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VIChome2025-04-11

Finding into death of EDH

32y · Female·mixed drug toxicity including phenobarbitone

A 32-year-old woman with borderline personality disorder and depression died by intentional self-administration of pentobarbitone (Lethabarb) accessed from her workplace. She had experienced extensive family violence in …

psychiatrypsychologysystemcommunicationpentobarbitone
VICcommunity2025-04-11

Finding into death of Karla Lee Jordan

50y · Female·Hanging

Karla Lee Jordan, a 50-year-old accountant at Ballarat Health Services, died by hanging on 29 August 2019. The coroner found workplace stress from a toxic workplace culture was the primary suicide stressor. Following a r…

general practicepsychiatrycommunicationdelayolanzapine
VIChospital2025-04-10

Finding into death of Hau Bui Nguyen

46y · Male·Aspiration pneumonia complicating epistaxis in the setting of prolonged nasal pr…

Hau Bui Nguyen, a 46-year-old man with severe acquired brain injury, dysphagia, and recurrent aspiration pneumonia, died from aspiration pneumonia complicating epistaxis following prolonged nasal prong oxygen therapy. Du…

general medicineemergency medicineamoxicillin
VIChospital2025-04-08

Finding into death of Mark Andrew Harvey

55y · Male·End stage renal failure

Mark Andrew Harvey, a 55-year-old NDIS participant with end-stage renal failure, died at Latrobe Regional Hospital on 17 July 2023. He resided in Specialist Disability Accommodation with support for daily functions inclu…

VIC2025-04-07

Finding into death of Child A

0y · Male·Unascertained in the setting of a remote head injury

Child A, a six-month-old Aboriginal boy, died from unascertained cause in the setting of a remote head injury sustained during family violence. The father violently assaulted the mother while holding the child unsupporte…

forensic medicinepaediatricscommunicationsystemmethamphetamine
VIC2025-04-07

Finding into death of Harold Lester Clayton

68y · Male·Effects of carbon monoxide

Harold Clayton, 68, died from carbon monoxide poisoning while working in the confined engine bay of his moored boat. The generator was running to supply power for his battery work, producing toxic carbon monoxide levels …

system
VIC2025-04-04

Finding into death of John Stuart Richards

81y · Male·Lung cancer

An 81-year-old man with advanced lung cancer and multiple comorbidities died of natural causes while receiving palliative care in prison. He had documented his wishes for comfort-focused care and was registered on the DN…

palliative caregeneral practice
VIChospital2025-04-03

Finding into death of Alan John Trevor Deem

67y · Male·Intracranial haemorrhage complicating coronary artery bypass graft surgery follo…

A 67-year-old man died from intracranial haemorrhage following coronary artery bypass graft surgery. He had suffered a right coronary artery dissection during percutaneous coronary intervention at Sunshine Hospital and w…

cardiologycardiothoracic surgerycommunicationsystemdual anti-platelet agents
VIChome2025-04-01

Finding into death of Andrew Cameron McDougall

57y · Male·Bilateral bronchopneumonia in a man with asthma, tetraplegia and multiple other …

Andrew McDougall, 57, a man with complex medical comorbidities including tetraplegia, COPD, asthma, ischaemic heart disease and diabetes, died from bilateral bronchopneumonia at his supported disability accommodation hom…

respiratory medicinegeneral practiceoxycodone
VIC2025-04-01

Finding into death of Paul Arthur Phelps

76y · Male·Complications of metastatic renal cancer in a man with multiple medical co-morbi…

A 76-year-old man with metastatic renal cancer and multiple comorbidities died in prison from complications of his malignancy. Following a family meeting in November 2023, goals of care were clarified and the patient cho…

oncologyurology
VIChome2025-04-01

Finding into death of Jack Elliot Atkinson

26y · Male·Drug toxicity (1,4 butanediol, gamma hydroxybutyrate, methylamphetamine, cocaine…

Jack Atkinson, 26 years old, died from mixed drug toxicity involving GHB/1,4-butanediol, methylamphetamine, cocaine, novel benzodiazepines (bromazolam, flubromazepam), nordiazepam, and ketamine. He had a history of subst…

general practiceaddiction medicine1,4-butanediol
VIChospital2025-04-01

Finding into death of ZSQ

81y · Male·Community acquired pneumonia in a man with acute on chronic renal failure

An 81-year-old man with chronic respiratory disease and renal failure died from community-acquired pneumonia complicated by acute-on-chronic renal failure. He presented to hospital on 25 April 2023 with respiratory failu…

intensive carerespiratory medicinediagnosticdelayadrenaline
VIC2025-03-31

Finding into death of George Platakis

54y · Male·Klebsiella pneumoniae pneumonia in a man with Huntington's Disease, with contrib…

George Platakis, a 54-year-old man with Huntington's Disease and COPD, died from Klebsiella pneumoniae pneumonia while residing in specialist disability accommodation. He had sustained a serious fall in January 2023 caus…

neurologyrespiratory medicine
VIC2025-03-31

Finding into death of John David Hogarth

59y · Male·Injuries sustained in a motorcycle incident (rider)

A 59-year-old experienced motorcyclist died from injuries sustained when his motorcycle lost control on the Western Freeway near Ballan, Victoria. He was riding a roadworthy Harley Davidson when he lost balance after rid…

diazepam
VIChospital2025-03-28

Finding into death of Barbara Anne Deal

86y · Female·Pulmonary thromboembolism in the setting of deep leg vein thrombosis, secondary …

Barbara Deal, 86, died from pulmonary embolism secondary to deep vein thrombosis 17 days after lumbar spinal fusion surgery. Critical failures included: no repeat VTE risk assessments despite policy requirements; inconsi…

neurosurgeryinfectious diseasesmedicationsystemapixaban
VICaged care2025-03-27

Finding into death of Janet Louise Cumming

89y · Female·Aspiration pneumonia and malnutrition, with contributing factors of dysphagia an…

Janet Cumming, aged 89, died from aspiration pneumonia and malnutrition due to dysphagia and cerebral palsy. She had lived in supported disability accommodation for over 20 years and required 24-hour care. In her final w…

general practicedisability medicineoxycodone
VIChospital2025-03-24

Finding into death of Isobel Francis

65y · Female·Status epilepticus complicating cerebral palsy

Ms Francis, a 65-year-old woman with cerebral palsy and intellectual disability, died from status epilepticus after multiple hospital admissions for aspiration pneumonia and declining functional status. She had recurrent…

general medicineneurologyantiepileptics
VIChome2025-03-18

Finding into death of R T

66y · Male·Complications of excess alcohol intake in a man with heart disease

A 66-year-old man died from complications of excess alcohol intake in the setting of underlying heart disease. He had a 40+ year history of heavy daily alcohol consumption (12+ cans of beer plus whiskey daily), chronic p…

general practiceemergency medicinealcohol
VIChospital2025-03-18

Finding into death of R J

41y · Male·complications of acute ethanol toxicity

Mr RJ, a 41-year-old man with a history of progressive alcohol misuse and mental health conditions (anxiety and depression), died from complications of acute ethanol toxicity following cardiac arrest due to aspiration an…

emergency medicineintensive caresystemalcohol
VIChome2025-03-14

Finding into death of Jonathan Mark Townsend

59y · Male·Unascertained

Jonathan Townsend, a 59-year-old Navy veteran with PTSD, alcohol use disorder, and multiple psychiatric comorbidities, died at home on 5 November 2021. The cause of death was unascertained despite autopsy and toxicology.…

trauma surgerypsychiatrycommunicationsystemdiazepam

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