Coronial
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SAhospital2023-08-30

Coroner's Finding: Fergusson, Logan Scott

0y · Male·hypoxia and reduced pulmonary perfusion complicating congenital heart disease

Logan Scott Fergusson, a 6½-week-old neonate with complex congenital heart disease (pulmonary atresia with ventricular septal defect), died from hypoxia and reduced pulmonary perfusion following surgery at the Royal Chil…

cardiologypaediatricsdelaydiagnosticheparin
SA2023-05-12

Coroner's Finding: Morrison, Wayne Fella

29y · Male·Hypoxic ischaemic encephalopathy and multi-organ failure due to out of hospital …

Wayne Fella Morrison, a 29-year-old Aboriginal man with undiagnosed coronary artery disease (70% stenosis of right coronary artery), died following cardiac arrest during his detention at Yatala Labour Prison. After attac…

emergency medicineintensive caresystemdelay
SAhospital2023-03-01

Coroner's Finding: Coats, Beverley Joy and West, Heather Maud and DSouza, Lorna Margaret

Female·haemopericardium due to aortic dissection (all three cases)

Three elderly women died from acute aortic dissection at Queen Elizabeth Hospital, South Australia. Beverley Coats (73) presented three times in July 2016 with back pain, nausea and vomiting; her known aortic dilatation …

emergency medicinecardiologydiagnosticcommunication
SAcommunity2023-01-31

Coroner's Finding: Bromage, Ronald

72y · Male·acute cerebral infarction complicating acute myocardial infarction

Ronald Bromage, aged 72, died from acute cerebral infarction complicating acute myocardial infarction. He presented with chest pain on 22 and 25 February 2016 to his GP, Dr P., who diagnosed costochondritis without perfo…

general practicecardiologydiagnosticdelayparacetamol/codeine
SAhome2022-12-22

Coroner's Finding: Abbott, John

69y · Male·plastic bag asphyxia and mixed drug toxicity (oxycodone and pentobarbitone)

John Abbott, aged 69, died from plastic bag asphyxia and mixed drug toxicity (oxycodone and pentobarbitone) while under home detention bail with electronic monitoring. He had a complex medical history including chronic o…

general practicepsychiatryoxycodone
SAhospital2022-12-22

Coroner's Finding: Shore Wayne John

55y · Male·right intracerebral haemorrhage and left middle cerebral artery cerebrovascular …

Wayne Shore, 55, died from right intracerebral haemorrhage and left middle cerebral artery stroke complicating infective endocarditis, end-stage renal failure, and multiple myeloma. He was subject to a Level 1 Inpatient …

neurologynephrologyanticoagulant therapy
SAhome2022-12-16

Coroner's Finding: Reid, Paul

50y · Male·ischaemic heart disease

Paul Reid, a 50-year-old Aboriginal man with severe ischaemic heart disease and poor medication compliance, died of a cardiac arrhythmia during his arrest by South Australian Police. He was highly intoxicated (BAC 0.25%)…

cardiologyforensic medicinediagnosticsystemalcohol
SAhospital2022-10-27

Coroner's Finding: Rentoulis Dimitrios

79y · Male·Iatrogenic right ventricular injury complicating drainage of pericardial collect…

A 79-year-old man died from iatrogenic right ventricular injury sustained during attempted drainage of a post-operative pericardial effusion following coronary artery bypass grafting. During a minimally invasive sub-xiph…

cardiothoracic surgeryanaesthesiaproceduralwarfarin
SAhospital2022-06-10

Coroner's Finding: McCallum, Myrtle Olive

95y · Female·acute left subdural haematoma complicating anticoagulant therapy for deep vein t…

A 95-year-old woman with multiple comorbidities including congestive heart failure was admitted with suspected pneumonia and cellulitis. She developed deep vein thrombosis and was started on enoxaparin anticoagulation. S…

psychiatrygeneral medicineenoxaparin
SAhospital2022-04-14

Coroner's Finding: Esposito, Pasquale

76y · Male·combined effects of acute myocardial infarction and urosepsis

Pasquale Esposito, age 76, died in custody at Lyell McEwin Hospital from combined acute myocardial infarction and urosepsis. He had extensive cardiac history including prior MI, CABG, COPD, and recent stent placement. On…

cardiologyinfectious diseasesantibiotics
SA2022-03-30

Coroner's Finding: Hohol, Peter

68y · Male·decompensated heart failure with pulmonary hypertensive crisis complicated by pn…

