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SA2004-10-01

Coroner's Finding: MAGEE Liam

19y · Male·traumatic rupture of the thoracic aorta with bilateral haemothoraces

A 19-year-old experienced motorcycle racer died from traumatic aortic rupture and bilateral haemothoraces after colliding with a concrete wall at 100 km/h at a racing circuit. He lost control at approximately 205 km/h an…

systemdelay
NTPodcast2004-10-01

Inquest into the death of Jade Lange-Loades, Rory Lange-Loades and Nathaniel Rose

8y · Male·Drowning as the result of a motor vehicle accident

Three children drowned following a motor vehicle accident on the Stuart Highway after a grouser plate fell from an inadequately restrained load on a road train, puncturing their vehicle's tyre and causing loss of control…

proceduralsystem
QLDmental health2004-09-30

Cif Lee Ja 20040930

23y · Male·compression of the neck, secondary to coronary arteriosclerosis

Julian Arasina Lee, a 23-year-old man, died on 1 February 2003 during a restraint incident in the Mental Health Unit at Cairns Base Hospital. Admitted voluntarily after exhibiting marked behavioral changes, he became inc…

psychiatryemergency medicineproceduralcommunicationdroperidol
SAcommunity2004-09-10

Coroner's Finding: CORNISH Peter Henry

43y · Male·aspiration of vegetable matter with occlusion of the upper airway

Peter Cornish, a 43-year-old man with a 17-year history of bipolar disorder, died on 25 September 2001 from aspiration of vegetable matter while experiencing a severe manic episode. In the two weeks before his death, mul…

psychiatryemergency medicinediagnosticsystemcannabis
SAcommunity2004-09-03

Coroner's Finding: EUSTICE Dean Stanley

73y · Male·ischaemic heart disease due to coronary atherosclerosis

A 73-year-old man found a purse at a shopping centre and attempted to leave his details with the information desk rather than hand it in directly. A security officer, believing him suspicious, confronted, accused him of …

cardiologyemergency medicineproceduralcommunication
WAmental health2004-09

Inquest into the Death of Peter Daniel Mahoney

55y · Male·Immersion (Drowning) arising by way of suicide

Peter Daniel Mahoney, a 55-year-old man with treatment-resistant bipolar affective disorder, died by drowning on 13 June 2003 after absconding from Joondalup Health Campus where he was detained as an involuntary patient …

psychiatrypsychiatrycommunicationsystemtemazepam
SA2004-08-27

Coroner's Finding: CUNLIFFE David

35y · Male·Cerebral lacerations associated with comminuted fractures of cranial vault and b…

David Cunliffe, aged 35, died from severe cerebral lacerations and comminuted skull fractures sustained when ejected from a vehicle during a rollover accident on Jungfer Road, Lobethal, South Australia on 27 February 200…

WAhospital2004-08-16

Inquest into the Death of Gregory Andrew Furniss

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…

emergency medicinegeneral practicediagnosticdelayterbutaline
SA2004-08-06

Coroner's Finding: FREDERICKS Jeffrey Ronald

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…

general practiceemergency medicinediagnosticcommunicationdosulepin
SA2004-08-06

Coroner's Finding: TURNER Troy Phillip

36y · Male·hanging

Troy Phillip Turner, aged 36, died by hanging in his prison cell on 2 September 2001 while on remand for serious domestic violence-related offences. The coroner identified several preventable failures: (1) Duty Superviso…

psychiatryemergency medicineproceduralsystemfluvoxamine
NThome2004-08-05

Inquest into the death of Stephen Power

35y · Male·left lower lobe pneumonia

Stephen John Power died of left lower lobe pneumonia on 5 September 2003 after two failed emergency calls requesting ambulance assistance. On Thursday 4 September, dispatcher Coralie Holland failed to send an ambulance d…

emergency medicineparamedicinecommunicationsystemflucloxacillin
SAcommunity2004-07-22

Coroner's Finding: LINDSAY Tyson Matthew Charles

14y · Male·closed head injury

A 14-year-old male died from a closed head injury following a high-speed collision while driving a stolen vehicle being pursued by police. The driver, aged 17, panicked when police attempted to intercept the vehicle and …

SAhospital2004-07-20

Coroner's Finding: QUINN Latoya Shelley

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…

emergency medicinepaediatricsdiagnosticcommunicationparacetamol
WAhospital2004-07-19

Inquest into the Death of Michael John Herrick

44y · Male·cardiac arrhythmia in a man with liver failure due to cirrhosis and focal corona…

Michael John Herrick, a 44-year-old prisoner with end-stage liver cirrhosis secondary to hepatitis C and alcohol abuse, died from cardiac arrhythmia at Sir Charles Gairdner Hospital. He had been receiving aggressive trea…

gastroenterologygeneral medicinecommunicationproceduralcaffeine
SAcommunity2004-07-16

Coroner's Finding: DINSDALE Cheree Ann and KLINGNER Peter James

20y · Unknown·Traumatic brain damage complicating gunshot wound to the head

Two young adults aged 20 died from gunshot wounds to the head on 29-30 May 2001 in what appears to be a murder-suicide involving Peter Klingner and his girlfriend Cheree Dinsdale. Klingner had paranoid schizophrenia with…

psychiatryemergency medicinediagnosticcommunicationolanzapine
SAhospital2004-07-15

Coroner's Finding: JOVANOVIC Katica

46y · Female·pulmonary thromboembolism due to bilateral deep calf vein thrombosis

A 46-year-old woman with schizo-affective disorder died from pulmonary thromboembolism secondary to bilateral deep vein thrombosis five days after involuntary psychiatric admission. She was severely withdrawn, refusing f…

psychiatrygeneral medicinediagnosticcommunicationzuclopenthixol
NThospital2004-07-02

Inquest into the death of John Colbert

55y · Male·Head injury from a fall, contributed to by chronic alcoholism and cirrhosis, res…

John Henry Colbert, a 55-year-old man with chronic alcoholism, Wernicke's encephalitis and cirrhosis, was admitted to Royal Darwin Hospital's ICU following a seizure. He was transferred to Ward 4A on 14 October 2002 and …

neurosurgeryemergency medicinesystemdelaydiazepam
WAcommunity2004-07

Inquest into the Death of Craig Dee Sandy

32y · Male·Multiple injuries sustained in a motor vehicle collision during bushfire fightin…

Craig Dee Sandy, a 32-year-old volunteer bushfire brigade captain, died on 26 January 2003 following a motor vehicle collision on Lancelin Road during a major bushfire response near Ledge Point, Western Australia. While …

systemcommunication
NT2004-06-18

Inquest into the death of Raymond Campbell

38y · Male·gunshot wound to the abdomen with massive internal haemorrhage

Ray Campbell, aged 38, died from a gunshot wound to the abdomen on 17 September 2002. He was found in a workshop with a Styre pistol nearby. The coroner returned an open finding, unable to determine definitively whether …

forensic medicinesystemmethamphetamine
NTcommunity2004-06-18

Inquest into the death of Gregory Nunggarrgalu

35y · Male·effects of exposure

Gregory Nunggarrgalu, a 35-year-old Aboriginal man, died from exposure in remote Northern Territory bushland in late October 2002. He left Numbulwar with companions to travel to Lake Evella when their vehicle broke down …

delay

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