Coronial

267 results for severe heart failure

VIChome2025-11-18

Finding into death of JZA

65y · Female·Combined effects of acute pneumonia, pancreatitis, urinary tract infection, and …

…ive functional decline died from combined effects of pneumonia, pancreatitis, urinary tract infection, and severe pressure ulcers with osteomyelitis following a prolonged lie at home. She had been largely bedridden for y…

geriatric medicineinfectious diseasessystemcommunicationpholcodine
VICcommunity2023-05-02

Finding into death of Trevor Henry McKie

48y · Male·Coronary artery atherosclerosis in the setting of immersion

…tazapine, cannabis, and possibly alcohol detected post-mortem. Critical clinical lessons: (1) pre-existing severe coronary atherosclerosis predisposed to sudden cardiac arrhythmia during physical exertion and stress; (2)…

delaymirtazapine
QLDhospital2014-12-17

Courtney, Victor

44y · Male·End stage non-small cell lung carcinoma

…ropriate. His cancer could not be staged or treated due to refusal to attend investigations, attributed to severe psychiatric disease. Competency assessments confirmed his capacity to refuse treatment. A not-for-resuscit…

oncologyrespiratory medicine
NSWcustody2022-07-21

Inquest into the death of Richard Navarro

43y · Male·Hypoxic Ischaemic Encephalopathy due to out of hospital cardiac arrest, secondar…

Richard Navarro, a 43-year-old man with severe obstructive sleep apnoea (OSA), morbid obesity, hypertension, and recurrent pneumonia, died of hypoxic isc…

respiratory medicinecardiologysystem
VIC2017-10-31

Finding into death of Andrew John Harman

49y · Male·Complications of heatstroke; Hyperthermia

…ide, became unable to access water from his blocked CamelBak pouch, and eventually collapsed with signs of severe heat illness including dizziness, vomiting, rapid heart rate and disorientation. He suffered cardiac arres…

emergency medicineintensive caredelay
VIChospital2014-10-02

Finding into death of Penrin John Maxworth Halliday

60y · Male·Ischaemic gut secondary to superior mesenteric artery dissection complicating in…

A 60-year-old man with severe coronary artery disease presented with acute myocardial infarction, requiring emergency stenting and subse…

cardiologycardiothoracic surgery
SAaged care2018-05-17

Coroner's Finding: BAUM Dorothy Mavis

93y · Female·blunt trauma with head injury on a background of ischaemic heart disease

… following an unprovoked assault by another nursing home resident with a plastic chain. Critical clinical failures occurred: the nursing home staff failed to immediately isolate the aggressive resident after she attacke…

geriatric medicineemergency medicinediagnosticcommunicationoxycodone
ACThospital2023-01-30

Inquest into the Death of Maarouf El-Cheikh

57y · Male·streptococcus pneumonia septicaemia due to splenectomy

… despite critical illness and acute kidney injury); delayed and sub-optimal antibiotic dosing and timing; failure to place arterial line for continuous blood pressure monitoring; and critically, failure to admit to ICU …

emergency medicineintensive carediagnosticmedicationceftriaxone
SAhospital2008-05-23

Coroner's Finding: KROL Riley

0y · Male·hypoxic ischaemic encephalopathy

…ivery on 1 March 2005. After artificial rupture of membranes during labour induction, the foetus developed severe, sustained bradycardia lasting approximately 30 minutes before delivery. The emergency caesarean section d…

obstetricsanaesthesiacommunicationsystemcervedil
SAhome2001-09-10

Coroner's Finding: CORNISH Olive Edna

75y · Female·Avulsion of the inferior vena cava from the heart due to severe crush injury of …

A 75-year-old woman died from crush injuries sustained when her 1982 Mitsubishi Sigma sedan reversed unexpectedly whilst she was behind it. The vehicle's automatic transmission selector linkage had worn bushes, allowing …

VIChospital2017-12-21

Finding into death of Sally Elizabeth Hopwood

57y · Female·Haemothorax following acute thoracic aortic dissection in a woman with congenita…

