Coronial

65 results for attention deficit hyperactivity disorder

VICmental health2012-10-12

Finding into death of Grant Elliot Phillips

29y · Male·Multiple injuries sustained in a train incident (intentional self-harm)

Grant Phillips, 29-year-old with schizophrenia and complex psychiatric history including multiple suicide attempts, was admitted involuntarily to Broadmeadows Inpatient Psychiatric Unit on 5 May 2007. Despite being asses…

psychiatrydiagnosticsystemdextroamphetamine
VIChome2023-07-28

Finding into death of Jackson Desmond David Stawicki

24y · Male·Haemorrhagic shock in the setting of a sharp force injury to the left arm

Jackson Stawicki, 24, died from haemorrhagic shock following a sharp force injury to his left arm while intoxicated with multiple illicit substances. He presented to the ED three times within 24 hours (4-5 September 2020…

emergency medicinepsychiatrycommunicationsystemflualprazolam
QLDhome2025-10-10

Inquest into the death of AB

31y · Male·Hanging

31-year-old male with borderline personality disorder, alcohol use disorder, and history of self-harm died by hanging. He had multiple presentations to emergen…

psychiatrygeneral practicesystemcommunicationalcohol
NSWhome2024-03-26

Inquest into the death of MO

6y · Unknown·methadone toxicity

A 6-year-old boy died from methadone toxicity after ingesting his parents' takeaway methadone mixed in juice at home. Both parents were on the NSW Opioid Treatment Program (OTP). The prescribing physician increased metha…

addiction medicinepaediatricsdiagnosticcommunicationmethadone
VICaged care2026-01-19

Finding into death of Kevin Thomas Maloney

39y · Male·Mixed drug toxicity (heroin, venlafaxine, alprazolam, pregabalin) with contribut…

Kevin Thomas Maloney, a 39-year-old man with complex mental health conditions and substance use disorder, died from mixed drug toxicity (heroin, venlafaxine, alprazolam, pregabalin) while residing in a supporte…

psychiatryaddiction medicinecommunicationsystemheroin
SAhospital2009-05-22

Coroner's Finding: ROBERTS Jarrad Delroy

10y · Male·sepsis (fusobacterium necrophorum) complicating right otitis media

…ntibiotic treatment. Critical systemic failures included: mother's severe untreated post-traumatic stress disorder and neglect; extremely poor living conditions; chronic school non-attendance (65 of 76 days absent in fir…

paediatricsgeneral practicedelaysystemamoxicillin
SAaged care2020-02-28

Coroner's Finding: NISCO Sophia Alessia

16y · Female·upper airway occlusion due to aspiration of a foreign body (disposable latex glo…

Sophia Nisco, a 16-year-old with severe cerebral palsy and intellectual disability, died from airway obstruction after aspirating a disposable latex glove at a respite care facility. She had documented oral fixation beha…

rehabilitation medicinesupervisionsystem
NSWhospital2020-01-31

Inquest into the death of OS

5y · Male·Combined effects of prescribed morphine, valproic acid and midazolam leading to …

A five-year-old child with complex neurodevelopmental conditions and polypharmacy (including valproic acid for epilepsy, benzodiazepines, and other medications) underwent routine burn dressing change at hospital with ora…

plastic and reconstructive surgeryanaesthesiamedicationproceduralmorphine
NSW2022-08-18

Inquest into the death of Gavin Ellis

31y · Male·hanging

Mr Gavin Ellis, 31 years old, died by hanging in custody on 2 April 2017 at the Metropolitan Remand and Reception Centre, Silverwater. He had a chronic treatment-resistant schizophrenic illness with extensive self-harm h…

psychiatrycorrectional healthdiagnosticcommunicationaripiprazole
VICcommunity2021-03-10

Finding into death of Jack David watson

26y · Male·Plastic bag asphyxia in the setting of a vitiated atmosphere with inert gases

Jack Watson, 26, died by intentional asphyxiation with inert gas on 2 August 2016. He had a long history of mental health issues including ADHD, depression and suicidal ideation. Following acute psychiatric admission to …

psychiatryemergency medicinecommunicationsystemdextroamphetamine
VIChome2023-01-17

