Capgras syndrome among illnesses suffered by morbidly obese man, Tasmanian coroner finds - ABC News

Tasmania's coroner has revealed the harrowing story of a man described as an "athletic and talented child" who was found in his room alone, dead at just 36 years of age, from complications of morbid obesity after a long battle with mental illness.

Key points:

• The coroner praised staff at Bayview Lodge for their treatment of the deceased man 
• He also acknowledged the man was a "challenging patient" due to his several ailments
• It was staff at Bayview Lodge who found the man, deceased, in his room

The investigation into the 2019 death of Dwayne Edward Rosendale has revealed he was plagued by hallucinations and delusions so severe that he once attacked his own mother or, as coroner Simon Cooper wrote, "A life terribly impacted by mental illness". 

Mr Rosendale was in his late teens and living in Tasmania, when he began to struggle with mental health issues, suffering from hallucinations and "significant and damaging delusions", Mr Cooper noted. 

Impostor delusion leads to 'brutal attack'

In 2000, the year he turned 18, Mr Rosendale returned to New South Wales where he was formally diagnosed as suffering with schizophrenia.

"From this time on, Mr Rosendale's mental illness dominated the rest of his life," Mr Cooper wrote, adding "while ill and delusional, he committed assaults, including one especially brutal attack on his mother."

That attack, in which his mother was seriously injured, saw Mr Rosendale charged, convicted and sentenced to prison.

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The coroner said the assault was "doubtless attributable" to his diagnosis of Capgras syndrome, in which he came to believe his mother had been replaced by an impostor.

In 2008, Mr Rosendale returned to Tasmania, where responsibility for his care was assumed by the Statewide Mental Health Services.

He found a home at Bayview Lodge, a supported accommodation facility run by Anglicare for people at risk of homelessness because of mental or physical illness or for some other reason.

But he was evicted, due to his behaviour, in 2013, but returned in March 2017, where he would remain until his death.

The problem was, as Mr Cooper wrote, the lodge could not cope with Mr Rosendale's complex behaviours, nor was it set up to.

"It is very clear though that, in the last year or so of his life, the staff were struggling to cope with Mr Rosendale's challenging behaviour," the coroner wrote.

"Real concerns existed about his ballooning weight, and the staff could do nothing about his health."

Junk diet worsens health problems

Mr Rosendale's weight issues were exacerbated by the fact he held the delusion that he suffered from sickle cell anaemia and a form of undiagnosed neurological disorder which prevented him from walking.

"These beliefs meant he was unable to exercise, essentially because he believed he could not," Mr Cooper noted.

"He was undoubtedly a challenging patient, presenting as he did with a complex mixture of mental and physical infirmity."

Mr Cooper wrote that the manager of the lodge had already raised concerns about Rosendale's health with Forensic Mental Health Services (FMHS) and there had been discussions about moving him to a more suitable facility.

"Nonetheless, Mr Rosendale remained living at Bayview Lodge, eating junk food, drinking fizzy cordial and raiding the fridges while his weight increased and his health substantially declined," Mr Coroner noted.

In January of 2019, Mr Rosendale began experiencing "significant breathing problems" and was taken to the Royal Hobart Hospital, staying for 11 days before returning to Bayview Lodge.

Management at the lodge were unaware he was returning, Mr Cooper wrote, adding "it is not an exaggeration to say staff were shocked and surprised to see him".

Staff discover body

About 1pm on January 17, two staff members at Bayview Lodge noticed that they hadn't seen Mr Rosendale all day.

After knocking on his door and receiving no response, they opened the door where they found him "obviously dead, lying on his back in his bed".

An autopsy the next day found Mr Rosendale weighed 183.5 kilograms, with a body mass index of 45.3 and his heart weighing in at 625 grams.

The doctor who performed the autopsy said the cause of death was "complications of morbid obesity" and that Mr Rosendale had choked on his own vomit, an opinion Mr Cooper agreed with.

In his coronial report, Mr Cooper said "without constant supervision" by others "in relation to his food and calorific intake", it was "in practical terms impossible to stop him gaining weight, let alone lose any".

"Bayview Lodge staff knew they were struggling with Mr Rosendale and had conveyed this repeatedly over a considerable period of time, but Mr Rosendale remained housed where he was," Mr Cooper wrote.

"The fact he was inappropriately housed was identified before 24 August 2018. A number of discussions occurred about rehousing Mr Rosendale, but none of them achieved an outcome."

Mr Cooper noted that even a shift to other facilities at Tolosa Park or Millbrook Rise "may not have prevented his death".

"But I consider, on the evidence, it would have given him at least a chance to address his morbid obesity and would have ensured greater compliance with his medication regime," Mr Cooper concluded.

He said the issue of "supervision of medication for residents at Bayview Lodge or similar facilities requires attention and clarification" and noted the communication by Royal Hobart Hospital relating to Mr Rosendale's return to Bayview Lodge was "poor".

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