46y · Female·hypoxic ischaemic brain injury as a result of cardiac arrest following a choking…
… 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…
53y · Male·Refractory seizures secondary to Lennox-Gastaut syndrome (palliated); pneumonia
…with increased seizure activity. During admission, he could not receive oral anti-epileptics due to poor swallowing, and there were difficulties administering intravenous anti-epileptics. He was transferred to palliative…
50y · Male·Hypoxic-ischaemic encephalopathy secondary to choking on food bolus
… his disability care residence. The carer appropriately called 000 and commenced CPR, but communication difficulties with the emergency dispatcher delayed recognition of cardiac arrest. Paramedics initially failed to vis…
45y · Male·Aspiration of food bolus, with cerebral palsy as contributing factor
…hts the critical importance of strict adherence to individualised feeding regimes for people with severe swallowing difficulties, especially after recommendations have been updated.
57y · Male·Combined effects of aspiration pneumonia and epilepsy (with cerebral palsy as un…
…buted to death. The case highlights the inherent risks of aspiration in patients with cerebral palsy and swallowing difficulties, and the challenges of managing complex seizure activity in this vulnerable population.
28y · Male·Aspiration pneumonia with antecedent cause of cerebral palsy
…onia at Northern Hospital. Aspiration pneumonia is a known complication in people with disability due to swallowing difficulties. The coroner found no evidence of deficient clinical management by either the supported liv…
64y · Male·Hypostatic bronchopneumonia complicating end stage Parkinson's disease
…ng in a disability group home. His Parkinson's diagnosis in 2016 led to rapid deterioration, with severe swallowing difficulties and inability to maintain oral intake by April 2019. He was admitted with dehydration and t…
61y · Male·aspiration pneumonia in a man with Down syndrome and early onset dementia
…that aspiration pneumonia remains a serious complication in individuals with intellectual disability and swallowing difficulties, despite appropriate supportive care. Early recognition of terminal decline and timely pall…
34y · Female·aspiration pneumonia in the setting of pseudo-obstruction of the large bowel
…year-old woman with cerebral palsy, developmental delay, epilepsy, chronic bowel pseudo-obstruction, and swallowing difficulties died from aspiration pneumonia. She was admitted to Austin Hospital with decreased consciou…
55y · Female·Aspiration pneumonia in a woman with cerebral palsy (spastic quadriparesis)
…ex medical history requiring pureed foods and thickened fluids. Following GP assessment for coughing and swallowing difficulties on 2 January 2019, she was admitted twice to hospital in January. She was discharged on 18 …
62y · Male·Aspiration pneumonia complicating epilepsy in the setting of Down syndrome
…ility accommodation and Austin Hospital was appropriate. This case illustrates the challenge of managing swallowing difficulties and recurrent aspiration in patients with progressive neurological disease, highlighting th…
66y · Male·Undetermined (natural causes)
…ons including Parkinson's disease, spastic gait syndrome, cognitive impairment, atrial fibrillation, and swallowing difficulties died at his supported disability accommodation home on 20 June 2024. He experienced acute r…
85y · Male·Pneumonia on a background of end stage Alzheimer's disease
…ehaviour requiring mental health detention orders. His clinical course involved progressive decline with swallowing difficulties, falls, and ultimately terminal respiratory failure. A palliative care approach was impleme…
80y · Male·inanition complicating end stage dementia
…ion he experienced multiple medical complications including urinary retention requiring catheterisation, swallowing difficulties, and a pulmonary embolism. A palliative approach was appropriately adopted from 11 May 2016…
81y · Male·gastrointestinal haemorrhage and multi-organ failure on a background of severe d…
…treatment including endoscopy. His declining physical health, weight loss, anaemia, cardiac failure, and swallowing difficulties progressed to multi-organ failure. The coroner found his detention lawful and that custodia…
75y · Female·Hypostatic bronchopneumonia in the setting of dementia
…a. She had been declining since April 2016 with progressive weight loss, increased agitation, falls, and swallowing difficulties. Her GP arranged weekly reviews from August 2016. Palliative care was referred in December …
66y · Male·Aspiration pneumonia in the setting of a small bowel obstruction
Michael Luno, a 66-year-old man with intellectual disability, autism, epilepsy, and swallowing difficulties, died from aspiration pneumonia complicating small bowel obstruction. He presented with vom…
63y · Female·Aspiration event in the setting of cerebral palsy, intellectual disability, and …
…ith intellectual disability have elevated aspiration risk; clinicians should maintain high vigilance for swallowing difficulties, ensure appropriate dietary modifications, and implement aspiration precautions in this vul…
48y · Male·sepsis in the setting of aspiration pneumonia and bowel obstruction
…se illustrates the challenges of managing complex gastrointestinal pathology in vulnerable patients with swallowing difficulties and the importance of early escalation and family involvement in care decisions.
60y · Male·Respiratory obstruction (choking by food)
… gradually reduced, and no 'as needed' sedatives given in the 24 hours before death. No prior choking or swallowing difficulties were documented. The coroner concluded this was an unfortunate, unforeseeable accident that…
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