Coronial

325 results for ischaemic injury

VIChospital2017

Finding into death of Nghi Trieu Gla Pham

4y · Male·Complications of T-cell lymphoma

…diac arrest, and was found to have a large mediastinal T-cell lymphoma. He suffered profound hypoxic brain injury during prolonged resuscitation and died. The coroner found clinical management was appropriate and reasona…

emergency medicineENT surgerycefalexin
VIChospital2018

Finding into death of Anthony Sean Jenkins

49y · Male·Hypoxic ischaemic brain injury complicating neck compression in the circumstance…

Anthony Sean Jenkins, a 49-year-old man with significant alcohol consumption, died by hanging on 30 August 2017 after police notified him of child sexual abuse allegations made by his daughter on 23 August 2017. He was f…

intensive carepalliative caresystemalcohol
TASaged care2021-03-05

Coroner's Finding: Street, Audrey

87y · Female·closed traumatic head injury from a fall at standing height; significant contrib…

An 87-year-old woman with dementia, congestive cardiac failure, and diabetes sustained a fatal closed head injury from a fall in her aged care room overnight. The coroner found that the responsible ECA did not perform th…

geriatric medicineneurosurgeryproceduralcommunication
NSWhome2018-02-23

Inquest into the death of Yongxing Wang

79y · Male·hypoxic brain injury due to cardio-respiratory arrest caused by opioid toxicity

Yongxing Wang, 79, died from hypoxic brain injury caused by opioid toxicity from combined morphine and oxycodone. After a minor back injury on 21 August, he…

general practiceradiologymedicationcommunicationmorphine
WAhome2017-09-15

Inquest into the Death of Mary Josephine Van der WALT

28y · Female·ligature compression of the neck

…drenaline, and restored circulation after 15 minutes. However, she had suffered irreversible hypoxic brain injury and died 2 days later. The coroner found the officers' decision understandable given their training emphas…

emergency medicineintensive carediagnosticcommunicationdesvenlafaxine
VIChospital2023-07-14

Finding into death of Reginald Desmond Benham

85y · Male·Intracranial haemorrhage in the setting of a fall in a man with multiple comorbi…

An 85-year-old man with multiple comorbidities suffered a fall at home and was transported to hospital with stroke symptoms. A CT brain scan revealed subtle subarachnoid haemorrhage (traumatic), but the VST consultant ne…

emergency medicineneurologydiagnosticcommunicationalteplase
QLDcommunity2011-09-07

Grillo, Carl Antony

42y · Male·Combined effects of moderately severe physical exertion; a lateral vascular neck…

…e failure to maintain recovery position contributed to an unnecessarily increased risk of hypoxic-ischemic injury.

emergency medicineintensive careproceduraldelaymethamphetamine
SAhospital2011-06-22

Coroner's Finding: TRENGROVE Ian

81y · Male·Retropubic and retroperitoneal haemorrhage complicating pelvic fractures with co…

…n a fall at church. He was on warfarin for atrial fibrillation with an excessive INR of 4.6 at the time of injury. Critical failures included: (1) no INR testing on emergency admission despite warfarin use—a routine test…

emergency medicinegeneral medicinediagnosticcommunicationwarfarin
QLDaged care2017-09-20

Mr RO'H - Non-inquest findings

69y · Male·septic shock due to infected decubitus ulcers complicated by osteomyelitis

…transfer. While earlier intervention might not have changed survival, adherence to evidence-based pressure injury prevention guidelines and timely escalation would have been appropriate.

geriatric medicinegeneral practicediagnosticsystemdicloxacillin
VICaged care2023-02-20

Finding into death of Terence Michael Brooks

76y · Male·Streptococcus pneumoniae sepsis in the setting of acute bronchopneumonia and ren…

Terence Michael Brooks, a 76-year-old man with dementia, vascular disease, and depression, died of streptococcal pneumoniae sepsis with acute bronchopneumonia and renal failure from obstructive uropathy at an aged care f…

geriatric medicinegeneral practicecommunicationdelayvenlafaxine
NSWhospital2025-02-28

