Finding into death of Raymond John Cox
Deceased
Raymond John Cox
Demographics
84y, male
Date of death
2014-05-03
Finding date
2018-06-28
Cause of death
Gunshot wound to the head
AI-generated summary
Raymond John Cox, an 84-year-old man with Alzheimer's disease, depression, and cognitive decline, died from a self-inflicted gunshot wound to the head. His wife had approached police in 2013 seeking assistance to remove his firearm, expressing safety concerns about his deteriorating mental state and physical frailty. Police advised she could not surrender the gun as she was not the licence holder. She subsequently secured the gun in a cabinet with the key hidden. However, Mr Cox managed to access the gun cabinet (possibly using tweezers to pick the lock) and fatally shot himself on 3 May 2014. The coroner found that Mrs Cox's initial police approach represented a missed opportunity for intervention. Had a formal mental health assessment and firearms licence review been conducted at that time, the death may have been preventable. The coroner noted that clearer guidance to the treating general practitioner about reporting to police might also have helped trigger a suitability review.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Error types
Drugs involved
Clinical conditions
Contributing factors
- Alzheimer's disease with progressive cognitive decline
- Depression and low mood
- Awareness of disease progression and future institutionalization
- Availability of firearm in the home
- Inadequate mental health assessment of firearm licence suitability
- Police member did not escalate wife's concerns about mental health to supervisory staff
- Lack of clear guidance to healthcare professionals about reporting mental health concerns to police firearms licensing division
- Wife's attempt to secure firearm was insufficient as patient managed to access it
Coroner's recommendations
- The coroner directed that a copy of this finding be provided to the family of Raymond Cox, Dr S., Leading Senior Constable Stuart Pritchard at Mansfield Police Station, and relevant government and police authorities.
- Implicitly recommended enhanced training and protocols for police members receiving enquiries about relinquishing firearms, particularly where mental health concerns are raised.
- Support for the 'Quick Guide: The Role of Health Professionals in the Firearm Licensing Process' that was developed following the Peter Quin-Conroy finding and issued in December 2014 (post-dating this death but addressing the identified gap).
Full text
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