101 results
42y · Male·ligature compression of the neck (hanging)
Wayne Larder, a 42-year-old man with depression, suicidal ideation, and substance use disorder, died by hanging in Hakea Prison on 22 February 2021. Critical failures in suicide risk management included: (1) mental healt…
0y · Male·Complications in association with fulminant sepsis in an infant (Streptococcus p…
Malakai Paraone, a seven-month-old infant, died from fulminant Streptococcus pyogenes sepsis and septic shock. Over three days, he was seen at three hospitals and a general practice clinic but sepsis was not identified. …
77y · Male·cardiac failure in an elderly man with valvular heart disease and other co-morbi…
Brian Attwell, a 77-year-old sentenced prisoner with multiple chronic conditions including diabetes, chronic renal failure, peripheral vascular disease, and valvular heart disease, died of cardiac failure in hospital. He…
67y · Female·bronchopneumonia and acute liver failure on a background of liver cirrhosis and …
Valerie Kelly, a 67-year-old woman with cirrhosis, hepatocellular carcinoma, and multiple comorbidities, died at Royal Perth Hospital from bronchopneumonia and acute liver failure. She was in custody at Bandyup Women's P…
73y · Male·Complications, including multi-organ failure and pneumonia, of chronic obstructi…
Alexander Robert Eatts, a 73-year-old prisoner with severe chronic obstructive pulmonary disease (COPD), congestive cardiac failure, and multiple comorbidities, died from complications of COPD including multi-organ failu…
69y · Male·Chronic obstructive pulmonary disease and coronary artery atherosclerosis
James Ronald Chi, aged 69, died from chronic obstructive pulmonary disease and coronary artery atherosclerosis at Broome Hospital. He was an involuntary mental health patient with treatment-resistant bipolar disorder and…
52y · Male·multiple organ failure and pulmonary thromboemboli complicating generalised seps…
A 52-year-old man with longstanding refusal of medical care presented with severe cellulitis, sepsis, and previously undiagnosed heart failure secondary to sleep apnoea. He lacked capacity to consent to treatment due to …
45y · Male·severe chronic obstructive pulmonary disease
Troy Michael Conley, aged 45, died from severe chronic obstructive pulmonary disease (COPD) while imprisoned. He had developed progressive lung disease from occupational exposure to gyprock dust, intravenous drug use (ta…
80y · Male·Bronchopneumonia complicating terminal palliative care in an elderly man with ch…
Aurelio Monterlegre Cruz, an 80-year-old man with complex medical conditions including chronic renal failure, ischaemic heart disease, diabetes, and COPD, died of bronchopneumonia complicating terminal palliative care wh…
68y · Male·Bronchopneumonia in a man with chronic obstructive pulmonary disease
Maris Kugis, a 68-year-old man with chronic schizophrenia, personality disorders, and multiple serious physical conditions including COPD, ankylosing spondylitis, and undiagnosed pancreatic adenocarcinoma, died from bron…
39y · Female·pulmonary thromboembolism due to deep vein thrombosis and sepsis due to pyelonep…
Lorna May Woods, 39, died from pulmonary thromboembolism due to deep vein thrombosis and sepsis secondary to pyelonephritis on a background of metastatic ovarian cancer. She presented to Joondalup Health Campus with uros…
62y · Male·bronchopneumonia on background of chronic obstructive pulmonary disease
Stephen Kenneth Ryan, a 62-year-old man with treatment-resistant schizophrenia and severe COPD from lifelong smoking, died of bronchopneumonia on 12 August 2013 at Bentley Hospital. He had been an involuntary psychiatric…
51y · Female·Ischaemic heart disease
Pauline Margaret Dodd, 51, died of ischaemic heart disease at Sir Charles Gairdner Hospital on 4 March 2014. She was an involuntary psychiatric patient with long-standing bipolar affective disorder, complicated by childh…
82y · Male·Pneumonia in an elderly man with advanced lung cancer (squamous cell carcinoma)
Charles William Mapp, 82, died of pneumonia secondary to advanced lung cancer at Sir Charles Gairdner Hospital. He had been an involuntary psychiatric patient at Graylands Hospital for nine years with chronic schizophren…
52y · Female·intracerebral haemorrhage in a lady with underlying cerebrovascular disease and …
A 52-year-old woman underwent right carotid endarterectomy for high-grade stenosis. Post-operatively she developed escalating blood pressure readings (160–220 mmHg), headaches, nausea, agitation, and abnormal behaviour o…
55y · Male·Complications of fibrosing alveolitis
John Majinski, a 55-year-old prisoner with severe fibrosing alveolitis, pulmonary hypertension, diabetes, and recurrent infections, died from complications of his lung disease while incarcerated. He received intensive me…
71y · Male·Organ failure in an elderly man receiving palliative medical care for renal fail…
Gheorghe Gruici, a 71-year-old life-sentenced prisoner, died of organ failure from chronic renal failure, infective endocarditis, and chest infection. Over 15 years in custody, he developed multiple comorbidities includi…
44y · Male·Early bronchopneumonia in a man receiving palliative medical care for liver fail…
Robert James, a 44-year-old prisoner with end-stage hepatitis C cirrhosis, died from early bronchopneumonia while receiving palliative care. He had been terminally ill for over a year, with progressively deteriorating li…
66y · Male·multiple organ failure associated with the combined effects of complications of …
Daniel Lahengking, a 66-year-old Indonesian visiting family in Esperance, was diagnosed with rheumatoid arthritis by locum GP Dr H. and prescribed methotrexate 5-10mg daily, a grossly excessive dose (normal: 7.5-20mg wee…
28y · Female·multiple injuries from deliberate fall from pedestrian bridge onto Mitchell Free…
Sarah Jane Rutherford, a 28-year-old woman with bipolar affective disorder and schizophrenia, died on 27 December 2009 after falling from a pedestrian bridge onto the Mitchell Freeway in Perth. She was an involuntary pat…
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