Case Report Highlights Vigilance for Electroconvulsive Therapy Preprocedural Fasting

This case report describes an instance of aspiration in a 50-year-old male who surreptitiously broke his fast before his second Electroconvulsive therapy despite multiple fasting confirmations and strict food security measures, leading to subsequent necessitating intensive care unit management. Although not confirmed, there was high suspicion of intentional sabotage. This case highlights the importance of ensuring fasting compliance in psychiatric patients and encourages clinicians to practice vigilance in patients who may be considered high risk and falsify fasting adherence.