Coroner's Finding: Daw Rodney Keith

63y · Male·acute blood loss due to self-inflicted sharp force incisional wounds of the throat and bilateral wrists and forearms

A 63-year-old man with multiple chronic conditions including psoriatic arthritis, depression, prostate cancer, and recent dental issues died by self-inflicted sharp force wounds while on approved leave from a mental health inpatient facility. He had been assessed as low risk and granted frequent leave. Clinical lessons include: the complexity of managing patients with multiple comorbidities and depression; the importance of risk assessment during periods of leave from mental health units, particularly around significant life stressors (tooth loss); and paramedic decision-making regarding Advanced Care Directives in acute trauma. The paramedics appropriately applied clinical practice guidelines, determining resuscitation was futile given massive blood loss incompatible with life.