Inquest into the Death of Yvonne HENDERSON
Deceased
Yvonne Henderson
Demographics
female
Date of death
2010-12-06
Finding date
2015-11-25
Cause of death
Multiple injuries
AI-generated summary
Yvonne Henderson was a middle-aged woman with chronic delusional disorder who died in a motor vehicle collision on 6 December 2010 while on approved leave from psychiatric hospitalisation. She was an involuntary patient in Albany Hospital's mental health unit. The coroner found her death accidental, resulting from inattention while driving. Although she was granted leave as part of a therapeutic strategy to encourage treatment engagement, critical procedural failures occurred. No documented risk assessment was conducted before granting leave or allowing vehicle access. Independent psychiatric experts confirmed neither her mental illness nor her medications impaired her driving ability. The coroner identified systemic failures in documentation and procedures rather than flawed clinical judgment. Albany Hospital subsequently implemented comprehensive reforms, including mandatory risk assessments and restrictions on involuntary patients' vehicle access.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
Specialties
Error types
Drugs involved
Contributing factors
- Involuntary psychiatric patient granted leave of absence without documented risk assessment
- No documented assessment of fitness to drive before vehicle access
- Lack of clear hospital policy regarding vehicle access for involuntary patients
- Driver inattention or distraction while operating vehicle
- Possible mental state affected by frustration following police station encounter
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