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TAShome2025-08-05

Coroner's Finding: Iliev, Patricia

57y · Female·starvation due to insufficient food intake

Patricia Iliev, a 57-year-old woman, died from starvation after progressively restricting her food intake over months while immobilised by chronic back pain. She had a gastrointestinal stromal tumour and advanced lung di…

general practicepsychiatrysystemdelayaspirin
VIChospital2025-08-04

Finding into death of Winifred Jean Carpenter

82y · Female·Peritonitis due to leakage of bowel contents from bowel anastomosis following el…

Winifred Carpenter, 82, died 11 days after a right hemicolectomy for colon cancer from peritonitis due to anastomotic leak. Critical failures occurred on discharge day (10 March 2023): clinicians did not recognize her de…

general surgerycolorectal surgerydiagnosticcommunication
NTcommunity2025-08-01

Inquest into the death of Grace Moulding

27y · Female·Multiple blunt force injuries in the context of a single vehicle rollover

Grace Moulding, a 27-year-old British woman, died in a single-vehicle rollover on the Sandover Highway while driving an unregistered Art Centre vehicle at an estimated 116 km/h on an unsealed road. Critical failures incl…

occupational and environmental healthemergency medicinesystemcommunication
TAShome2025-08-01

Coroner's Finding: de-identified UV

33y · Male·Mixed drug toxicity

A 33-year-old man with complex psychiatric history (bipolar disorder, schizoaffective disorder, autism, ADHD) and long-standing substance use disorder died from mixed drug toxicity. Postmortem toxicology revealed high-co…

psychiatrygeneral practicesystemcommunicationmorphine
SAhospitalPodcast2025-07-31

Coroner's Finding: Panella, Anna Vincenza and Skeffington, Bernard Anthony and Jessett, Graham Henry

Unknown·Panella: pulmonary thromboembolism due to left calf deep vein thrombosis; Skeffi…

Three South Australians died following extended waits on ambulance ramps outside metropolitan hospitals. Anna Panella (76) died from pulmonary thromboembolism; Bernard Skeffington (89) died from aspiration pneumonia afte…

emergency medicinecardiologycommunicationsystem
VIChospital2025-07-30

Finding into death of MHT

86y · Male·Complications of blunt force trauma in a man with cardiac amyloidosis and athero…

An 86-year-old man with dementia, cardiac amyloidosis and atherosclerotic cardiovascular disease died from complications of blunt force trauma sustained in an assault by his adult son. The deceased had been diagnosed wit…

emergency medicineneurosurgerysystemcommunicationondansetron
NSWhome2025-07-30

Inquest into the death of Hilary Gordon-Squire

65y · Male·Pneumonia, due to chronic lung disease with atherosclerotic cardiovascular disea…

A 65-year-old man with severe chronic lung disease, COPD, and coronary artery disease died at home. Evidence suggests he deliberately ingested benzodiazepines and possibly other substances in a self-harm attempt. However…

forensic medicinegeneral practicesystemdelaybenzodiazepines
VIChospital2025-07-29

Finding into death of Mr SV

74y · Male·Sepsis complicating pyelonephritis and pseudo large intestinal obstruction (pall…

A 74-year-old man with intellectual disability, Parkinson's disease, and dysphagia died from sepsis complicating pyelonephritis and pseudo-obstruction after prolonged hospitalisation. He was admitted in February 2024 wit…

general medicineemergency medicine
VIChospital2025-07-28

Finding into death of Ann Williams

71y · Female·Aspiration pneumonia complicating dysphagia and status epilepticus

Ann Williams, a 71-year-old woman with severe intellectual disability and chronic dysphagia, died of aspiration pneumonia complicated by status epilepticus while residing in specialist disability accommodation. She prese…

emergency medicinerespiratory medicine
VIChome2025-07-28

Finding into death of Heather Ida Simone Calgaret

30y · Female·Hypoxic ischaemic encephalopathy complicating cardiac arrest of unknown aetiolog…

Heather Calgaret, a 30-year-old Aboriginal woman, died from hypoxic ischaemic encephalopathy after being administered a first dose of buprenorphine (Buvidal) injection without prior stabilisation on sublingual Suboxone. …

general practiceaddiction medicinemedicationdiagnosticbuprenorphine
VICaged care2025-07-24