Peter Hohol, a 68-year-old prisoner with significant cardiac comorbidities including ischaemic and dilated cardiomyopathy, died from decompensated heart failure with pulmonary hypertensive crisis complicated by pneumonia…

cardiologygeneral medicine
SAhospital2022-03-29

Coroner's Finding: Foster, Clive Anthony

76y · Male·end-stage renal failure

A 76-year-old man died of end-stage renal failure while imprisoned. He had pre-existing hypertension, diabetes, and stage 3 chronic kidney disease. During his final year in custody, he experienced acute kidney injury sup…

general medicinenephrology
SA2021-11-25

Coroner's Finding: Clark, Murray Eric

81y · Male·valvular heart disease with cardiac amyloidosis

Murray Eric Clark, 81-year-old prisoner with extensive cardiac history including aortic stenosis, sick sinus syndrome with pacemaker, and recent TAVI procedure, collapsed and died in prison infirmary on 20 September 2019…

cardiologyemergency medicineanticoagulants
SAhospital2021-11-23

Coroner's Finding: Barry, Margaret Joan

80y · Female·Right haemothorax due to bleeding right pleural adhesion with contributing apixa…

Margaret Joan Barry, 80, died from right haemothorax due to bleeding from a pleural adhesion while on apixaban anticoagulation therapy for atrial fibrillation. She was admitted to Royal Adelaide Hospital for psychiatric …

psychiatrycardiologyapixaban
SAhospital2021-11-23

Coroner's Finding: Osborne, Brian Thomas

89y · Male·combined effects of cerebrovascular accident, pneumonia and chronic cardiac fail…

An 89-year-old man with multiple comorbidities (ischaemic heart disease, diabetes, COPD) presented with chest infection and was admitted for heart failure. He suffered an acute stroke with subsequent delirium and combati…

cardiologyneurologyinsulin
SAhospital2021-11-16

Coroner's Finding: Kresevic, Ivanka

74y · Female·acute myocardial infarction due to coronary artery thrombosis

74-year-old woman presented to emergency department with chest pain on 6 January 2017. She was diagnosed with gastro-oesophageal reflux disease and discharged after 53 minutes. She died of acute myocardial infarction due…

emergency medicinecardiologydiagnosticcommunication
SA2021-06-02

Coroner's Finding: DUFFIELD Clinton John

35y · Male·unascertained - multifactorial cardiorespiratory arrest

A 35-year-old male died in police custody following arrest for dangerous driving and property damage. He displayed acute psychotic behaviour with paranoia, aggression, and 'super-strength' during restraint. Post-mortem e…

forensic medicineemergency medicinecannabis
SA2021-05-28

Coroner's Finding: GIBSON Ian Keith

46y · Male·congestive cardiac failure due to cardiomyopathy and coronary artery atheroscler…

A 46-year-old man with significant cardiac and medical comorbidities died of congestive cardiac failure due to cardiomyopathy and coronary artery atherosclerosis while in police custody. He was correctly categorized as H…

cardiologygeneral practiceproceduralcommunication
SA2021-01-15

Coroner's Finding: MITTIGA Saverio

89y · Male·multi-organ failure on a background of advanced dementia and small cell lung can…

An 89-year-old prisoner with advanced dementia and small cell lung cancer died from multi-organ failure whilst in lawful custody at Yatala Labour Prison. He entered prison aged 83 with complex medical needs including isc…

general practicepalliative caremorphine
SAhospital2020-12-22

Coroner's Finding: MAVRIDIS Emanuel

64y · Male·Heart failure secondary to alcohol related liver disease, coronary obstructive p…

Emanuel Mavridis, aged 64, died of heart failure secondary to alcohol-related liver disease, COPD, and ischaemic/alcoholic cardiomyopathy. He presented to Royal Adelaide Hospital hypotensive with metabolic acidosis and w…

intensive caregeneral medicine
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