402 results for “fall risk”
Female·multiple injuries due to a fall from height (suicide by jumping from multi-store…
…ust 2004 against medical advice, declining ECT and antipsychotic medication despite being delusional and at risk. On 19 September she deteriorated acutely with suicidal ideation and was admitted to Princess Alexandra Hos…
34y · Male·Consistent with injuries sustained by falling tree impacting cabin of truck
Steven Kadar, 34, died when a 30-metre alpine ash tree fell onto his vehicle during firefighting operations at Pheasant Creek Track on 13 February 2013. The coroner found no fault with the strategic decision to use this …
24y · Female·Exsanguination from injuries sustained while attempting to climb from a height i…
…lood spatter patterns, and movement patterns indicated her descent was substantially controlled, not a free fall. The investigation initially focused on foul play but the coroner concluded this was neither suicide with i…
41y · Male·Multiple traumatic injuries
This inquest examined the death of a 40-year-old man who died by suicide following a fall from a cliff. He had three involuntary admissions to mental health facilities in a fortnight before his dea…
51y · Female·Multiple injuries sustained from a fall from the top floor of a multi-storey car…
…ssion on 28 May 2020 for blood transfusion, Mosman Park Home staff clearly communicated her high absconding risk and requirement for constant supervision via telephone conversations, a transfer form, and comprehensive me…
6y · Male·Complications of Head Injury following a fall from a Fairground Ride
Six-year-old Eugene Mahauariki was ejected from the Cha Cha ride at a carnival in Rye, Victoria on 17 April 2017 and died from head injuries four days later. The coroner found the death was preventable due to three criti…
57y · Male·Consequences of multiple injuries (from fall from elevated walkway)
Mladen Jovanoski, a 57-year-old remand prisoner, died from head injuries sustained after falling from a prison walkway on 11 April 2018. He had suspected metastatic thyroid cancer requiring urgent biop…
67y · Male·Complications of pressure ulcers in the setting of a thoracic vertebral fracture…
…pressure ulcer complications following a spinal injury sustained during a CT scan on 3 January 2023. He had fallen from his wheelchair at home and presented to ED with hypotension and back pain. Despite being unable to l…
36y · Male·multiple injuries consistent with a fall from a height
A 36-year-old man with severe depression, social isolation, and recent life crises (job loss, marital breakdown, reduced child contact) posted suicidal messages on social media and stood on a cliff ledge. Police negotiat…
84y · Male·The available evidence does not allow for any finding to be made as to the cause…
…ayed engagement of a Land Search and Rescue Coordinator (not deployed until 19 September despite 'very high risk' assessment), lack of designated family liaison officer creating ad hoc communication, and failure to consu…
23y · Male·injuries sustained in fall from Tasman Bridge and/or drowning after submersion i…
…from baseline; (2) Capacity assessment requires gathering information beyond the interview itself; (3) High risk should prompt more rigorous scrutiny of the capacity determination; (4) A 'best practice' approach includes…
29y · Female·Multiple injuries due to fall from height
A 29-year-old woman with rapidly deteriorating mental health presented to Ipswich Hospital ED triaged as ATS Category 3 requiring assessment within 30 minutes. Multiple systemic and clinical failures delayed appropriate …
64y · Male·Electrocution from contact with fallen low-voltage power lines that remained ene…
Graham Tait died from electrocution after contacting fallen low-voltage power lines while investigating a partial power loss at his home. A partial loss of supply or…
26y · Male·multiple injuries from fall from height
…ate management of homelessness, missing substance use intervention, and failure to recognise a complex high-risk patient requiring dedicated case management. The coroner emphasised that while Channa's symptoms were chall…
39y · Male·Excited delirium, probably caused by amphetamine toxicity-induced psychosis. Dea…
…nd multiple taser activations. He had acute amphetamine toxicity and was displaying excited delirium—a high-risk medical emergency. Clinical lessons include: (1) excited delirium with amphetamine toxicity is potentially …
Female·Multiple causes: Ruby Natasha Nicholls-Diver: ligature compression of neck (hang…
…ng critical failures in mental health service delivery. Key clinical lessons: (1) Individual management and risk assessment plans must be documented for all patients, especially those with chronic suicide risk; (2) Famil…
Unknown·Ms Fensom: influenza A (H1N1 2009, pandemic swine flu) with myocarditis causing …
Two deaths from H1N1 influenza in 2009. Ms Fensom (41) died from myocarditis complicating swine flu after inadequate recognition and management of persistent hypotension at Millicent Hospital. Her condition required esca…
Unknown·Four deaths: three by self-inflicted hanging, one by multiple injuries from fall
Four Aboriginal Tiwi Islanders died in 1998 from suicide by hanging (three cases) and by falling from a power pole (one case). The inquest identified widespread alcohol and cannabis abuse, domestic vio…
25y · Female·Chest injuries due to fall from height
…as a schizophrenic patient who threatened to jump the day of her death but was not assessed or reviewed; no risk assessment was conducted despite clinical deterioration postpartum. AW spent 462 days in an unsuitable acut…
32y · Male·Asphyxia in a man with Friedreich's Ataxia due to positional asphyxia; unable to…
…lie Troy Ovens, a 32-year-old man with progressive Friedreich's Ataxia, died from positional asphyxia after falling from his wheelchair. He had deteriorated significantly after hospitalisation in June 2013 and was weaken…
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