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VIChospital2025-01-28

Finding into death of Dustin Buckley

17y · Male·Gunshot wound to the head

Dustin Buckley, 17, died from a gunshot wound to the head at Royal Melbourne Hospital on 27 August 2017. The incident occurred during target shooting at Cat Track when KD fired a .22 rifle that discharged, striking Dusti…

trauma surgeryemergency medicinesystemproceduralmidazolam
TASaged care2025-01-24

Coroner's Finding: Sheedy, Alan Noel

86y · Male·Traumatic closed head injury suffered in a fall

Alan Noel Sheedy, 86 years old, died from traumatic closed head injury sustained in a fall at a residential aged care facility. He had been admitted for respite care following previous falls and was assessed as moderate …

geriatric medicineneurologylevetiracetam
NSWaged care2025-01-24

Inquest into the deaths at Newmarch House

Unknown·COVID-19 infection with various comorbidities as contributing factors

This inquest examined 19 COVID-19 deaths at Newmarch House residential aged care facility in April-May 2020. Deaths occurred during inadequate infection control, severe staffing shortages, and suboptimal clinical managem…

geriatric medicineinfectious diseasessystemdiagnosticmorphine
WAAugust 2024

Inquest into the Death of Robert Allan EXELL

55y · Male·Complications of liver cirrhosis and hepatocellular carcinoma in a man with mult…

Robert Exell, a 55-year-old Aboriginal man, died from complications of liver cirrhosis and hepatocellular carcinoma while in custody. He had chronic hepatitis C and alcohol-related liver disease since at least 2012. Key …

hepatologygastroenterologydelaysystemmorphine
VIC2024-12-16

Finding into death of Caroline Monique Hall

52y · Female·Spinal injuries sustained in falls in a woman with multiple medical comorbiditie…

Caroline Monique Hall, a 52-year-old woman with intellectual disability, epilepsy, schizophrenia, and multiple comorbidities living in supported disability accommodation, died from spinal injuries sustained in falls. She…

general practiceemergency medicinediagnosticdelaymorphine
VICcommunity2024-12-09

Finding into death of Forrest Caves Beach Accident

Unknown·Drowning (Reema Sondhi, Jagjeet Singh Anand, Kirti Bedi); Complications followin…

Four members of a family group from India drowned at Forrest Caves Beach, Phillip Island on 24-25 January 2024. All four deceased had limited or no swimming ability and no experience with Australian ocean conditions. The…

amlodipine
NSWhome2024-11-28

Inquest into the death of Michael Peachey

27y · Male·Cardiac arrest due to cardiac arrhythmia triggered by prone restraint (some of w…

Michael Peachey, a 27-year-old First Nations man, died in custody following a police-initiated restraint during an acute psychotic episode. Over preceding days, his family repeatedly sought mental health intervention. On…

emergency medicinepsychiatryproceduralcommunicationdroperidol
VIChospital2024-11-26

Finding into death of Zarif Haidary

20y · Male·Multiple injuries sustained in a motor vehicle incident (driver)

A 20-year-old male died from multiple injuries sustained in a head-on motor vehicle collision. He was driving a utility vehicle at 153-161 km/h in a 70 km/h zone, overtaking other vehicles on the wrong side of the road a…

trauma surgeryintensive carefentanyl
VIChospital2024-11-19

Finding into death of Daniel Surtees

36y · Male·Complications of thermal burn injuries

Daniel Surtees, aged 36, died from complications of extensive thermal burn injuries (>80% body surface area) sustained during a domestic violence incident. After consuming 14 cans of bourbon at a party, Daniel returned h…

plastic and reconstructive surgeryintensive caremorphine
WAhospital2024-11-13

Inquest into the death of Chloe Grace Tupper

31y · Female·organ failure due to anorexia nervosa

Chloe Tupper died of organ failure due to severe anorexia nervosa at age 31. She had suffered from this illness for 17 years since age 14, receiving multiple episodes of hospital-based refeeding that never achieved lasti…

