Coroner's Finding: Rubenach, Timothy Luke

32y · Male·Aspiration pneumonia and reflux oesophagitis

Timothy Luke Rubenach, aged 32, died of aspiration pneumonia following severe reflux oesophagitis. He had profound intellectual disability and drug-resistant epilepsy from meningococcal infection at 5 months. His parents discontinued conventional anti-seizure medications around 2010, citing perceived intolerance, and subsequently used medicinal cannabis. In his final year, Mr Rubenach suffered multiple episodes of haematemesis requiring eight hospital admissions. He was commenced on palliative care on 15 May 2018 with morphine analgesia, delivered appropriately via syringe driver. Daily GP review occurred until his death on 22 May 2018. The coroner found no evidence of negligent care, inappropriate morphine dosing, or harm by his devoted parents despite Mrs Rubenach expressing distress to her psychologist. The death was attributable to the natural consequences of his acquired brain injury.