3,476 results
63y · Female·Pulmonary thromboembolism
A 63-year-old woman died from pulmonary thromboembolism within 24 hours of bilateral total knee arthroplasty despite aspirin and sequential compression devices. The surgeon assessed her as standard risk and did not presc…
15y · Female·Unknown - insufficient evidence for finding
This coronial finding concerns the disappearance and suspected death of Katrina Bohnenkamp, a 15-year-old girl in state care who was last seen on 26 October 2012. While not a traditional medical case, the finding highlig…
91y · Male·Complications following cardiac arrest in the setting of anaesthetic induction d…
A 91-year-old man with COPD, asthma, and previous cardiac arrest from suxamethonium died from complications following anaphylaxis to rocuronium during anaesthetic induction for emergency small bowel obstruction surgery. …
17y · Male·Hanging
A 17-year-old male with a history of mental health concerns, prior suicide pact attempt, and escalating aggressive behaviour died by hanging shortly after being excluded from his home via a Family Violence Intervention O…
5y · Female·aspiration of vomit with microscopic early pneumonia, in a child with a history …
A five-year-old girl with cerebral palsy and epilepsy resulting from non-accidental head injuries at two months old died from aspiration of vomit with early pneumonia. Critical lessons: bruising in non-ambulant infants i…
54y · Male·Hypoxic-ischaemic brain injury attributed to cardiac arrest due to choking
A 54-year-old man with paranoid schizophrenia died of hypoxic-ischaemic brain injury from choking on food whilst in seclusion in a psychiatric intensive care unit. Key failures included: unsupervised provision of food to…
23y · Male·Effects of fire
Harley Larking, a 23-year-old Aboriginal man with treatment-resistant schizoaffective disorder, died from effects of fire on 13 May 2016 while absconding from a psychiatric unit. He was on clozapine for only two weeks wh…
44y · Male·compression of the neck consequent upon hanging
A 44-year-old man with a 42-year history of intimate partner violence died by hanging. He had recently separated from his wife and was enrolled in a 18-week men's behaviour change program, having completed 17 of 18 sessi…
23y · Female·multiple blunt force injuries from fall from height
Grace Herington, 23, died from multiple blunt force injuries sustained in a fall from a highway off-ramp during an acute psychotic episode induced by cannabis use. She had attended Royal North Shore Hospital the previous…
6y · Male·Sepsis due to melioidosis
A six-year-old previously healthy boy died from sepsis due to melioidosis after multiple presentations to a remote hospital over five days (5–10 January 2017) with fever, vomiting, diarrhoea, and headache. Initial diagno…
27y · Male·unascertained; likely death from entering water
Thomas Hunt, a 27-year-old man, died after entering the water near Bondi Beach on 23 March 2017, likely after experiencing an acute mental health crisis characterised by paranoid delusions and auditory hallucinations. Mu…
0y · Male·Complications in association with fulminant sepsis in an infant (Streptococcus p…
Malakai Paraone, a seven-month-old infant, died from fulminant Streptococcus pyogenes sepsis and septic shock. Over three days, he was seen at three hospitals and a general practice clinic but sepsis was not identified. …
40y · Female·hypoxic brain injury and acute lung injury; multiple drug toxicity with oxycodon…
A 40-year-old woman with advanced multiple sclerosis died from drug toxicity and hypoxic brain injury following intentional overdose and gas inhalation. She had completed an Advance Care Directive (ACD) 12 months prior r…
48y · Male·unascertained
Gregory David Tory, aged 48, disappeared from Mallacoota, Victoria in April 2018 and is presumed deceased. He had a history of methamphetamine use with associated paranoia and thought disorder, requiring psychiatric admi…
55y · Male·Electrocution
Gavin Boyd, a 55-year-old truck driver, died from electrocution when his trailer contacted overhead 22kV power lines while delivering fertiliser to a dairy farm. The farm owner directed him to unload in Paddock 1 but did…
38y · Male·Consistent with Drowning
A 38-year-old male tourist from the UK drowned while swimming at an unpatrolled beach (Mounts Bay, Apollo Bay) in Victoria. Despite being described as a competent swimmer with recent ocean swimming experience, he encount…
0y · Female·Sudden Infant Death Syndrome (SIDS Category II)
A 3-month-old female infant died from Sudden Infant Death Syndrome (SIDS Category II) after co-sleeping with her parents. The death occurred in the context of unsafe sleeping practices despite prior intervention by Child…
69y · Female·Toxicity to pentobarbitone in circumstances where she intended to end her own li…
Heather Telfer, a 69-year-old woman with longstanding asthma, chronic health anxiety, and significant social isolation, died from pentobarbitone toxicity. She had a prior suicide attempt 12 years earlier and expressed su…
74y · Male·acute myocardial ischaemia related to stenosis of the right coronary artery
Geoffrey Raymond Murray, aged 74, presented to Launceston General Hospital ED on 24 February 2019 with fever, vomiting and dizziness. After triage at 6:27pm, he waited unattended for over 4 hours without further medical …
43y · Male·Multiple injuries sustained in motor vehicle crash
Trinton Harmon, a 43-year-old intoxicated male with high alcohol and methamphetamine levels, was struck by a vehicle driven by Simone Bridges while walking on the South Arm Highway at night. He sustained fatal traumatic …
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