Finding into death of Silvie Marion Burton

89y · Female·Acute upper airway obstruction by food bolus

An 89-year-old woman with dementia died from acute upper airway obstruction by food bolus while being fed lunch at an aged care facility. CCTV footage revealed significant discrepancies between reported actions and actua…

geriatric medicineemergency medicineproceduraldelaycitalopram
VIChome2025-07-24

Finding into death of Jill Hughes

75y · Female·Infective complications of a left hand injury with diabetic ketoacidosis

A 75-year-old woman died from infective complications of a left hand wound sustained in a fall from a ladder in November 2023, complicated by undiagnosed diabetic ketoacidosis. Despite family encouragement to seek medica…

infectious diseasesendocrinologydelaydiagnostic
VICmental health2025-07-24

Finding into death of Mr SWX

32y · Male·1(a) Aspiration of gastric contents; 1(b) Combined drug toxicity

A 32-year-old Eritrean refugee died on 22 August 2017 in a mental health unit from aspiration of gastric contents and combined drug toxicity. During his six-day admission, Mr SWX received 64 doses of 11 medications with …

psychiatryemergency medicinemedicationcommunicationolanzapine
NSWcustodial setting (correctional facility) with death at hospital2025-07-23

Inquest into the death of James Cunneen

60y · Male·Ischaemic heart disease with a bleeding duodenal ulcer being a significant contr…

James Joseph Cunneen, a 60-year-old man with significant medical comorbidities (ischaemic heart disease, diabetes, peripheral arterial disease), died from cardiac arrest due to ischaemic heart disease with a bleeding duo…

general practiceinfectious diseasesdiagnosticmedicationpantoprazole
QLDhospital2025-07-22

Inquest into the death of Hazel Mary Ritchie Brodie

79y · Female·Dilated cardiomyopathy with decompensated heart failure not appropriately treate…

A 79-year-old woman with severe COPD and heart failure presented with two weeks of nausea and vomiting. She was diagnosed with left ventricular failure (EF 33%) on day 1 of admission. Two cardiologists had key roles: Dr …

cardiologyrespiratory medicinediagnosticcommunicationfurosemide
VIChospital2025-07-22

Finding into death of Helena Zoe Broadbent

32y · Female·Head injuries in a motor vehicle incident

Helena Zoe Broadbent, a 32-year-old pregnant Aboriginal woman, died from severe head injuries sustained when her partner William Wilson drove off in a vehicle while she was partially inside it, causing her to be ejected …

emergency medicinetrauma surgerycommunicationsystemcannabis
NSWhospital2025-07-22

Inquest into the death of Prabha Arunkumar

41y · Female·multiple stab wounds to the neck

This inquest examined the death of Prabha Arunkumar, a 41-year-old computer programmer who died from multiple stab wounds to the neck sustained during an attack in Parramatta Park on 7 March 2015. She was transported to …

trauma surgeryvascular surgery
VICcommunity2025-07-17

Finding into death of John Michael Jurdeczka

62y · Male·Hypoxic ischaemic encephalopathy complicating cardiac arrest in setting of acute…

John Michael Jurdeczka, a 62-year-old man with autism, intellectual disability, and dysphagia, died from hypoxic ischaemic encephalopathy following cardiac arrest caused by acute upper airway obstruction from a food bolu…

speech pathologygeneral practicecommunicationsystemmorphine
QLDhospital2025-07-15

Inquest into the death of Errol George Radan

83y · Male·left middle cerebral artery cerebrovascular accident

An 83-year-old male prisoner died from a left middle cerebral artery stroke on 26 October 2022, seven days after presenting with acute stroke symptoms. Mr Radan had atrial fibrillation and was prescribed dabigatran for a…

neurologyemergency medicinedabigatran
VIChome2025-07-15

Finding into death of Lachlan Rayner

44y · Male·Airways obstruction with mucous plugging secondary to quadriplegia post accident

Lachlan Rayner, a 44-year-old man with quadriplegia from a 2019 spinal injury, died from airways obstruction due to mucous plugging and pneumonia. He was a specialist disability accommodation resident receiving in-home c…

emergency medicineneurologydelayoxycodone

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