Coroner's Finding: Wayne Lawler
Deceased
Wayne Lawler
Date of death
2009-07-30
Finding date
2011-05-26
Cause of death
Coronary Artery Thrombosis due to Coronary Artery Atherosclerosis
AI-generated summary
Wayne Lawler died on 30 July 2009 from Coronary Artery Thrombosis due to Coronary Artery Atherosclerosis (acute myocardial infarction) at Concord Hospital. An inquest was held in May 2011 before State Coroner Mary Jerram. The coroner's findings confirmed the cardiac cause of death and focused on the ambulance service response. The coroner recommended that the Ambulance Service institute a requirement (where possible) that paramedic interns be assigned only to ambulance units with a fully qualified paramedic present. This recommendation suggests potential concerns about the adequacy of pre-hospital paramedic response and supervision. The case underscores the clinical importance of ensuring proper supervision and staffing protocols in emergency ambulance services, ensuring less experienced paramedic staff are adequately supported by fully qualified personnel to deliver optimal pre-hospital care in acute cardiac emergencies.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Specialties
Error types
Clinical conditions
Contributing factors
- paramedic supervision gap
Coroner's recommendations
- The Ambulance Service should consider instituting a requirement that a paramedic intern only be assigned to an ambulance unit with a fully qualified paramedic present, if and wherever possible
Full text
Related cases
Source and disclaimer
This page reproduces or summarises information from publicly available findings published by Australian coroners' courts. Coronial is an independent educational resource and is not affiliated with, endorsed by, or acting on behalf of any coronial court or government body.
Content may be incomplete, reformatted, or summarised. All court orders for redaction and non-publication are respected; documents with technically defective redaction have been excluded from the database entirely. Always refer to the original court publication for the authoritative record.
Copyright in original materials remains with the relevant government jurisdiction. AI-generated summaries and tagging are for educational purposes only, may contain inaccuracies, and must not be treated as legal documents. We welcome feedback for correction —