Deceased
Dominic Joshua Clifford
Demographics
23y, male
Coroner
Deputy State Coroner Paresa Spanos
Date of death
2024-09-21
Finding date
2026-01-08
Cause of death
Plastic bag asphyxia in setting of irrespirable atmosphere induced by nitrogen gas inhalation
AI-generated summary
Dominic Joshua Clifford, a 23-year-old with a complex history of mental illness including depression, anxiety, ADHD, and likely autism spectrum disorder, died by nitrogen gas inhalation in September 2024. He had multiple prior suicide attempts and was under care of various mental health services. On 9 September 2024, he consulted with Dr Anthony Gallagher who changed his medication from aripiprazole/olanzapine to mirtazapine/brexpiprazole with oxazepam. Mr Clifford reported being non-suicidal at that visit. The coroner found no clinical fault in Dr Gallagher's management, noting Mr Clifford appeared to respond positively to the new medication in the intervening period before his death 12 days later. The coroner used this case to highlight ongoing concerns about public access to nitrogen gas cylinders without restriction and the need for design modifications and regulatory changes to prevent inert gas inhalation suicides.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.
Specialties
Drugs involved
Clinical conditions
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