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NSWhospital2021-05-27

Inquest into the death of George McLEOD

80y · Male·Atherosclerotic cardiovascular disease, with dementia, diabetes mellitus and hyp…

An 80-year-old man with extensive medical comorbidities (atherosclerotic cardiovascular disease, dementia, diabetes, hypertension, COAD, previous MI with bypass grafts) died in custody at Long Bay Hospital from natural c…

forensic medicinegeriatric medicine
NSW2021-05-26

Inquest into the death of Liam WOLF

19y · Male·unexpected arrhythmogenic event leading to a fall from height, blunt force head …

PTE Liam Wolf, a 19-year-old Australian Army recruit, died after collapsing on an obstacle course at Kapooka during the final training exercise. He experienced a sudden unexpected cardiac arrhythmia while climbing a ladd…

emergency medicinecardiologysystemdelay
NSWhospital2021-05-25

Inquest into the death of Melvin LYNCH

72y · Male·Complications of subtotal colectomy for diffuse polyposis and invasive adenocarc…

Melvin Lynch, aged 72, died in custody at Prince of Wales Hospital on 9 December 2019, nine days after elective subtotal colectomy for bowel cancer. Post-operatively, he developed complications including pleural effusion…

colorectal surgerygeneral surgery
NSWcommunity2021-05-21

Inquest into the death of Pono Wairua Aperahama

17y · Male·Cardiac arrhythmia during restraint, with previous traumatic brain injury as a s…

Pono Aperahama, a 17-year-old with severe traumatic brain injury and moderate intellectual disability, died from cardiac arrhythmia during restraint at a swimming pool. His escalating behaviour in 2017—triggered by schoo…

neurologypsychiatrysystemcommunication
NSWhome2021-05-20

Inquest into the deaths of Bruce ROBERTS and Shane SNELLMAN

Male·Shane Snellman: gunshot wound to the supraclavicular fossa; Bruce Roberts: unasc…

Two unrelated deaths investigated together at the same property: Shane Snellman died from a gunshot wound to the supraclavicular fossa inflicted by the property owner Bruce Roberts in October 2002 after Snellman gained u…

methamphetamine
NSW2021-05-12

Inquest into the death of Jack KOKAUA

30y · Male·Malignant ventricular arrhythmia without myocardial infarction, precipitated by …

Jack Kokaua, a 30-year-old with schizophrenia and coronary artery disease, died from malignant ventricular arrhythmia during a police encounter after absconding from hospital. Contributing factors included positional asp…

emergency medicinepsychiatryproceduralcommunicationzuclopenthixol
NSWcommunity2021-05-07

Inquest into the death of S

42y · Male·Gunshot wound to the head

A 42-year-old NSW Police Sergeant died from a self-inflicted gunshot wound while on highway patrol duty. One week prior, he had been notified of a criminal misconduct investigation by Professional Standards Command, but …

psychiatryoccupational and environmental healthsystemcommunication
NSWhospitalPodcast2021-05-07

Inquest into the death of Brent Justin CROUGH

24y · Male·Complications of Brown Snake Bite

Brent Crough, a 24-year-old man, died from complications of brown snake bite in hospital. He was bitten on his right finger while separating the snake from his dog and was transported to Tamworth Base Hospital. Despite a…

emergency medicinetoxicologysystemdelaybrown snake antivenom
NSWhospital2021-05-07

Inquest into the death of Channa

26y · Male·multiple injuries from fall from height

A 26-year-old man with schizophrenia was discharged from mental health inpatient care on a community treatment order without meeting his allocated case manager, confirmed accommodation, or drug and alcohol intervention. …

psychiatryemergency medicinecommunicationdelaypaliperidone
NSWhome2021-04-30

Inquest into the deaths of Gabriella THOMPSON and Tafari WALTON

27y · Male·Gabriella: Multiple stab wounds; Tafari: Gunshot injuries to the head and abdome…