Finding into death of Steven John Bamblett

29y · Male·Hanging

Steven John Bamblett, a 29-year-old Aboriginal man, died by hanging on 14 January 2020 following service of a Family Violence Intervention Order application. He had a documented history of untreated mental illness with f…

psychiatryforensic medicinecommunicationsystemcannabis
NSWhome2023-08-22

Inquest into the death of George Campbell

17y · Male·hydrocarbon toxicity (petrol inhalation)

George Campbell, an Aboriginal youth with complex trauma, ADHD, and emerging volatile substance misuse, died aged 17 from hydrocarbon toxicity after inhaling petrol. While living with supportive kinship carers (Paul and …

paediatricspsychiatrycommunicationsystempetrol
VIC2022-07-28

Finding into death of Master S

17y · Male·Unascertained in the setting of volatile substance abuse

Master S, a 17-year-old Yorta Yorta young man, died on 3 July 2017 at the Bert Williams Hostel from a cause unascertained in the setting of volatile substance abuse (chroming Rexona deodorant). He had a history of exposu…

paediatricspsychiatrycommunicationsystemrexona deodorant
SAhospital2004-07-20

Coroner's Finding: QUINN Latoya Shelley

12y · Female·raised intracranial pressure due to ventriculo-peritoneal shunt blockage

A 12-year-old girl with congenital hydrocephalus and a ventriculo-peritoneal shunt presented to the ED with severe unrelieved headache after head trauma. An inexperienced junior doctor (6 weeks in role, minimal neurosurg…

emergency medicinepaediatricsdiagnosticcommunicationparacetamol
QLDhospital2009-03-20

Wright, Liam John and Powell, Charles Michael

Male·Multiple injuries due to train over-run (suicide by train)

Two separate suicides by train in July 2006 of young men admitted to Logan Hospital mental health services. Liam Wright (19) was transferred from the secure Acute Observation Area (AOA) to an open ward on 14 July 2006 de…

psychiatryemergency medicinediagnosticcommunicationolanzapine
NSWprison2023-07-14

Inquest into the death of GS

43y · Male·Hanging

GS, a 43-year-old man with complex mental health history (depression, anxiety, borderline personality disorder, substance use), died by hanging in Goulburn Correctional Centre after 183 days in custody. The critical …

psychiatrygeneral practicediagnosticcommunicationsertraline
WAprison2022-07-22

Inquest into the Death of Callum MITCHELL

26y · Male·ligature compression of the neck (hanging)

…his cell at Hakea Prison on 21 April 2019. He had a longstanding history of self-harm, severe personality disorders (borderline and antisocial), and significant adverse childhood experiences. Despite 55 self-harm inciden…

psychiatrycorrectional healthsystemcommunicationtramadol
VIChome2024-05-24

Finding into death of L I

16y · Male·mixed drug toxicity (codeine, morphine, tramadol, alprazolam and desmethylvenlaf…

LI, a 16-year-old with borderline personality disorder, factitious disorder, and opioid use disorder, died from mixed drug toxicity (codeine, morphine, tramadol…

general practicepsychiatrymedicationdiagnosticcodeine
QLDhospital2010-10-29

Spence, Samantha Rose

12y · Female·Raised intracranial pressure due to acute-on-chronic hydrocephalus in the contex…

Samantha Rose Spence, 12 years old, died two days after spinal fusion surgery for severe scoliosis. She had a pre-existing, asymptomatic Chiari type 1 malformation detected on pre-operative MRI of her spine. A paediatric…

orthopaedic surgeryneurologydiagnosticcommunicationmorphine
WA2025-07-08

Inquest into the Death of Tim Alan LOOKER

29y · Male·ligature compression of the neck (hanging)

Tim Looker, aged 29, died by suicide in Bunbury Regional Prison on 3 October 2023 by hanging from a bedsheet attached to a protruding bolt in his cell. Tim had ADHD diagnosed since childhood (previously prescribed dexamp…

general practicepsychiatrysystemcommunicationdextroamphetamine

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