In addition, this factor was identified by the Coroner as resulting from James vomiting up plant material that he had eaten at an unspecified point prior to his death.įollowing a post-mortem examination, it was also revealed that James had had a hard mass of plant material in his stomach, the medical term for which is a ‘phytobezoar’.
The cause of his death was recorded by HM Coroner as the ‘obstruction of his airway and/or cardiac arrest’. This was a very positive move for James as previously two other (brief) adult placements had not worked out. As a result, James was unable to keep himself safe and required a significant amount of care.Ī few months prior to his death, James had moved to a new residential setting and he was reportedly settling in. Throughout his life, many of his behaviours had been described as very ‘challenging’ and included self-injury and anxiety. James Frankish was autistic, had a learning disability and pica, all of which were considered to be ‘severe’. What we do know is that pica can be compulsive, very dangerous and preventing it can also be very difficult (Sturmey & Williams, 2016).
People engaging in pica often have highly specific preferences for consuming items such as: Pica is also reported across the world, and throughout history, with stories of people eating coal and earth documented as far back as Roman times (Parry-Jones & Parry-Jones, 1992). In this latter group pica is reported to be often more severe (Matson et al, 2011). Pica as a medical term refers to the persistent eating of non-nutritive, or non-food, items (American Psychiatric Association 2013).Ĭases of pica are reported in many different groups including pregnant women and in people with a learning or intellectual disability and/or are autistic. Pica is the Latin name for ‘magpie’, a well-known bird that reputedly collects and eats almost anything. We hope that anyone who is negatively affected by the content and/or the circumstances of James’s death will be able to seek appropriate support1. These are not intended to shock, but rather to tell James's story and emphasise the very real dangers pica behaviour can present to the individual who engages in it. Out of necessity, some disturbing details are recounted in this article. This article accompanies another on practical guidelines for the management of pica. In addition, it highlighted lessons to be learnt, some of which this article will examine. It should be said at the outset that the Coroner’s Inquest into James’s death (which took place in 2017) recorded a ‘narrative’ conclusion due to the many and complex factors involved. By recalling the events that led to his death, we hope to both honour James’s memory and take a step towards preventing what happened to him afflicting anyone else. It has a single purpose: to educate the autism community about what led to his death, namely his pica (or the eating of non-foods, see box out). This article is written at the request of, and in collaboration with, James's parents and family. Very sadly I discovered all of this after he died, and during the inquest into his tragic and untimely death in 2016. I quickly heard how full of life he was, how challenging his behaviour could be, and, most of all, how much he was loved. I never had the opportunity or good fortune to meet James, but I heard a lot about him from those that knew him best: his family and those who cared for him in his home. After explaining what pica is, Dr Shea then explores James' story and the lessons that need to be learnt as a result of his death. Gift Aid and making your donation go furtherĭr Liz Shea from the Birmingham Food Refusal Clinic tells the story of James Frankish, a young autistic man who sadly died from issues related to pica. Our patron, president and vice presidents
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