29 results
58y · Female·lymphangitic carcinomatosis leading to hypoxaemic respiratory failure and cardia…
June Nutter, a 58-year-old woman presenting with weight loss, anorexia, and unexplained shortness of breath, underwent gastroscopy and colonoscopy at a private hospital to investigate suspected gastric pathology. She had…
27y · Male·multiple organ failure due to the consequences of multiple gunshot wounds to the…
Mahmoud Houri died aged 27 in custody from multiple organ failure, a consequence of gunshot wounds sustained in 2002. The inquest examined whether appropriate care was provided on 21 August 2008 when he presented with vo…
49y · Male·Metastatic cholangiocarcinoma
Jamie Walker, a 49-year-old man with pre-existing epilepsy, cirrhosis, and hepatitis C, died in custody from metastatic cholangiocarcinoma. He presented with abdominal pain and leg swelling; initial ED assessment on 19 O…
33y · Male·complications of acute peritonitis caused by rupture of a duodenal ulcer
Sony William Tran-Bui, aged 33, died from acute peritonitis caused by a ruptured duodenal ulcer while in custody at Silverwater Correctional Centre in November 2013. The death was not preventable given the sudden, unexpe…
67y · Female·Sepsis as a result of gastric perforation
Margaret Pegum, aged 67, died from sepsis following gastric perforation after an intragastric balloon (IGB) procedure for weight loss. She had undergone fundoplication for hiatus hernia in 2012. Despite prior gastric sur…
3y · Female·peritonitis caused by small bowel perforation due to blunt force trauma
A 3-year-old girl died from peritonitis caused by small bowel perforation. Expert evidence established the perforation resulted from blunt force trauma, not natural disease or accidental mechanisms. The manner of injury …
82y · Male·complications of metastatic pancreatic cancer with end stage liver failure
An 82-year-old man died of end-stage liver failure due to metastatic pancreatic cancer while serving a custodial sentence. He was comprehensively assessed on entry to prison and housed in an Aged Care Unit where his mult…
1y · Female·aspiration of gastric contents due to recent gastroenteritis and vomiting leadin…
Bridgett Currah was a 19-month-old girl with complex medical needs including cyanotic congenital heart disease, gastro-oesophageal reflux, and feeding difficulties. She presented to Mildura Base Hospital on 21 May 2013 w…
88y · Female·combined effects of an overdose of hydromorphone and complications of pneumonia …
An 88-year-old woman with chronic lung disease, heart disease, and recent pneumonia following faecal transplant for clostridium difficile colitis was prescribed 0.5 mg hydromorphone subcutaneously for respiratory distres…
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