Coroner's Finding: Towns, Martin John

38y · Male·acute on chronic right hemisphere subdural haematoma

Martin Towns, 38, died from acute-on-chronic subdural haematoma after a fall while severely intoxicated on 30 December 2015. He had a chronic subdural haematoma from an earlier injury sustained when falling against a bathtub in October 2015 while attempting entry to his residence. He was a heavy daily drinker with a history of uncontrolled alcoholism following personal losses in 2011. Towns was on fluoxetine and diazepam, and had recently been discharged from psychiatric admission following suicidal ideation. The coroner found it likely Towns fell and struck his right temporal region in the early hours of 30 December while intoxicated, causing re-bleeding from the chronic subdural haematoma. Clinical lessons include the vulnerability of patients with chronic subdural haematoma to minor trauma, the compounding risks of heavy alcohol use with anticoagulation risk, and the need for safety planning in patients with both psychiatric vulnerability and severe substance misuse.