Coronial

20 results for airway suctioning

SAaged care2009-10-16

Coroner's Finding: CHILDS Hayden William

77y · Male·hypoxic-ischaemic encephalopathy and cerebral infarction due to upper airway obs…

A 77-year-old man with advanced dementia died from hypoxic-ischaemic encephalopathy caused by upper airway obstruction from a handkerchief. An agency carer placed a handkerchief in his breast pocket during morning…

geriatric medicineemergency medicinecommunicationsystem
VIChospital2013-05-09

Finding into death of Argyrios Carras

38y · Male·Aspiration pneumonia in the setting of cerebral palsy

…investigations identified pneumonia/aspiration changes on chest X-ray. Despite intravenous antibiotics and airway suctioning, his condition worsened. Active management ceased on 16 March and palliative care was initiated…

respiratory medicineinfectious diseasesdiazepam
QLDhospital2022-07-08

R - Non-inquest findings

<1y · Male·Hypoxic ischaemic encephalopathy secondary to post-operative respiratory distres…

…as a sign of tube malpositioning, maintain capnography during manual ventilation and CPR, and ensure clear airway role assignment during resuscitations.

anaesthesiaintensive carediagnosticproceduralpropofol
QLDhospital2010-05-07

Cramb, Fay - aka Valmae Beck

64y · Female·Haemorrhage into atheromatous plaque, due to coronary atherosclerosis

…erred to a medical ward where an equipment malfunction (fractured in-line suction system nozzle) delayed suctioning of airway secretions. The immediate clinical lesson is that clinicians should ensure proper instruction …

cardiologyintensive caresystem
QLDhospital2005-10-06

Fernandez, Adam Anthony

33y · Male·Aspiration due to alcoholic intoxication; coronary atherosclerosis contributed

…te sedation for aggressive behaviour, he vomited copiously, aspirating semi-solid food that obstructed his airway. Emergency attempts at intubation and surgical airway management were unsuccessful. The coroner found no c…

emergency medicineanaesthesiasedatives
VIChospital2024-08-07

Finding into death of Georgios Stamkos

68y · Male·Complications of a witnessed airway obstruction from food bolus in a man with dy…

A 68-year-old man with dysphagia and bipolar disorder died from airway obstruction and aspiration pneumonia after choking on a sandwich brought by his wife during a supervised h…

psychiatryspeech pathologyrisperidone
NSWmental health2019-06-04

Inquest into the death of Andrea Sewell

46y · Female·hypoxic ischaemic brain injury as a result of cardiac arrest following a choking…

Andrea Sewell, a 46-year-old woman with Osmotic Demyelination Syndrome (ODS) and acute psychiatric illness, died from hypoxic brain injury following a choking episode during a meal in a psychiatric intensive care unit (P…

psychiatryneurologyantipsychotic medications
SAhospital2016-09-12

Coroner's Finding: RAU Edward Morgan

77y · Male·aspiration pneumonia due to dysphagia on a background of dementia

…d intravenous fluids. He deteriorated with persistent chest congestion despite supportive care including suctioning, nebulisers and oxygen. He was found unresponsive on 31 October 2014 and died shortly after. The clinica…

geriatric medicinespeech pathology
VIChome2026-07-30

Finding into death of PSD

66y · Female·Acute oesophagitis complicated by gastrointestinal haemorrhage

A 66-year-old woman with cerebral palsy, dysphagia, and chronic reflux oesophagitis presented with acute gastrointestinal bleeding while in supported disability accommodation. She was treated conservatively with IV proto…

emergency medicinegastroenterology
VIChospital2024-02-04

Finding into death of Miranda Louise Lynch

46y · Female·Sepsis of unknown origin

Miranda Lynch, a 46-year-old woman with severe cerebral palsy, spastic quadriplegia, epilepsy, and aspiration pneumonia history, died from sepsis of unknown origin. She was admitted to Box Hill Hospital on 20 April 2023 …

emergency medicinegeneral medicineintravenous fluids
VIChospital2019-09-16

Finding into death of Marco Angelo Virgona

45y · Male·Aspiration pneumonia with acquired brain injury as a contributing factor

