Report for Coroner Dr. Eleanor Vance
Concerning the Coronial Inquest into the death of Mr. David Miller
Mr. David Miller was a registered patient at our medical practice from 2018. I was his general practitioner, providing ongoing primary healthcare services and supportive medical care from 12th January 2018 until 10th October 2024, when he sadly passed away.
Summary of Medical and Mental Health Background:
Mr. Miller had a history of depression, diagnosed in 2019. He was also diagnosed with hypertension in 2021, which was managed with medication. He reported occasional alcohol use, but denied any substance abuse.
Symptoms, Investigations, and Outcomes:
Mr. Miller presented with increasing fatigue and low mood in the months leading up to his death. Blood tests were conducted, revealing slightly elevated liver enzymes, but no definitive diagnosis was made. A referral to a gastroenterologist was pending.
Medication Changes:
Mr. Miller's antidepressant medication, Sertraline, was increased from 50mg to 100mg daily in July 2024 due to worsening depressive symptoms. His antihypertensive medication, Lisinopril, remained unchanged.
History of Suicidality:
Mr. Miller reported suicidal ideation on several occasions, particularly during periods of low mood. He had a previous suicide attempt in 2020, for which he received counselling.
Mental Health Treatment and Referrals:
Mr. Miller received regular counselling sessions with a local therapist. He was also referred to a psychiatrist in 2020 following his suicide attempt, but did not attend the appointment.
History of Alcohol or Drug Abuse:
Mr. Miller reported occasional alcohol use, but denied any substance abuse.
Last Consultation:
Mr. Miller's last consultation was on 5th October 2024. He reported feeling increasingly hopeless and fatigued. The plan was to review his blood test results and follow up with the gastroenterologist referral. He was also encouraged to continue with his counselling sessions.
Stressors:
Mr. Miller reported significant stressors, including ongoing physical health symptoms and lack of a definitive diagnosis, which contributed to his low mood.
Mental Health Act Status:
Mr. Miller was not under the Mental Health Act.
Further Information:
Relevant documentation, including clinical notes and blood test results, are available for review. All clinical notes from January 2024 to October 2024 are included.
Sincerely,
Dr. Sarah Jones
MBBS, MRCGP
123 High Street, Anytown, UK
