69y · Female·multi-organ failure due to sepsis of unknown origin
…ation on blood film) requiring tertiary care. Early recognition of this developing sepsis and prompt IV rehydration were limited by inability to establish intravenous access and lack of available hospital beds. While ki…
0y · Male·Complications of hypoxic ischaemic encephalopathy secondary to recurrent episode…
…y died from irreversible brain injury. Key lessons: early recognition that vomiting despite nasogastric rehydration warrants escalation and imaging; clear communication of clinical urgency to nursing and retrieval servi…
77y · Female·Venlafaxine toxicity in a woman with severe renal impairment and depression
…oroner found the death was preventable through adequate medical review, transfer to medical ward for IV rehydration, and proper handover of clinical concerns. No pre-ECT anaesthetic assessment identified the concurrent …
39y · Male·Complications arising from widely disseminated primary pulmonary small cell carc…
A 39-year-old male inmate died from complications of widely disseminated small cell lung cancer with hepatitis C cirrhosis. He presented with acute psychosis and catatonia in December 2018, receiving appropriate psychiat…
3y · Male·Influenza A infection (Type H3N2)
…ng resuscitation by ~14 minutes. Early proactive differentiation of hyponatraemia cause and appropriate rehydration plus albumin may have prevented death.
70y · Female·Severe dehydration and renal complications secondary to intestinal obstruction d…
A 70-year-old woman presented to a rural hospital with 48 hours of vomiting and dehydration secondary to an inguinal hernia obstruction. The initial assessment by the hospital medical officer failed to adequately review …
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