Marco Virgona, a 45-year-old man with acquired brain injury and epilepsy, died from aspiration pneumonia at Frankston Hospital on 23 May 2017. He initially presented to Ambulance Victoria in the morning with vomiting and…

emergency medicineintensive carewarfarin
NTcommunity2012-04-20

Inquest into the death of Lado Stephen Lazorous

4y · Male·drowning

A 4-year-old boy of Sudanese descent drowned at Lake Leanyer Recreation Park on 1 May 2011 despite lifeguard presence. While the facility had been extensively improved following earlier drowning deaths and met RLSSA stan…

systemdelay
SAcommunity2023-05-26

Coroner's Finding: Latouche Mazzei, Lucas

5y · Male·acute upper airway obstruction from nectarine stone

Lucas Mazzei, aged 5 years, died on 27 March 2017 from acute upper airway obstruction caused by an uncut nectarine stone. While attending school, he was separated from his class du…

emergency medicinepaediatricscommunicationsystemlamotrigine
VIChome2021-08-04

Finding into death of NB

1y · Male·Global cerebral ischaemia in an infant with upper airway obstruction

…ly signs of tracheostomy obstruction (gasping, cyanosis, apnoea) and did not perform appropriate emergency airway management. She did not suction the tracheostomy or change the tube, instead providing ineffective CPR wit…

respiratory medicineintensive carediagnosticcommunication
VIC2021-02-24

Finding into death of Mark Capovilla

39y · Male·Choking on a food bolus

Mark Capovilla, a 39-year-old man with severe intellectual disability, epilepsy, and dysphagia, died from choking on food at his day program. He had a documented choking risk but lacked a current mealtime support plan at…

general practiceforensic medicinecommunicationsystem
WAmental health2020-08-06

Inquest into the Death of Stephen Michael KELL

35y · Male·acute vomit aspiration in a man with acute large intestine obstruction (severe m…

Stephen Michael Kell, a 35-year-old man with treatment-resistant schizophrenia, died at Graylands Hospital from acute vomit aspiration in the setting of acute large bowel obstruction and clozapine-induced gastrointestina…

psychiatrygastroenterologysystemdelayclozapine
QLDhome2008-12-22

Plint, Hannah Isabella Alyson

2y · Female·Drowning in an above-ground swimming pool

Hannah Plint, a 2½-year-old, died from drowning after accessing an above-ground pool by dragging a chair to the gate and opening it unsupervised. Her mother was inside with a younger sibling. The pool fence and gate sepa…

emergency medicinepaediatricssystemdelay
NSWhospital2022-12-21

Inquest into death of Andrea LESTER

49y · Female·Hypoxic brain injury related to tracheostomy complications in form of airway occ…

…equired tracheostomy for bulbar dysfunction. On 13 June 2018, she suffered cardiorespiratory arrest due to airway occlusion from sputum plugging and/or tube dislodgment while a tracheostomy cap (not the planned speaking …

neurosurgeryintensive carediagnosticcommunicationtramadol
QLDcommunity2026-02-13

Inquest into the passing of Steven Lee Nixon-McKellar

27y · Male·Sudden cardiac arrest in the context of physical and psychological exertion duri…

Steven Nixon-McKellar, a 27-year-old First Nations man, died following a physical altercation with Queensland Police officers attempting to arrest him on 7 October 2021. He suffered cardiac arrest during restraint, with …

emergency medicineforensic medicinemethamphetamine
NSWaged care2014-05-23

Inquest into the death of Beryl Joyce WATSON

70y · Female·Aspiration pneumonia, associated with Huntington's disease

Beryl Watson, a severely disabled 70-year-old with advanced Huntington's disease and dementia, died of aspiration pneumonia following a three-week respite stay at a BUPA aged care facility. Critical failures included: om…

geriatric medicinegeneral practicemedicationcommunicationclonazepam

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