Inquest into the Death of Francis Gerald ROBERTS

62y · Male·fatal cardiac arrhythmia secondary to end-stage ischaemic cardiomyopathy

A 62-year-old prisoner with severe ischaemic heart disease, diabetes, and cardiomyopathy died from a fatal cardiac arrhythmia in hospital. He had extensive cardiac history including pacemaker insertion, coronary stents, and bypass grafting. Throughout his 10-year imprisonment, he received numerous specialist consultations and hospital transfers but was frequently non-compliant with medical management, using refusal of treatment as a means of controlling his prison placement. His condition progressively deteriorated despite intensive medical intervention. The coroner found supervision, treatment and care while imprisoned to be reasonable and appropriate, though his poor compliance and resistance to medical advice complicated management. Death was from natural causes due to end-stage ischaemic cardiomyopathy with fatal ventricular arrhythmia.