Coronial

52 results for speech delay

QLDhospital2013-04-19

Brockel, Ronald James

64y · Male·aspiration pneumonia following insertion of a jejunostomy tube

Ronald Brockel, a 64-year-old with cerebral palsy, oropharyngeal dysphagia, and recurrent aspiration pneumonia, underwent insertion of a feeding jejunostomy tube (FJT) on 23 December 2004 to bypass his stomach and improv…

general surgerygastroenterologyproceduraldiagnosticomeprazole
SAhome2004-11-18

Coroner's Finding: CUNNINGHAM Tracey-Lee

26y · Female·morphine toxicity complicated terminally by bronchopneumonia

…ng approximately 7.3 grams over the final month. Despite clear signs of intoxication on 21-22 May (slurred speech, drowsiness, incoordination), morphine continued to be prescribed. The coroner found the prescription of l…

general practiceneurologymedicationdiagnosticmorphine
TAShospital2018-10-17

Coroner's Finding: Jones, Tristan Adam

40y · Male·Subarachnoid haemorrhage due to ruptured right middle cerebral artery aneurysm

A 40-year-old man presented to the ED with sudden-onset severe headache, slurred speech, and vomiting. He was appropriately triaged and quickly diagnosed with subarachnoid haemorrhage due to rup…

emergency medicineneurosurgerysystemcommunicationparacetamol
QLDaged care2018-06-05

Milward, Paul Joseph

53y · Male·Choking on food bolus in pharynx, with Huntington's disease and coronary atheros…

Paul Joseph Milward, aged 53 with Huntington's disease causing cognitive impairment and swallowing difficulties, died from choking on a bread sandwich while unsupervised in his aged care room. His care plan specified min…

geriatric medicinespeech pathologycommunicationsystemsodium valproate
NSWhome2010-08-26

Coroner's Finding: Kate Therese Bugmy

26y · Female·Streptococcal Sepsis resulting from Skin Ulceration and complications of Cerebra…

…ne 2007, Kate was severely malnourished, dehydrated, and had extensive infected pressure sores. Her family delayed seeking medical help despite obvious critical illness. When Dr W. intervened (threatening Guardianship B…

general medicineemergency medicinesystemcommunication
QLDhospital2026-03-06

Non-inquest findings into the death of Ms B

35y · Female·Hypoxic-ischaemic encephalopathy due to cardiorespiratory arrest due to vertebro…

A 35-year-old woman presented to a rural hospital with a three-day history of collapses, slurred speech, vomiting, and abnormal eye movements. A non-contrast CT head scan was normal, and she was discharged with…

emergency medicinegeneral practicediagnosticcommunication
VIC2022-03-10

Finding into death of Joanne Callahan

43y · Female·choking on a food bolus

Joanne Callahan, a 43-year-old woman with intellectual disability and autism, died from choking on a food bolus while attending a disability day program. Critical failures in communication between her residential care pr…

speech pathologyparamedicinecommunicationsystem
WAhome- 15 May 2014

Inquest into the Death of Helen Barbara MINETT

55y · Female·Multiple drug toxicity in a woman with coronary artery atherosclerosis

A 55-year-old woman with complex medical history including chronic pain, previous multiple abdominal surgeries, gastrointestinal disorders, mental health issues including DID, and suicidal ideation died from multiple dru…

general practicepain medicinediagnosticcommunicationmorphine hydrochloride
VIChospital2025

Finding into death of TBL

81y · Female·Multisystem failure in the setting of hyponatraemia secondary to chronic malnutr…

An 81-year-old woman with chronic schizophrenia, heart failure, and dementia died from multisystem failure secondary to severe malnutrition and hyponatraemia. Over four years, her son (Medical Power of Attorney) progress…

psychiatrygeneral practicesystemdelayrisperidone
VIChospital2011-07-29

Finding into death of Marlene Kenny

64y · Female·Bilateral pulmonary embolism with left middle cerebral artery/posterior cerebral…

…ged her without investigation. She re-presented next day with neurological symptoms (arm weakness, slurred speech) suspicious for TIA. The hospital failed to recognise she had a paradoxical stroke caused by a patent fora…

emergency medicinegeneral practicediagnosticcommunicationdiazepam
NSWhospital2022-12-21

Inquest into death of Andrea LESTER

49y · Female·Hypoxic brain injury related to tracheostomy complications in form of airway occ…

Andrea Lester, age 49, suffered a subarachnoid haemorrhage from a PICA aneurysm in March 2018 with delayed diagnosis. Following complex neurosurgery causing Wallenberg syndrome, she required tracheostomy for bul…

neurosurgeryintensive carediagnosticcommunicationtramadol
VICcommunity2026-04-15

Finding into death of LX

31y · Male·mixed drug toxicity (methadone, diazepam, pregabalin, promethazine, pizotifen)

A 31-year-old man subject to a post-sentence supervision order died from mixed drug toxicity (methadone, diazepam, pregabalin, promethazine, pizotifen) at a residential facility. He was a vulnerable person with acquired …

addiction medicinepsychiatrymedicationsystemmethadone

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