Two deaths in a domestic violence and police operation context. Gabriella Thompson, 27, was fatally stabbed by her partner Tafari Walton in domestic violence circumstances on 13 March 2019. Police received a concern for …

psychiatrygeneral practicecommunicationsystemmethamphetamine
NSWcommunity2021-04-19

Inquest into the suspected death of Quanne DIEC

12y · Female·Precise cause not determined - no postmortem examination conducted; alleged stra…

Quanne Diec, aged 12, disappeared on 27 July 1998 while walking to school in Granville, NSW. She was reported missing that evening and was never located. This inquest, held in 2021 (23 years later), examined extensive po…

NSWmental health2021-04-16

Inquest into the death of Pamuk RONA

53y · Female·unascertained natural causes

Ms Rona, a 53-year-old woman with major depression, was admitted involuntarily to Bungarabee House psychiatric unit on 6 August 2018 after presenting with catatonic features, mutism, and refusal to eat or drink. She was …

psychiatryemergency medicinelorazepam
NSWhospital2021-04-16

Inquest into the death of Kelvin MOULDS

61y · Male·Hypoxic encephalopathy arising from cardiac arrest following self-removal of a c…

Kelvin Moulds, a 61-year-old man, died of hypoxic encephalopathy following a cardiac arrest caused by self-removal of a central venous catheter (CVC) on day 14 post-bilateral lung transplant. The CVC was still in situ de…

cardiothoracic surgerytransplant medicinecommunicationsystemoxycodone
NSWhome2021-04-14

Inquest into the death of Adam COBLE

Male·stab wound to the chest

Adam Coble died from a stab wound to the chest inflicted during an episode of interpersonal violence on 14 January 2019 in North Richmond, NSW. The fatal injury occurred during a violent altercation that escalated from a…

forensic medicine
NSWhome2021-04-07

Inquest into the deaths of John, Jack and Jennifer EDWARDS

Multiple gunshot wounds to the head, chest, abdomen and extremities (Jennifer); …

Two children, Jack (15) and Jennifer (13), were fatally shot by their father John Edwards at their home on 5 July 2018. John had a 35-year history of family violence across multiple relationships, with documented evidenc…

diagnosticsystem
NSWcommunity2021-04-01

Inquest into the death of Braydon Worldon

15y · Male·Multiple Blunt Force Injuries from being struck by a motor vehicle

Braydon Worldon, aged 15, died from multiple blunt force injuries sustained when struck by a vehicle on a rural road in NSW. He had consumed modest amounts of alcohol (estimated BAC 0.057g/100ml) and was standing on Rive…

NSWhome2021-03-31

Inquest into the death of John Glen LAURENSON

47y · Male·sequelae of ruptured brain aneurysm

John Laurenson, a 47-year-old remand prisoner, died from rupture of a brain aneurysm on 20 June 2017, four days after collapsing in his prison cell. He had multiple intracranial aneurysms identified in 2015-2016, includi…

neurosurgerygeneral practicediagnosticcommunication
NSWcommunity2021-03-26

Inquest into the death of Stuart DOHRN

Male·remains undetermined

Stuart Dohrn was a missing person whose remains were found in the Royal National Park, Sutherland Shire, NSW. He died on or shortly after 14 December 2015. Following an inquest conducted on 26 March 2021, the State Coron…

NSWhome2021-03-17

Findings Becky

15y · Female·methylamphetamine and methadone toxicity

Becky, aged 15, died on 26 March 2016 from methylamphetamine and methadone toxicity at a private residence in Armidale, NSW. She was in the parental responsibility of the Department of Family and Community Services (FACS…

social workcommunicationsystemmethamphetamine
NSWhome2021-03-11

Inquest into the death of Chan Chen

35y · Female·Stab wounds to the chest

Chan Chen, 35, was killed by her husband Andrew Luo in their home through stab wounds to the chest. Luo had displayed increasingly erratic behaviour throughout 2019, including delusions of persecution, beliefs that Chen …

general practicepsychiatrydiagnosticcommunicationrisperidone
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