowel obstruction surgery. Clini…
61y · Male·Natural causes unascertained
David Evan Wild, 61 years old, died of natural causes of unascertained origin while residing in specialist disability accommodation. He had frontal temporal dementia diagnosed in 2020 and required 24/7 care. He experienc…
66y · Female·urinary tract infection with contributing hypertensive heart disease, diabetes m…
…nt with vaginal pain and signs of infection. She had a long-term indwelling catheter placed for urinary incontinence. The ED doctor did not recognize catheter-associated urinary tract infection (CAUTI) despite key clinic…
51y · Female·embolic infarcts complicating infective endocarditis
…ere physical deterioration over three days including swollen feet, respiratory distress, confusion, and incontinence. Despite her son suggesting an ambulance call earlier, paramedics were not contacted until day four. Sh…
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