Inquest into the death of Heather Winchester

75y · Female·multiple organ failure due to severe anaemia secondary to blood loss post electi…

A 75-year-old woman died from multiple organ failure due to severe anaemia after elective hysterectomy surgery. Critical failures occurred: the surgical and anaesthetic teams held conflicting understandings about whether…

gynaecologyanaesthesiacommunicationsystem
VIChome2022-10-06

Finding into death of Ms F

79y · Female·Combined Effects of Neck Compression and Haemothorax in the Setting of a Fractur…

Ms F, a 79-year-old woman with complex medical history including ischaemic heart disease, chronic airways disease, seizures, and bipolar affective disorder, died from neck compres…

amitriptyline
VIChospital2015-12-09

Finding into death of Benjamin David Johnston

36y · Male·Global hypoxic brain injury due to hanging

Benjamin Johnston, a 36-year-old male, died by hanging after six weeks of varenicline (Champix) treatment for smoking cessation. Two weeks before death, his partner noted significant behavioral changes: withdrawal, irrit…

general practicepsychiatryvarenicline
SAaged care2026-06-19

Coroner's Finding: Fowle, Colleen Margaret

78y · Female·urinary tract infection and pneumonia on a background of facial fractures and de…

…fied during her initial hospital assessment as radiological imaging was not deemed necessary, despite head injury. She was discharged and gradually deteriorated with declining oral intake and mobility. Readmitted on 15 A…

general practicegeriatric medicinediagnostic
NSWhospital2023-06-23

Inquest into the death of Baylen Pendergast

21y · Male·Complications of blunt head injury resulting from at least two separate acts of …

Baylen Pendergast, 21 months old, died from complications of blunt head injury sustained in two separate traumatic incidents (17 and 28 November 2013). The coroner found injuries were n…

paediatricsemergency medicinediagnosticcommunication
VIChospital2014-05-29

Finding into death of Lilian Olive Blanche McClurkin

61y · Female·Peritonitis due to anastomotic leak at gastrectomy site; pathological obesity as…

… days post-operatively before bursting on day three, causing sudden cardiac arrest and fatal hypoxic brain injury. Clinical lessons include: difficulty detecting post-operative deterioration in obese patients (abdominal …

bariatric surgerygeneral surgerycommunicationsystemtramadol
SAhospital2006-01-25

Coroner's Finding: RAPHAEL Glenn Howard

74y · Male·cardiac and renal failure complicating treatment of infected ischaemic toes resu…

Glenn Howard Raphael, 74-year-old admitted for infected ischaemic toe secondary to diabetes mellitus. During his 17-day hospital stay, he developed acute renal failure le…

vascular surgerygeneral medicinemedicationcommunicationgentamicin
QLDmental health2006-09-08

Robinson, Terence James

54y · Male·Global cerebral hypoxic injury due to or as a consequence of status epilepticus

Terence James Robinson, 54, died from status epilepticus causing global cerebral hypoxic injury after 16 days at Belmont Private Hospital. He was admitted following a violent altercation with police and…

psychiatryneurologydiagnosticcommunicationparoxetine
VIChospital2014-08-27

Finding into death of Robert Vivian Hawkins

55y · Male·Multi-system failure complicating intra-operative haemorrhage due to inadvertent…

…ognized the error and converted to open surgery, requesting senior surgical assistance, the bowel became ischaemic. The patient was transferred to Albury Hospital ICU then St Vincent's Hospital where vascular surgeons a…

urologygeneral surgerydiagnosticprocedural
VIChospital2018-10-18

Finding into death of Maxwell Norman Campbell

68y · Male·pulmonary thromboembolism in the setting of recent surgery

A 68-year-old man died from pulmonary thromboembolism following revisional gastric bypass surgery. He developed multiple post-operative complications including fever, elevated inflammatory markers, and a possible bowel p…

bariatric surgerygeneral surgeryheparin
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