…urner syndrome, coarctation of the aorta, and bicuspid aortic valve, presented to ED on 23 March 2012 with severe acute back and chest pain (8/10). A chest X-ray revealed widened mediastinum. She was admitted to CCU unde…

cardiologyemergency medicinediagnosticcommunicationglyceryl trinitrate
WAhospital2019-04-04

Inquest into the Death of Maris KUGIS

68y · Male·Bronchopneumonia in a man with chronic obstructive pulmonary disease

…ances. Key clinical lessons include recognising that treatment-resistant psychiatric illness combined with severe medical comorbidity creates extreme management challenges, and that late presentation of malignancy (pancr…

psychiatryrespiratory medicinehaloperidol
NT2012-01-04

Inquest into the death of Barnabas Naroldol

33y · Male·Longstanding atheromatous coronary artery disease with severe stenosis and cardi…

…ECG was performed. He was discharged with paracetamol and collapsed within two hours. Post-mortem revealed severe coronary stenosis with complete blockage of a major artery. Clinical lessons: better communication (potent…

general practiceemergency medicinecommunicationsystemparacetamol
VICaged care2022-10-14

Finding into death of Beryl Eileen Brindley

74y · Female·Diabetic ketoacidosis

…ood glucose levels remained persistently elevated (>33 mmol/L) despite escalating insulin doses. Critical failures included: inadequate monitoring of vital signs and ketones; lack of 'sick day' management protocols; no …

general practiceendocrinologydiagnosticcommunicationinsulin
QLDaged care2020-12-18

Murphy, Maxwell

89y · Male·multi-organ failure with pneumonia due to ingestion of a corrosive liquid (quate…

An 89-year-old man with severe dementia died from multi-organ failure following ingestion of concentrated Bacban (quaternary ammonium com…

emergency medicineintensive carediagnosticcommunicationbacban
WA2026-01-08

Inquest into the Death of Lewis Walter WARD

Male·out-of-hospital cardiac arrest due to atherosclerotic cardiovascular disease and…

Lewis Walter Ward, a Ngarinyin man in his early thirties, died from out-of-hospital cardiac arrest while playing sport at West Kimberley Regional Prison. He had Type 2 diabetes, hypertension, dyslipidaemia, and was a smo…

cardiologyemergency medicinediagnosticsystem
WAhospital2005-03-03

Inquest into the Death of Giovanni Bertoncini

72y · Male·acute gangrene of colon with probable perforation along with bowel obstruction a…

Giovanni Bertoncini, a 72-year-old man with diabetes and cardiac disease, presented to Sir Charles Gairdner Hospital on Christmas Day 2002 with acute abdominal pain and vomiting. Over two days, his condition deteriorated…

emergency medicinegeneral medicinediagnosticdelayparacetamol
VIChospital2013-06-17

Finding into death of Trevor Edward Hammond

72y · Male·ischaemic heart disease secondary to coronary artery disease

…ans for outpatient cardiology review. He died at home the next day from myocardial infarction secondary to severe triple-vessel coronary artery disease. The critical omission was failure to order troponin testing despite…

emergency medicinecardiologydiagnosticdelaydigoxin
WAhome2015-06-08

Inquest into the Death of Baby B

0y · Male·severe hypoxic ischaemic encephalopathy due to apparent perinatal asphyxia

Baby B suffered severe perinatal asphyxia during a planned home birth and died from hypoxic ischaemic encephalopathy. An obstetri…

obstetricsmidwiferycommunicationsystem
VIChome2022-01-03

Finding into death of Patricia Jocelyn Eve Grant

83y · Female·Aspiration bronchopneumonia in a setting of cerebral infarction

…nchopneumonia following cerebral infarction while living with her son and daughter-in-law. She experienced severe neglect and elder abuse in her final years: cessation of epilepsy medication (March 2013), progressive imm…

general practicegeriatric medicinediagnosticsystem
110111214

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