Man Misdiagnosed with Gastroenteritis Dies of Fecal Impaction
On.cc · 2 SOURCESabout 1 hour ago2 MIN
Summary
A 44-year-old man with schizophrenia and intellectual disability died from fecal impaction causing intestinal obstruction after being misdiagnosed with gastroenteritis at Tuen Mun Hospital on March 2, 2024 . The coroner’s inquest, presided over by Coroner Chow Chi-wai with a five-person jury, began hearing evidence on January 6, with the Hospital Authority and Tuen Mun Hospital named as interested parties .
Key Points
- The deceased, Cheung Chi-keung, 44, was a resident of Yan Wing Rehabilitation Centre with schizophrenia and a history of fecal impaction .
- On March 2, 2024, he was sent to Tuen Mun Hospital emergency department with fever, abdominal pain, and vomiting, but was diagnosed with gastroenteritis and discharged the same afternoon .
- Dr. Mak Ho-hang, the treating emergency doctor, admitted he could not recall asking about bowel habits and had no record of such inquiry, possibly due to omission .
- Dr. Mak considered intestinal obstruction but deemed it unlikely due to normal bowel sounds, and declined to perform a rectal examination as it was invasive .
- Forensic pathologist Dr. Ko Wing-fu confirmed massive fecal impaction in the large intestine, rectum, and small intestine, stating it was not formed in a short time .
- Dr. Ko testified that an X-ray examination could have revealed intestinal obstruction symptoms, potentially preventing death .
- The deceased had been prescribed anti-diarrheal and anti-emetic medication, which a forensic expert confirmed was counterproductive for a constipated patient .
- Cheung collapsed in the rehabilitation centre toilet around 1 a.m. on March 3 and was pronounced dead at 2:50 a.m. at Tuen Mun Hospital .
- His brother alleged administrative negligence by Tuen Mun Hospital and sought investigation .
Why It Matters
The case raises serious concerns about emergency department diagnostic protocols for patients with psychiatric conditions and communication barriers . It highlights potential gaps in clinical assessment, documentation standards, and the need for thorough physical examinations when patients present with abdominal symptoms, particularly those on constipating psychiatric medications .
The case raises serious concerns about emergency department diagnostic protocols for patients with psychiatric conditions and communication barriers . It highlights potential gaps in clinical assessment, documentation standards, and the need for thorough physical examinations when patients present with abdominal symptoms, particularly those on constipating psychiatric medications .