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October 8, 1982

Aspiration of Food by Psychiatric Patients

JAMA. 1982;248(14):1712. doi:10.1001/jama.1982.03330140026023

To the Editor.—  As Mittleman and Wetli indicated in their article entitled "The Fatal Cafe Coronary: Foreign-Body Airway Obstruction" in The Journal (1982;247:1285), their purpose was to isolate the factors predisposing a person to this cause of sudden death and, in this connection, found that their data showed a meaningful number of such fatalities in institutionalized persons with evidence of mental retardation or senility. However, they did not refer to accidental deaths of this sort in chronic schizophrenic patients, and, for this reason, I wonder whether they had not encountered this particular fatal syndrome in patients afflicted with this particular type of mental illness.For many years, both before and after the introduction of phenothiazines or other neuroleptic drugs, such a case of sudden death has been reported. In my discussion of this syndrome in my book, under the rubrics of alimentary strangulation,1 I have emphasized that the important