Half of all disability deaths in care over the past six years potentially could have been avoided, Queensland's public advocate has found in a damning review.
The landmark report warned of "catastrophic outcomes" if changes weren't made as the rollout of the National Disability Insurance Scheme increased the load on disability services in coming years.
The 73 deaths included cases where people with known swallowing difficulties choked to death because they were served the wrong meals.
It investigated 73 deaths between 2009 and 2014, including several cases of people with known swallowing difficulties choking to death because they were served the wrong meal.
"They were supposed to be given soft moist food cut into small pieces, but one man died after being given a burger and chips, another died after being given a piece of cake and another died after eating a sausage," Queensland public advocate Jodie Griffiths-Cook said.
"These deaths should never have happened and the remedy is relatively inexpensive – enhanced awareness through better information and training."
Other fatalities occurred after serious conditions went misdiagnosed or undiagnosed, including one woman who was thought to have asthma for years.
She died two days after eventual hospitalisation and x-rays found multiple advanced cancers in her chest.
Ms Griffiths-Cook warned the number of people accessing disability care was expected to double under the NDIS, potentially making the situation worse.
Of the 73 fatalities, the review found almost 60 per cent weren't expected to die just one day earlier.
Nearly half died in their 20s, 30s and 40s and 53 per cent were potentially avoidable.
The report noted Queensland government predictions the NDIS would increase the number of people seeking disability support from 45,000 to 97,000 and bring an extra 13,000 jobs to multiple sectors.
"Many of these 13,000 people may lack background knowledge and expertise in providing services and supports to people with disability," it reads.
"A targeted strategy to educate and inform people with disability, their families/carers, support staff, service organisations, health practitioners and the myriad of other relevant people and agencies in the broader community about health management and risk factors for people with disability is much needed.
"Without this, the lack of cohesion that is a notable feature in service provision for people with disability may result in catastrophic outcomes over coming years."
Ms Griffiths-Cook said the problems uncovered in her expert investigation had largely been hidden by a lack of systematic reporting and recommended the coroner report annually on deaths in care.
Disability services Minister Coralee O'Rourke said any death in care was one too many and some of the issues raised were "alarming".
"I've asked my Director General to work with the other relevant agencies to consider the recommendations, " she said
"Queensland has some of the most robust quality and safeguard requirements in the country to ensure the safety of people with disability, but clearly there is more to be done.
"My Department constantly reviews practices to make improvements and has a role in reviewing and investigating deaths in care, to ensure the safety of people with disability."