Coronial

537 results for sepsis

NSWhospital2018-06-29

Inquest into the death of Aidan Mara

3y · Male·Influenza A infection (Type H3N2)

Aidan Mara, a 3-year-old boy with influenza A pneumonia and hyponatraemia, collapsed and died from cardiovascular failure on hospital day 3. Critical clinical lessons include: (1) distinguishing SIADH from dehydration ea…

paediatricsemergency medicinediagnosticcommunicationcefotaxime
VIChospital2012-04-05

Finding into death of Abdullah Kocoglu

4y · Male·Complications of cutaneous thermal burn injuries

Abdullah Kocoglu, age 4, died from complications of severe thermal burn injuries sustained in a house fire on 14 February 2011 at his grandparents' home in Hampton Park, Victoria. The fire was ignited when Abdullah playe…

plastic and reconstructive surgeryintensive caresystemdelay
VIChospital2021-04-08

Finding into death of Ian Lindsay Gould

64y · Male·Complications of Creutzfeldt-Jakob Disease following a fall

Ian Gould, a 64-year-old man with a non-MRI compatible pacemaker, presented with vision loss in June 2019. Initial neurological and ophthalmological evaluation was normal; functional visual loss was suspected. He develop…

neurologyophthalmologysystemrivaroxaban
QLDhospital2009-11-20

Johnston, Margaret Allan

82y · Female·Complications from hypoglycaemic brain damage and cerebral vascular accident

Margaret Allan Johnston, 82-year-old admitted for UTI and confusion, was found comatose on 4 September 2006 with severe hypoglycaemia (glucose 0.8 mmol/L) despite being non-diabetic. Blood tests revealed high insulin and…

anaesthesiaendocrinologymedicationsysteminsulin
VICaged care2014-04-29

Finding into death of Marie Goder

84y · Female·Major cerebral infarct due to hypoglycaemia

Marie Goder, an 84-year-old with diabetes, developed severe hypoglycaemia following insulin administration at a nursing home on 1 November 2009, resulting in prolonged unconsciousness and bilateral cerebral infarcts. Aft…

general practicegeneral medicinediagnosticmedicationactrapid
QLDhospital2006-09-13

Rawson, Robert Donald

68y · Male·Internal haemorrhage due to coagulopathy and upper gastrointestinal varices, cir…

Robert Donald Rawson, a 68-year-old man with end-stage cirrhosis and multiple comorbidities, died hours after undergoing intercostal catheter insertion for pleural effusion drainage at Rockhampton Hospital. While the pro…

general surgeryrespiratory medicinesystemproceduralfresh frozen plasma
WAhome2012-09-07

Inquest into the Death of Mulvaney

54y · Female·Multi-organ failure following a decreased level of consciousness caused by compl…

Linda Christina Mulvaney, 54, died of multi-organ failure following a prolonged period of unconsciousness caused by a combination of obstructive and central sleep apnoea complicated by sedating substances. On 2 June 2008…

respiratory medicineintensive caredelaydiazepam
VICcommunity2022-07-12

Finding into death of Timothy Dale Fehring

15y · Male·Hypoxic-ischaemic encephalopathy complicating cardiac arrest in the setting of b…

Timothy Fehring, 15-year-old on a school excursion to Europe, died of hypoxic-ischaemic encephalopathy from cardiac arrest in the setting of bronchopneumonia and gastroenteritis. He developed gastroenteritis symptoms on …

paediatricsemergency medicinediagnosticcommunicationparacetamol
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
VIChome2019-12-11

Finding into death of Maddox Garry Wheeler

0y · Male·Unascertained

A 10-week-old boy born at 35 weeks gestation was found asleep on his mother's chest while she was asleep on a couch and died from an unascertained cause. Post-mortem toxicology detected methamphetamine and cannabis; the …

neonatologyobstetricscommunicationdelaymethamphetamine
VIChome2022

Finding into death of Baby A

0y · Male·Pneumonia in the setting of malnutrition

Baby A, born at home without medical assistance, died at 19 days old from pneumonia complicated by severe malnutrition and dehydration. He weighed 2.87kg at autopsy, far below his reported 4kg birth weight. He had diffic…

neonatologypaediatricsdelaycommunication
NSWaged care2015-03-09

Inquest into the deaths and fire at the Quakers Hills Nursing Home, Hambledon Road, Quakers Hill

smoke inhalation and burns from deliberately-lit fire (primary cause varies by i…

