Coronial
NSWhospital

Inquest into the death of JBO

Deceased

JBO

Demographics

27y, female

Date of death

2023-07-28

Finding date

2025-12-19

Cause of death

Cardiac arrhythmia (first confirmed as ventricular fibrillation) of unascertained cause

AI-generated summary

A 27-year-old Aboriginal woman suffered sudden cardiac arrhythmia (ventricular fibrillation) immediately after recording video evidence of a suspected breach of her protective apprehended personal violence order (APVO). She had been assaulted 5 days prior, experiencing significant psychological trauma, anxiety, and hypervigilance whilst awaiting legal protection. She collapsed whilst documenting the alleged breach in video, suffered cardiac arrest, and could not be resuscitated despite 65 minutes of high-quality CPR. Autopsy revealed no structural abnormalities. Experts unanimously opined fatal arrhythmia was triggered by severe emotional/psychological stress superimposed on underlying cardiac predisposition (likely channelopathy such as long QT or Brugada syndrome). Clinical lessons: psychological trauma following violent assault carries serious physiological consequences requiring comprehensive mental health support; protection order enforcement must be coordinated to prevent re-traumatisation; recognition of stress-induced arrhythmia syndromes is critical in young people with unexplained collapse.

AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.

Specialties

emergency medicinecardiologyneurologygeneral practiceparamedicine

Error types

communicationsystemdelay

Drugs involved

amiodaroneadrenaline

Clinical conditions

cardiac arrhythmiaventricular fibrillationventricular tachycardiastress-induced cardiac syndromechannelopathy (long QT syndrome or brugada syndrome suspected)concussionpost-traumatic stressanxiety disorderacute trauma response

Procedures

cardiopulmonary resuscitationdefibrillationintubationendotracheal intubation

Contributing factors

  • Severe psychological trauma from violent assault 5 days prior
  • Ongoing anxiety, hypervigilance and fear following assault
  • Accumulation of stressors including assault on brother the day prior
  • Frustration and emotional distress at alleged breach of protection order
  • Underlying predisposition to cardiac arrhythmia (likely inherited channelopathy)
  • Acute adrenaline surge triggered by seeing the alleged perpetrator
  • Inadequate mental health follow-up post-assault

Coroner's recommendations

  1. A copy of these findings to be provided to Northern NSW LHD to inform policy development regarding care of deceased persons in hospitals and access for grieving families, particularly regarding cultural protocols for Aboriginal families
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