Finding into death of Eoghan Jerome Arnold

42y · Male·Hypoxic ischaemic brain injury secondary to cardiac arrest caused by massive pulmonary embolism, arising from deep venous thrombosis post tibial fracture in motor vehicle accident

A 42-year-old man died from hypoxic ischaemic brain injury following cardiac arrest due to a massive pulmonary embolism. He sustained a tibial fracture in a motor vehicle accident and underwent external fixation. He developed a deep venous thrombosis despite receiving standard prophylaxis with enoxaparin 40mg daily and TED stockings. The PE occurred intraoperatively during planned definitive fixation surgery 11 days post-injury. The coroner found the medical care provided at both Royal Melbourne Hospital and Brunswick Private Hospital was appropriate and timely. Standard DVT prophylaxis was given, though enoxaparin was withheld the night before surgery (later identified as not required by unit protocol for non-major pelvic/spinal surgery). The coroner emphasised the significant burden of venous thromboembolism in hospitalised patients and the lack of a consensus Australian guideline, recommending development of a Victorian evidence-based guideline.