Deceased
Terry Grady
Demographics
59y, male
Coroner
Decision ofState Coroner O'Sullivan
Date of death
2019-08-09
Finding date
2024-12-11
Cause of death
Hanging
AI-generated summary
Terry Grady, a 59-year-old man with a history of alcohol dependence, depression, and chronic pain, died by suicide in custody at Parklea Correctional Facility on 8-9 August 2019. He was bail-refused for domestic violence charges and held for only two days before his death. Key clinical issues identified: delayed provision of his antidepressant Pristiq (due to incomplete release of information), and potential medication withdrawal effects increasing suicide risk. An independent psychiatrist noted that while Pristiq discontinuation can cause withdrawal symptoms increasing suicide risk within 1-5 days, Mr Grady had multiple risk factors (alcohol dependence, chronic pain, depression, recent incarceration stress). The coroner found no fault with the two-day medication delay, noting correctional facility protocols differ from standard clinical practice. Improvements since death include enhanced medication reconciliation procedures, updated withdrawal management policies, and ligature-risk reduction in cells. The death highlights the importance of rapid medication reconciliation in custody settings and recognition of acute suicide risk in newly incarcerated individuals with complex mental health and substance use histories.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.
Specialties
Error types
Drugs involved
Clinical conditions
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PE, aged 53, died by hanging in Parklea Correctional Centre on 3 February 2024, four days after entering custody for the first time on remand. The coroner found PE's death was self-inflicted at a time of emotional turmoi…
28y · Male·In keeping with Hanging
A 28-year-old man with a history of depression, anxiety, and previous self-harm died by hanging during a police response to a domestic violence incident. Police attended after his sister reported he had breached an ADVO …
39y · Male·Hanging
A 39-year-old man died by hanging on 16 February 2023 at his home in St Marys, NSW. His mother requested a police welfare check at 8:40pm after he posted a suicide note on Facebook at 2:30pm. Police attended twice (11pm …
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