Inquest into the death of Ryan Smiler

39y · Male·cardiac arrest caused by alcoholic cardiomyopathy

Ryan Smiler was a 39-year-old Aboriginal man who died from cardiac arrest caused by alcoholic cardiomyopathy while in custody at Darwin Correctional Centre. He had a long history of alcohol abuse, hypertension, and heart failure that he had been warned about repeatedly. While imprisoned for a traffic offence related to drink-driving, he was admitted to Katherine District Hospital with decompensated cardiac failure on 27 June 2013, where he was examined and discharged as fit for custody on 30 June. At Darwin Correctional Centre, the initial medical assessment was conducted by a nurse rather than a doctor, though this did not contribute to his death. On 2 July, he was not seen for a doctor's review as scheduled due to a lock-down, though his condition appeared stable. He presented with seizures on 2 July and was transferred to hospital where he deteriorated and died. The coroner found no criticism of the care provided and noted that medication decisions, particularly the decision not to restart warfarin, were reasonable given his liver disease and non-compliance.