2,762 results
44y · Male·Severe head injuries from large tree limb falling onto vehicle roof during extre…
Brendan Mark Smith, aged 44, died on 9 February 2014 when a large Black Gum tree limb fell onto his utility vehicle on Channel Highway in Tasmania during extreme wind conditions (gusts of 130-133 km/h). The coroner found…
34y · Female·Blunt force trauma on a background of contributing ischaemic heart disease
A 34-year-old Aboriginal woman died from blunt force trauma inflicted by her domestic partner over a prolonged period. Critical failures in police coordination and communication systems delayed apprehension of the perpet…
52y · Male·Intestinal failure/sepsis arising from venous ischemia as a result of superior m…
Patrick Thomas, a 52-year-old man, died from intestinal failure and sepsis following an accidental division of the superior mesenteric vein (SMV) during laparoscopic surgery for colon cancer at Kareena Private Hospital o…
48y · Male·injuries sustained in a motor vehicle collision
Christopher Stewart, a 48-year-old experienced drag racing driver, died from injuries sustained when his vehicle collided with a concrete safety barrier at South Coast Raceway, Victoria at 259.97 km/h. The initial impact…
76y · Male·Bronchopneumonia complicating fractured ribs sustained in a fall on a bus
John Wilks, a 76-year-old wheelchair user, fell when his wheelchair tilted during a left-turn on a bus on 13 August 2017. He sustained fractured ribs and a small haemothorax. Although initially treated with painkillers, …
drowning
FW died by drowning in September 2017 at Bellerive, Tasmania, after entering the water from the Tasman Bridge. This case highlights systemic issues in public safety infrastructure and inter-agency coordination. While not…
30y · Male·methadone toxicity
A 30-year-old man with schizoaffective disorder, narcolepsy, and obesity died from methadone toxicity while an involuntary psychiatric patient. He was prescribed multiple sedating medications including methadone, benzodi…
56y · Male·pulmonary thromboembolism due to left deep vein thrombosis
A 56-year-old man died from pulmonary thromboembolism secondary to deep vein thrombosis. He presented to his GP on 20 January 2017 with persistent dyspnoea and chest pain following a 22-hour flight to Greece and respirat…
40y · Male·metastatic malignant melanoma
A 40-year-old man with metastatic melanoma died at Queen Elizabeth Hospital on 2 September 2015. He had atypical nevi removed in 2009 and melanoma diagnosed in 2013, initially undergoing surgery with curative intent. How…
76y · Male·advanced atherosclerotic and hypertensive cardiovascular disease
76-year-old man with recent cardiac history (stent placement 4 months prior, cardioversion 6 days prior) presented to ED with shortness of breath and ECG changes. Elevated troponin (59) was not recognised as high-risk; r…
25y · Female·Airway obstruction complicating laryngeal dilation for the treatment of subglott…
Ms Sobb, a 25-year-old woman with spondylo-epi-metaphyseal dysplasia causing severe airway abnormalities and subglottic stenosis, died from airway obstruction following laryngeal dilation. She was admitted to ICU with as…
51y · Male·Pulmonary thromboemboli due to deep vein thrombosis on a background of a leg bur…
Stephen Kline, a 51-year-old Aboriginal man, died from pulmonary thromboembolism due to deep vein thrombosis following a leg burn wound sustained when NSW Police deployed a taser during a confrontation on 8 March 2016. H…
multi-drug toxicity (opioids, heroin, benzodiazepines, prescription drugs)
This inquest examined six opioid-related deaths in NSW occurring in May 2016, with causes ranging from heroin and fentanyl toxicity to multi-drug overdoses. The coroner identified multiple preventable factors: inadequate…
Female·self-inflicted death
Emily, a child in out-of-home care since infancy, died by suicide in 2014. She had early childhood trauma, attachment difficulties, and anxiety managed by a psychologist from age 5. Critical clinical lessons: (1) Complet…
40y · Female·Clozapine toxicity in a woman with cardiomegaly
A 40-year-old woman with depression, anxiety, alcoholism and undiagnosed cardiomegaly died from clozapine toxicity after obtaining the drug from a co-resident at a Peer Recovery Community. She was not prescribed clozapin…
88y · Female·Sepsis complicated by multiple organ failure in a woman with comorbidities in th…
An 88-year-old woman died from sepsis with multiple organ failure following shoulder surgery. She developed an undiagnosed urinary tract infection after placement of an indwelling catheter. Critical failures included: in…
36y · Male·Combined effect of gunshot wounds to the chest and abdomen
Paul Lambert, 36, was shot by NSW Police on the Pacific Highway after attacking and stabbing his former girlfriend Dr J. multiple times. He had a longstanding pattern of intimate partner violence, stalking, emotional abu…
89y · Female·Blunt force head injury on a background of ischaemic and valvular heart disease
An 89-year-old woman with dementia and cardiac disease died from blunt force head injury sustained during an assault by another resident with alcohol-related dementia in an aged care facility. The resident had a document…
74y · Female·complications of metastatic intra abdominal malignancy (unknown primary)
A 74-year-old woman in residential disability care presented with non-specific illness in late August 2017. Following GP consultation, she was admitted to Beechworth Health Service then transferred to Wangaratta Hospital…
Ligature compression of the neck (hanging) in 12 cases; one open finding
This complex coronial inquest examined 13 Aboriginal children and young persons who died by suicide in the Kimberley Region between 2012–2016. The coroner found 12 deaths were suicides and one open finding. Common contri…
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