3,476 results
34y · Female·Pneumonia in a woman with intellectual disability and asthma
Simone Grigg, a 34-year-old woman with intellectual disability and asthma, died from pneumonia. She was living in DHHS supported accommodation and attending Amicus day services. On 21 November 2017, she developed respira…
32y · Male·Head injuries sustained in a motor vehicle incident (pedestrian)
Richard Powell, a 32-year-old with a history of violent behaviour and methamphetamine use, died from head injuries sustained in a motor vehicle incident while assaulting his domestic partner. This case reveals critical f…
33y · Female·Multiple Injuries
Simone Quinlan, a 33-year-old woman with a history of substance misuse and homelessness, was murdered on 25 August 2015 by her partner Brendan Neil and his associate Wayne Marmo in circumstances of intimate partner viole…
81y · Female·Aspiration pneumonia in an elderly lady
An 81-year-old woman with intellectual disability, phenylketonuria, and severe dysphagia died from aspiration pneumonia following repeated admissions for the same condition. She had been assessed as 'very high risk of as…
42y · Male·Asphyxia due to traumatic compression of the chest and airway caused by roof col…
Todd Andrew Carver, a 42-year-old truck driver, died in a rollover of a prime mover and fish tanker on Esperance Coast Road, Tasmania on 13 July 2014. He died of asphyxia when trapped in the crushed cabin. The investigat…
8y · Male·acute exacerbation of chronic asthma
An 8-year-old boy with undertreated chronic asthma presented to North West Regional Hospital with acute exacerbation. Initial assessment underestimated severity. Despite initial improvement with salbutamol, ipratropium a…
59y · Male·Head injuries sustained when struck by a falling tree
A 59-year-old man died from severe head injuries sustained when struck by a falling tree during tree felling operations on a rural property. He was working with his employer who used a tractor to push over dead trees whi…
30y · Male·Hanging
Joshua Stachor, aged 30, died by hanging in Yatala Labour Prison on 19 November 2017. He was a remand prisoner on charges of domestic violence. The coroner found critical failures in his admission assessment on 6 Novembe…
74; 30y · Male; male·Sestilio Malaspina: stab wound to the chest; Hassan Khalif Shire Ali: gunshot wo…
A 74-year-old Italian-Australian, Sisto Malaspina, was fatally stabbed during a terrorist attack in Melbourne's CBD on 9 November 2018. Hassan Khalif Shire Ali, aged 30, detonated an improvised explosive device in his ve…
74; 30y · Male; male·Sestilio Malaspina: stab wound to the chest. Hassan Khalif Shire Ali: gunshot wo…
On 9 November 2018, Hassan Khalif Shire Ali committed a premeditated ISIS-inspired terrorist attack in Bourke Street, Melbourne, using an improvised explosive device in his vehicle followed by a knife assault. He fatally…
23y · Male·multiple injuries sustained in head-on motor vehicle collision
Jordan Thorsager, a 23-year-old motorcyclist, was killed in a head-on collision with a car driven by Kylee King, who was evading police while under the influence of methylamphetamine (20 times the impairment threshold). …
46y · Male·Haemopericardium complicating aortic dissection
A 46-year-old man with untreated hypertension and smoking history presented to the ED with acute chest pain radiating to jaw and back. ECG showed changes initially interpreted as NSTEMI with troponin elevation. A cardiol…
48y · Female·Hypoxic/Ischaemic Encephalopathy; Aspiration of Food with Respiratory Arrest wit…
Kathryn O'Rourke, aged 48, a resident with severe intellectual disability and dysphagia in a disability residential care facility, aspirated a piece of toast during breakfast on 10 May 2018 and died from hypoxic-ischaemi…
3y · Female·bronchopneumonia in an infant with obstructive sleep apnoea
A 3-year-old Aboriginal girl died from bronchopneumonia complicated by severe obstructive sleep apnoea. She had rapid-onset childhood obesity (36 kg at death; normal weight 14-16 kg) with multiple cardiopulmonary complic…
Male·Mr Gleeson: fatal chest injuries from fall; Mr Lucas: chest and abdominal injuri…
Three mining deaths at Mount Lyell Mine in Tasmania. Craig Gleeson and Alistair Lucas fell 22 metres down a shaft on 9 December 2013 while replacing flask linkages on an unsafe, unsecured timber platform over a 35-metre …
12y · Female·Undetermined (asphyxiation or choking)
Tiahleigh Palmer, age 12, was murdered on 29 October 2015 by her foster carer Richard Thorburn, who asphyxiated or choked her. The coroner identified critical systemic failures including: inadequate permanency planning b…
47y · Male·acute alcohol intoxication
Julian Horne, 47, died from acute alcohol intoxication at home after 11 hospital admissions in 6 weeks during a severe binge relapse. He had lifelong struggles with alcohol, depression and anxiety, previously tried multi…
43y · Male·Drowning as a consequence of capsized boat
Martin Sydney Cunningham, 43, died by drowning after the fishing vessel Cygnet Lass collided with the tugboat Svitzer Nana near Bowen, Queensland on 25 May 2016. Both vessels were operating on autopilot in a crossing sit…
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.…
49y · Male·hanging
A 49-year-old man with severe schizoaffective disorder died by hanging in his prison cell while serving a 16-year sentence for murdering his three children. Despite a chronically high suicide risk and prior suicide attem…
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