Finding into death of Pamela Dorothy Otway

71y · Female·Cardiogenic shock due to sudden cardiac event, with scleroderma as contributing factor

Pamela Dorothy Otway, aged 71 years, with significant intellectual disability from childhood and residing in Specialist Disability Accommodation, died of cardiogenic shock and ventricular standstill following a sudden cardiac event. Her extensive medical history included scleroderma, epilepsy, bipolar affective disorder, anaemia, dysphagia, osteoporosis and previous transient ischemic attacks. While dining at her residence, she suddenly became unresponsive. Disability support staff immediately called emergency services and commenced cardiopulmonary resuscitation. Paramedics noted severe bradycardia unresponsive to inotropic support and transported her to The Royal Melbourne Hospital where cardiogenic shock and ventricular standstill were diagnosed. Following a family discussion with the medical team, end-of-life comfort care was provided. Post-mortem examination confirmed natural causes. Although scleroderma is known to predispose to cardiac fibrosis and arrhythmias, the specific cause for the cardiac arrest could not be identified. Emergency response was timely and appropriate. No clinical errors were identified, and family expressed satisfaction with disability care provided.