Fourteen elderly residents died in a deliberately-lit fire at Quakers Hill Nursing Home on 18 November 2011, set by drug-dependent nurse Roger Dean to destroy evidence of medication theft. Dean had worked while visibly i…

geriatric medicineoccupational and environmental healthsystemcommunicationoxycodone
VIChospital2014-12-16

Finding into death of Michael Justin Nicoll

36y · Male·Multiorgan failure complicating Streptococcus pyogenes septicaemia

Michael Nicoll, 36, presented to Cabrini Hospital ED with diarrhoea, vomiting, and dehydration. Dr P. diagnosed gastroenteritis and discharged him after IV fluids, despite dehydration, tachycardia, elevated creatinine, a…

emergency medicineintensive carediagnosticsystemondansetron
VIC2020-12-09

Finding into death of Alma Lynette Honeychurch

76y · Female·Ludwig's angina

A 76-year-old woman with Ludwig's angina presented to urgent care with facial swelling and fever. She was appropriately diagnosed and arrangements made for transfer to a tertiary centre. However, staff failed to recognis…

emergency medicinedentistrydiagnosticcommunicationantibiotics
VIChospital2010-03-15

Finding into death of Deborah Margaret Ricklefs

29y · Female·Invasive aspergillosis

A 29-year-old registered nurse with systemic lupus erythematosus (SLE) died from invasive aspergillosis. Dr G. prescribed lamotrigine 100 mg daily (double the recommended initial dose of 50 mg) on first consultation with…

addiction medicinegeneral practicemedicationdiagnosticlamotrigine
SAhome2007-09-20

Coroner's Finding: EDWARDS Elizabeth Rose

0y · Female·combined effects of asphyxia and inhalation of gastric contents

Elizabeth Rose Edwards, a 9-month-old premature infant with perinatal brain injury, died of asphyxia and aspiration of gastric contents while in temporary foster care. She had been placed with carers (the Todds) with min…

paediatricsneonatologysystemcommunication
QLDhome2019-10-02

Banjo, Neil Richard

53y · Male·Traumatic brain injury sustained from police use of force on 25 February 2016, t…

Neil Banjo, a 53-year-old Aboriginal man, died from traumatic brain injury sustained during a police confrontation on 25 February 2016 in Normanton, Queensland. Officers attended a family birthday party to arrest his int…

trauma surgeryemergency medicinesystemdelay
VIChospital2023-08-14

Finding into death of Md Fakrul Alam Sozon

33y · Male·Haemoperitoneum secondary to lacerated spleen as a result of peritoneal ascitic …

A 33-year-old man with severe alcoholic liver disease (Child-Pugh C) and poor prognosis died from haemoperitoneum following splenic laceration during a diagnostic ascitic tap procedure. Two junior doctors (HMOs/Basic Phy…

gastroenterologyintensive careproceduraldiagnostic
ACThospital2019-11-22

Inquest into death of JAMIE LAWRENCE MITCHELL

36y · Male·Septicaemia and cerebral artery air embolism, due to complications related to cl…

…ber after CT imaging. Urgent surgery at The Canberra Hospital and Calvary occurred with delay, followed by sepsis despite treatment. The coroner, applying strict causation principles, determined no public hearing was nec…

cardiologycardiothoracic surgerydiagnosticdelay
VIChospital2024-10-10

Finding into death of Makayla Lee Wadeson

9y · Female·Streptococcus pneumoniae and Candida albicans pneumonia and empyema in a girl wi…

Makayla Lee Wadeson, a 9-year-old autistic girl with ulcerative colitis on immunosuppressive therapy, presented to the emergency department with ear infection symptoms on 29 July 2022. She was triaged Category 4 and disc…

emergency medicinepaediatricsdiagnosticsystemcefalexin
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