Inquest into the death of Andrea Sewell

46y · Female·hypoxic ischaemic brain injury as a result of cardiac arrest following a choking episode

Andrea Sewell, a 46-year-old woman with Osmotic Demyelination Syndrome (ODS) and acute psychiatric illness, died from hypoxic brain injury following a choking episode during a meal in a psychiatric intensive care unit (PICU). She had a prior history of swallowing difficulties from ODS but had made substantial symptomatic recovery by the time of her acute psychiatric admission. The coroner examined whether her swallowing ability was adequately assessed before prescribing antipsychotic medications that could impair swallowing. Expert evidence concluded that without observed eating or drinking difficulties during admission, failure to obtain a speech pathology assessment was not unreasonable, and that her choking was likely due to impulsive eating behaviour rather than ODS-related swallowing dysfunction. No clinical negligence was found. The hospital subsequently implemented improved emergency response procedures including a 24-hour rapid response team.