Finding into death of Malcolm Colin Vincent

IN THE CORONERS COURT OF VICTORIA AT MELBOURNE Court Reference: COR 2015 4970

FINDING INTO DEATH WITHOUT INQUEST

Form 38 Rule 60(2) Section 67 of the Coroners Act 2008

I, PETER WHITE, Coroner having investigated the death ofp MALCOLM COLIN VINCENT without holding an inquest:

find that the identity of the deceased was MALCOLM COLIN VINCENT

born on 29 April 1958

and the death occurred on 29 September 2015

at the Western Hospital, 160 Gordon Street, Footscray, Victoria

from:

1(a) SMALL BOWEL ISCHAEMIA (OPERATED) 1(b) INCARCERATED UMBILICAL HERNIA

Pursuant to section 67(1) of the Coroners Act 2008 I make findings with respect to the following circumstances:

1. Malcolm Colin Vincent was a 57 year old man who lived in residential care at Capello House in Yarraville. Capello House is run by the Australian Community Support Organisation (ACSO). He had lived at Capello House since 2009, Mr Vincent was able to provide basic care for himself. I note that Capello House does not provide medical care to residents.

2. On 28 September 2015, Mr Vincent was seen having a cigarette just before 7am. Shortly afterwards, the carer found Mr Vincent lying on the lounge room couch complaining of stomach pain. The carer called an ambulance and paramedics transported Mr Vincent to the Western Hospital.

3. On arrival at hospital, Mr Vincent deteriorated and he was admitted to the Intensive Care Unit. He underwent an emergency laparotomy where four meters of small intestine were removed due to ischaemic gut. A second laparotomy was planned for 24 to 48 hours later to ensure the ischaemic gut had not spread.

4. Mr Vincent continued to deteriorate and developed hypoglycaemia and multiple organ failure. He was given a poor prognosis as he was not responding to medication. Mr Vincent passed away at 1.30am on 29 September 2015.

5. As Mr Vincent was a resident of an ACSO facility, funded by the Department of Health and Human Services, his death was reported to the Coroners Court of Victoria.

6. Forensic Pathologist Dr Gregory Young of the Victorian Institute of Forensic Medicine performed a post mortem medical examination. Dr Young provided me with a report of his findings at autopsy. The post mortem examination revealed evidence of small bowel resection, with patchy mucosal ischaemic changes in the residual jejunum. There was no evidence of widespread peritonitis. Dr Young was of the opinion that Mr Vincent’s death was due to natural causes. Dr Young concluded that the cause of death was 1(a) small bowel ischaemia (operated) and 1(b) incarcerated umbilical hernia.

7. As part of my investigation, First Constable Colin Burge provided me with a coronial brief of evidence (the brief). The brief contains statements from Dr Craig French of the Western Hospital, Mr Vincent’s GP Dr Leah Curtis and Capello House Welfare Worker Diprensrasinh Gohil. It also contains statements from investigating police. I have relied on the totality of the material before me in setting out this finding,

8. On the material before me, I am satisfied that Mr Vincent was very unwell by the time he presented at the Western Hospital. There were no issues identified with his care at the Western Hospital.

Pursuant to section 73 (1B) of the Coroners Act 2008, I direct that this finding be published on the

internet in accordance with the rules.

I direct that a copy of this finding be provided to the following:

Mr Vincent’s family

Ms Belinda Maloney, Australian Community Support Organisation

First Constable Colin Burge

Signature:

PETER WHITE CORONER

Date: 26 July A ee