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QLDhospital2026-04-14

Inquest into the death of Francis Michael Fahey

70y · Male·Metastatic melanoma with ischaemic heart disease as a contributing condition

Francis Michael Fahey, a 70-year-old prisoner, died from metastatic melanoma with contributing ischaemic heart disease. He presented with a rapidly enlarging axillary mass in February 2023, confirmed as metastatic melano…

oncologygeneral medicinesystemdelayimmunotherapy
VIChospital2026-03-13

Finding into death of Wayne Ronald Watson

61y · Male·Intracranial haemorrhage and myocardial infarct

A 61-year-old man with extensive cardiac disease collapsed at a supermarket, striking his head and losing consciousness for less than 10 seconds. Paramedics identified STEMI and administered heparin on advice from Austin…

cardiologyemergency medicinediagnosticcommunicationheparin
SAcommunity2025-10-20

Coroner's Finding: Kennedy, John Douglas

65y · Male·Ischaemic heart disease on a background of hypertension

John Kennedy, 65, died from ischaemic heart disease with hypertension on 16 April 2020 after a 24-minute delay in ambulance dispatch. He called triple zero at 00:19 with severe chest pain and difficulty breathing (Priori…

emergency medicinecardiologycommunicationsystematenolol
VICcommunity2025-07-17

Finding into death of John Michael Jurdeczka

62y · Male·Hypoxic ischaemic encephalopathy complicating cardiac arrest in setting of acute…

John Michael Jurdeczka, a 62-year-old man with autism, intellectual disability, and dysphagia, died from hypoxic ischaemic encephalopathy following cardiac arrest caused by acute upper airway obstruction from a food bolu…

speech pathologygeneral practicecommunicationsystemmorphine
SAhospital2025-06-12

Coroner's Finding: Salter, Kathleen Ethel

76y · Female·multi-organ failure and sepsis due to complications of cholecystectomy

A 76-year-old woman died from multi-organ failure and sepsis following a laparoscopic cholecystectomy at a rural hospital. During surgery, the surgeon became misoriented in the inflamed surgical field and divided the com…

general surgeryanaesthesiadiagnosticproceduralapixaban
VIChospital2025

Finding into death of Ms NXA

54y · Female·neck compression secondary to hanging

Ms NXA, a 54-year-old woman with complex mental health conditions including depression, CPTSD, and anxiety, presented to hospital after a suicide attempt by overdose on 9 August 2021. She was experiencing severe tinnitus…

emergency medicinepsychiatrydiagnosticcommunicationdiazepam
VIChospital2023-08-01

Finding into death of Michele Valentino

81y · Male·Head injury sustained in a fall

Michele Valentino, 81, died from a head injury sustained in a fall on 20 December 2019, with death occurring on 24 December 2019. A CT angiogram at 3:45pm showed worsening intraventricular haemorrhage (IVH) that was not …

emergency medicineradiologydiagnosticcommunicationaspirin
VICprison2022-03-30

Finding into death of Charles Bertram Squires

76y · Male·Intracranial haemorrhage

Charles Bertram Squires, a 76-year-old prisoner on anticoagulant therapy (apixaban and aspirin), fell and struck his head on 26 January 2017. Nursing staff at the correctional facility inadequately assessed his traumatic…

emergency medicineneurosurgerydiagnosticcommunicationapixaban
QLDhome2021-06-15

Bradford, Teresa and Bradford, David - Non-inquest findings

40y · Female·Head injuries inflicted by axe blows in context of intimate partner domestic abu…

Teresa Bradford, aged 40, was killed by her husband David Bradford in a premeditated domestic homicide at their Pimpama home on 31 January 2017, followed by his suicide. She died from head injuries inflicted with an axe.…

general practicepsychiatrycommunicationsystemwarfarin
VIChospital2020-08-12

Finding into death of Antoine Alam

81y · Male·Injuries sustained in a motor vehicle collision (pedestrian)

