Inquest into the death of Mahmoud Houri

27y · Male·multiple organ failure due to the consequences of multiple gunshot wounds to the body

Mahmoud Houri died aged 27 in custody from multiple organ failure, a consequence of gunshot wounds sustained in 2002. The inquest examined whether appropriate care was provided on 21 August 2008 when he presented with vomiting and abdominal pain, which led to emergency surgery revealing a rare small bowel volvulus requiring total bowel resection. Expert evidence established that this volvulus was exceptionally rare and unpredictable, with academic literature showing diagnosis requires CT imaging in most cases. Justice Health staff appropriately assessed Mahmoud at 3:35am, 6:00am, 9:00am and 1:00pm with vital signs remaining normal or improved until 1:00pm. Although the treating surgeon noted symptoms in retrospective letters that Mahmoud may not have communicated at the time, the contemporaneous clinical findings were not indicative of serious intraabdominal pathology. Even if earlier medical review at 9:00am had occurred, surgery would only have been brought forward by approximately 4 hours when the bowel was already unsalvageable, making no material difference to outcome. No clinical basis existed for recommendations.