20y · Female·Severe traumatic brain injury sustained in a pedestrian versus motor vehicle col…
A 20-year-old Aboriginal female pedestrian with bilateral hearing loss was struck by a vehicle driven by an intoxicated male driver (BAC 0.158%) travelling at 74 kph in a …
5y · Male·extensive skull fracturing and traumatic brain injury from pedestrian strike by …
… 5-year-old boy with significant disabilities from pneumococcal meningitis and stroke (right hemiparesis, hearing loss, epilepsy) was temporarily placed in care by the Department of Children and Families for medication …
81y · Male·Unable to determine - likely dehydration and exposure in remote bushland terrain…
… 1986 from a remote area near Davyhurst, Western Australia. He had cognitive decline with short-term memory loss, difficulty walking due to hip surgery complications, a heart condition managed with a pacemaker, and heari…
39y · Male·acute myocardial ischaemia, coronary artery thrombosis and coronary artery ather…
Jeremy Tunkin, an Aboriginal man with severe hearing loss, died of acute myocardial infarction while in prison custody. On 6 August 2017, he presented to the …
90y · Female·Type II respiratory failure in the setting of severe respiratory injury followin…
Pearl Recht, a 90-year-old woman living alone with hearing loss and mobility limitations, died from Type II respiratory failure following severe respiratory injury …
3y · Female·COMPLICATIONS FROM SEVERE CEREBRAL PALSY
Baby E, a 3-year-old with severe cerebral palsy, spastic quadriplegia, bulbar dysfunction and upper airway obstruction, died from complications of her severe cerebral palsy. She presented with seizures, dark green sputum…
87y · Male·Blunt trauma of the head and chest
Henry Arthur Roberts, 87, died from blunt trauma to head and chest after being overrun by his tractor on 16 March 2020. He had multiple serious health conditions including leukaemia, severe vision impairment from macular…
68y · Male·Hanging
…reen for tinnitus-related distress and conduct suicide risk assessment; treatment should address both the hearing condition and psychological impact through education, coping strategies and reassurance rather than relyi…
5y · Female·Pneumonia as a complication of septo-optic cerebral dysplasia
…ain malformation causing profound developmental delay, spastic quadriparesis, poorly controlled epilepsy, hearing and visual impairment, and diabetes insipidus. She was in state care under joint guardianship from age 10…
32y · Male·self-inflicted hanging
…nd failure to refer to mental health specialists despite marked distress. His critical request mentioning hearing voices in April 2017 was never actioned, and subsequent attempts to access treatment programs resulted in…
43y · Male·Combination of exsanguination and inhalation of smoke
…e sustained a lacerated brachial artery to the elbow while breaking a window and escaped the house. After hearing his daughter's voice, he re-entered the burning residence and collapsed from blood loss combined with smo…
Unknown·Sally-Anne Wills: multiple stab wounds to the chest; Christopher Polden: single …
…g notes that Mohammed may have been suffering from an undiagnosed psychiatric illness, including possible hearing of voices and paranoia following his marital separation and loss of contact with his children. No clear m…
22y · Male·Unascertained
A 22-year-old male with schizophrenia disappeared on 28 November 1984 after ceasing prescribed medication approximately six months prior. He left home to withdraw money from a bank but was never seen again. His vehicle w…
Traumatic injuries sustained when struck by stolen motor vehicle (principally he…
Finding into six deaths resulting from the Bourke Street mass casualty incident on 20 January 2017 in Melbourne, Victoria. James Gargasoulas drove a stolen vehicle into crowds in Bourke Street Mall, killing Matthew Poh C…
21y · Male·Internal haemorrhage due to chest and abdominal injuries sustained in motorcycle…
Matthew Cullen, 21, died after losing control of his motorcycle at high speed while attempting to evade police during a random breath test intercept in Bundaberg. He had a blood alcohol level of 0.14%. After ignoring pol…
96y · Female·Decompensated frailty syndrome following right femoral neck fracture from fall
Margaret Wood, a 96-year-old resident of St Ann's aged care facility, died from decompensated frailty syndrome following a fall that resulted in a right femoral neck fracture. She was a frail elderly woman with multiple …
71y · Male·The available evidence and the absence of any postmortem examination does not al…
This coronial finding concerns a missing person inquest where KHL, a 71-year-old man, disappeared while rock fishing at Eagle Rock in Royal National Park, NSW in August 2023. The coroner found KHL deceased based on exten…
83y · Male·end-stage Parkinson's disease (palliated)
Raymond John Blackney, an 83-year-old man with end-stage Parkinson's disease, died in custody at Port Phillip Prison from natural causes. He had complex medical needs including dementia, intellectual disability, and mult…
99y · Female·Chest injuries in the setting of a tram incident (pedestrian)
A 99-year-old woman with dementia and reduced mobility was struck by a tram while crossing at a roundabout intersection in Essendon, Victoria. She sustained severe chest injuries including bilateral pneumothoraces, haemo…
58y · Female·Mixed drug toxicity (oxycodone, temazepam, diazepam, oxazepam, citalopram, fluox…
…Sandon). Over 22 months, she experienced severe anxiety and depression, fearing criminal prosecution, asset loss, and homelessness for her disabled son. Although IBAC had not contemplated prosecution, this uncertainty pe…
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