I’ve worked in healthcare my whole adult life. People do die from such instances.
When you accidentally inhale your food, a healthy person has a good chance of being able to cough it out. An elderly person, immunocompromised person, or people with certain disabilities may not be able to cough it out properly.
The food/fluid then stays there and causes aspiration pneumonia.
Some people also have a condition called dysphagia. There’s a tiny flap of skin that is meant to cover the windpipe when you’re swallowing food/fluid and open when breathing. This doesn’t work properly for people with dysphagia, and they end up with food/fluid going ‘down the wrong hole’. People with this condition are at great risk of aspiration pneumonia.
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