psychiatrypaediatricssystemcommunicationmirtazapine
VIC2024-11-12

Finding into death of Master K

2y · Male·Drowning

Master K, a two-year-old, drowned in a hotel pool after falling from a step into the deeper adult pool section. He remained unnoticed underwater for over nine minutes while his mother was distracted by her mobile phone, …

communicationsystemmorphine
VIChospital2024-10-24

Finding into death of Tamara Kudeviita

59y · Female·Pneumonia

Tamara Kudeviita, a 59-year-old woman with Down's syndrome and advanced Alzheimer's disease, died of pneumonia in a palliative care unit. She had been declining throughout 2022, with loss of swallowing ability, mobility,…

palliative caregeneral practicemidazolam
QLDhospital2024-10-18

Findings into the death of John Ainsworth

68y · Male·Cerebrovascular disease

John Raymond Ainsworth, a 68-year-old prisoner, died of cerebrovascular disease following a severe stroke on 25 November 2020. He had poorly controlled Type II diabetes, hypertension, and high cholesterol. Prior to his a…

neurologyemergency medicinedelaymetformin
VIChospital2024-10-11

Finding into death of Maria Presti

62y · Female·Aspiration pneumonia secondary to cerebral palsy

Maria Presti, 62-year-old non-verbal woman with cerebral palsy and dysphagia living in specialist disability accommodation, died from aspiration pneumonia with acute kidney injury and severe hypernatremia. She was admitt…

respiratory medicineinfectious diseasesantibiotics
QLDaged care2024-10-10

Non-inquest findings into the death of Jean Alice Dowson

79y · Female·Chronic obstructive pulmonary disease

Jean Alice Dowson, 79, died in an aged care facility after being commenced on end-of-life medications. She had severe COPD and was frail (29kg). On 10 April 2017, when she deteriorated with respiratory distress, a Clinic…

general practicepalliative caremedicationdiagnosticmorphine
VIC2024-09-23

Finding into death of Gerard Richard Bailey

64y · Male·End stage Alzheimer's Disease secondary to Trisomy 21

Gerard Richard Bailey, a 64-year-old man with Down syndrome and Alzheimer's disease, died from end-stage Alzheimer's disease at Bendigo Hospital following a series of seizures. He had recently been diagnosed with epileps…

neurologyemergency medicinemidazolam
VIChospital2024-09-17

Finding into death of Hannah Gray

34y · Female·Aspiration pneumonia in a woman with cerebral palsy and Lennox-Gastaut syndrome

Hannah Gray, a 34-year-old woman with cerebral palsy and Lennox-Gastaut syndrome living in specialist disability accommodation, died from aspiration pneumonia. She had experienced progressive health deterioration over th…

neurologygeneral practicecannabidiol
VIChospital2024-08-21

Finding into death of Hayley Michelle Impey

50y · Female·Aspiration pneumonia, with epilepsy with frequent seizures as contributory cause

Hayley Michelle Impey, aged 50, died from aspiration pneumonia complicated by epilepsy with frequent seizures. She presented with status epilepticus requiring intubation and transfer to a tertiary hospital. She was extub…

emergency medicineintensive careclonazepam
QLDaged care2024-08-15

Non-inquest findings into the death of Charlotte Paluszak

84y · Female·Complications associated with Diabetes Mellitus (likely hyperosmolar hyperglycae…

Mrs Charlotte Paluszak, 84, died at a residential aged care facility after rapid deterioration from complex dementia and diabetes. On 10 November 2017, she developed acute semiconsciousness and agitation. The clinical nu…

geriatric medicinepalliative caremedicationdiagnosticmorphine sulphate
QLDaged care2024-08-15

Non-inquest findings into the death of Donald Richard Gunthorpe

81y · Male·Carcinoid tumour (metastasis) / metastatic cancer

Donald Richard Gunthorpe, an 81-year-old man with metastatic rectal carcinoma, was appropriately transitioned to end-of-life (palliative) care at a residential aged care facility after hospitalisation for abdominal pain.…

palliative caregeneral practicemedicationdocumentationmorphine

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