160 results
19y · Male·acute bacterial meningitis with secondary cerebritis (meningococcus)
Adam Fabre, a 19-year-old with fever, severe headache, neck pain, muscle pain (10/10), vomiting, tachycardia and blanching rash, presented to Casey Hospital ED at 3:45am on 14 July 2006. Despite expressing clear concern …
42y · Male·incised wound to the neck
Wesley Robert Jennings, a 42-year-old male with long-standing depression, anxiety, hepatitis C and substance use history, died by suicide by incised neck wound whilst on remand in prison. The coroner found no demonstrabl…
60y · Male·Hypertensive heart disease with chronic fatty liver as other significant conditi…
David Duggan, a 60-year-old man with hypertensive heart disease and cardiomegaly, was admitted to Caloundra Hospital on 10 January 2007 for management of severe acute back pain caused by a suspected L3/4 disc herniation …
45y · Male·intracerebral haemorrhage caused by rupture of arterial aneurysm
A 45-year-old man with an intracerebral haemorrhage from a ruptured aneurysm presented to an emergency department and general practice on multiple occasions in October 2005 with headache, vomiting, dizziness, and neck st…
62y · Male·Acute Gastrointestinal Haemorrhage in association with Acute on Chronic Peptic U…
Kenneth Charles Fox, 62, presented to Fremantle Hospital ED on 12 April 2006 with a gastrointestinal bleed after fainting. He was diagnosed with a massive bleed causing hypovolaemic shock and stabilized with fluid resusc…
47y · Female·Cardiac arrhythmia due to severe coronary artery atherosclerosis
A 47-year-old woman presented to a level one rural hospital with chest pain. The doctor diagnosed muscular pain (99% certain) and discharged her without troponin testing or admission, despite chest pain being the present…
36y · Male·morphine toxicity
A 36-year-old man with morbid obesity, possible sleep apnoea, and respiratory symptoms died from morphine toxicity after taking three 100mg MS Contin tablets within 6 hours, despite being opioid-naïve. He presented to ED…
31y · Female·right cerebellar cerebrovascular accident (cerebellar infarction with obstructiv…
31-year-old woman presented with acute onset headache, dizziness, vomiting, facial numbness and speech difficulties. Initial CT brain showed equivocal left temporal hypodensity. Dr B. diagnosed acute migraine/benign posi…
24y · Male·Aspiration pneumonia secondary to drug abuse and overdose of multiple drugs
A 24-year-old man with schizophrenia died from aspiration pneumonia following overdose of multiple drugs including diazepam, tramadol, morphine, and others. The day before death, he took excess diazepam to manage auditor…
31y · Female·Septicaemia following Acute Osteomyelitis following Fractures of the Left Leg
Isabelle Manyita, a 31-year-old Aboriginal woman, died from septicaemia following acute osteomyelitis complicating fractures of her left leg. She presented to Royal Darwin Hospital on 22 April 2005 with a tibial and fibu…
45y · Male·Coronary artery disease due to severe atherosclerosis; acute myocardial infarcti…
Mario Emmy Tyssen, a 45-year-old man in custody on approved leave, died suddenly while gardening from coronary artery disease due to severe atherosclerosis. He had a documented history of cardiac symptoms (chest pain pre…
23y · Female·drowning and citalopram overdose
23-year-old woman with major depressive disorder presented to multiple healthcare providers on 17 March 2004 with suicidal ideation. She was referred to Flinders Medical Centre Emergency Department by her GP, where she w…
29y · Female·respiratory depression caused by morphine intoxication on a background of upper …
A 29-year-old woman with infectious mononucleosis and severe sore throat died from respiratory depression caused by morphine intoxication with concurrent upper airway narrowing. A GP administered 30mg intramuscular morph…
29y · Male·Aspiration due to acute gastric dilatation
Mark Herricane, aged 29, died of aspiration from acute gastric dilatation during opioid withdrawal in custody at Arthur Gorrie Correctional Centre on 3 January 2002. Despite repeated intercom calls requesting medical hel…
34y · Male·Septicaemia resulting from Melioidosis
Warren Maminyamanja, a 34-year-old Aboriginal man, died from melioidosis septicaemia on 13 June 2004 whilst in custody at Darwin Correctional Centre. Clinical assessment for melioidosis was not considered, though expert …
25y · Male·cerebral craniopharyngioma
Gregory Andrew Furniss, a 25-year-old male with a history of asthma and congenital cataracts, presented to Swan District Hospital on 11 August 2002 with a persistent headache. He was seen by Dr H. (registrar) who diagnos…
41y · Male·haemorrhage due to incised wounds to left and right cubital fossae
Jeffrey Ronald Fredericks, aged 41, died in Adelaide Remand Centre custody from haemorrhage due to self-inflicted incised wounds to both cubital fossae. Critical clinical lessons: screening tools identified significant s…
12y · Female·raised intracranial pressure due to ventriculo-peritoneal shunt blockage
A 12-year-old girl with congenital hydrocephalus and a ventriculo-peritoneal shunt presented to the ED with severe unrelieved headache after head trauma. An inexperienced junior doctor (6 weeks in role, minimal neurosurg…
56y · Female·subarachnoid haemorrhage complicating berry aneurysm of the right middle cerebra…
Margaret Joyce Taylor, aged 56, died from subarachnoid haemorrhage due to rupture of a berry aneurysm on the right middle cerebral artery. She presented to three medical practitioners over 6 days with progressive occipit…
25y · Male·coronary thrombosis resulting from coronary atherosclerosis
A 25-year-old Aboriginal man with undiagnosed coronary artery disease collapsed and died one hour after a consultation at an Aboriginal health clinic. The coroner found the medical examination by Dr M. was inadequate and…
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