81-year-old man struck by car while crossing Thompson Road in North Geelong to access a bus stop. He sustained severe head injuries with intracranial haemorrhage and bilateral haemothoraces and died at Alfred Hospital. T…

citalopram
VICcommunity2020-02-12

Finding into death of Stephen James Johnston

57y · Male·Complications of multiple blunt force injuries in a man with ischaemic heart dis…

Stephen Johnston, a 57-year-old man with ischaemic heart disease, obesity, depression and alcohol dependence, was assaulted on 7 December 2016 by Kevin Knowles and Amanda Bourke after an evening of drinking. Johnston suf…

emergency medicineintensive caredelayoxycodone
VIC2020

Finding into death of Bernice Edna Northover

89y · Female·Multiple injuries sustained in a motor vehicle incident (driver)

An 89-year-old woman died from multiple injuries sustained in a motor vehicle collision at a semi-rural intersection. She was driving a vehicle eastbound and turned right across the path of an oncoming vehicle travelling…

systematenolol
QLD2019-11-21

Gavenor, Ashley Glenfield

48y · Male·Coronary atherosclerosis and minor trauma

Ashley Glenfield Gavenor, a 48-year-old Indigenous man with coronary artery disease, hypertension, diabetes, and bipolar affective disorder, died in Townsville Correctional Centre following a brief altercation with anoth…

cardiologypsychiatryaspirin
VIChome2019-10-04

Finding into death of Trevor John O'Brien

63y · Male·Chest injuries

Trevor O'Brien, aged 63, died from chest injuries sustained while performing DIY maintenance on his caravan. He improperly used the caravan's jockey-wheel as a vehicle jack to support the vehicle's weight while working u…

proceduralamitriptyline
VICaged care2017-10-31

Finding into death of Baher Kondos

33y · Male·Sudden Unexplained Death in Epilepsy (SUDEP)

Baher Kondos, a 33-year-old man with epilepsy, intellectual disability, and schizophrenia, died suddenly at his supported accommodation facility. He was found unresponsive in bed and despite CPR, could not be resuscitate…

neurologypsychiatryclozapine
VIChome2016-07-29

Finding into death of Rodney Griffin

64y · Male·Foreign body associated small bowel obstruction

Rodney Griffin, a 64-year-old man with moderate intellectual disability and autism living in a community residential unit, died from small bowel obstruction caused by a 45mm quartz-like stone he had ingested. Despite a k…

general practicegastroenterologyatenolol
QLD2016-07-06

Mickelo, Garnett Allan

48y · Male·myocardial infarction due to coronary atherosclerosis (medically treated)

Garnett Mickelo, aged 48, died from myocardial infarction due to coronary atherosclerosis while in custody at Woodford Correctional Centre on 24 November 2012, shortly after discharge from Princess Alexandra Hospital fol…

cardiologycardiothoracic surgerymedicationcommunicationisosorbide mononitrate
VICmental health2014-08-04

Finding into death of Frederick Joseph Williamson

52y · Male·consistent with plastic bag asphyxia

Frederick Williamson, a 52-year-old man with chronic treatment-refractory schizophrenia, was found dead in the bathroom of his room at Austin Health's Secure Extended Care Unit with a plastic bag over his head, consisten…

psychiatryforensic medicinediagnosticsystemquetiapine
VIChospital2014-06-05

Finding into death of Constandia Petzierides

74y · Female·haemothorax secondary to dissecting thoracic aorta

Mrs Petzierides, a 74-year-old woman, presented to the emergency department with sudden-onset, severe left scapular pain radiating to the jaw, occurring shortly after midnight. She was assessed by an emergency medicine r…

emergency medicinecardiologydiagnosticcommunicationwarfarin
VIChospital2013-06-05

Finding into death of Lenin McLarty

68y · Male·Dilated cardiomyopathy with previous aortic valve replacement and aortic graft

A 68-year-old man with aortic valve replacement died from undiagnosed dilated cardiomyopathy, with retroperitoneal haemorrhage as a contributing factor. He developed a large perinephric haematoma (1900mL) secondary to ov…

cardiothoracic surgeryemergency medicinecommunicationsystemwarfarin

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