Male·Crush injuries sustained when struck by and pinned under a heavy truck wheel as …
…enance. The fatal incident resulted from a chain of events: inadequate deflation procedures during earlier valve stem repair, leading to rim component displacement, then catastrophic failure of inner tyre components whe…
0y · Female·Pneumonia in an infant with surgically repaired congenital heart disease, premat…
A 9.5-month-old girl with complex medical history (prematurity at 29 weeks, congenital heart disease status post multiple repairs, necrotising enterocolitis with ileostomy, failure to thrive) died from acute pneumonia ca…
71y · Male·End-stage chronic obstructive pulmonary disease and atherosclerotic heart diseas…
Colin Albert Winter, a 71-year-old prisoner who died from end-stage COPD and atherosclerotic heart disease, received comprehensive medical care during 33 years of incarceration at Casuarina Prison. Key clinical lessons i…
75y · Male·multifactorial causes on a background of ischaemic heart disease, generalised va…
…ry artery disease, chronic kidney disease, and diabetes, died five days after elective right total knee replacement surgery. The coroner found that surgery should have been delayed due to markedly elevated creatinine (3…
68y · Female·Complications of a right subdural haemorrhage (palliated), sustained in a fall
Vanna Vassallo, a 68-year-old with schizophrenia, chronic comorbidities and documented high fall risk, died from complications of a subdural haemorrhage sustained in a fall at an aged mental health inpatient unit. She ha…
48y · Female·Acute respiratory failure (cerebral hypoxia) in a woman dependent on non-invasiv…
…tory oversight of non-registered disability service providers was inadequate; and emergency equipment (bag-valve-mask) and anchoring devices for ventilators could improve safety. The VRSS provided appropriate equipment …
20y · Male·hypoxic ischaemic encephalopathy secondary to displacement of tracheostomy and p…
… but this did not occur for approximately 46 minutes. Staff attempted blind bougie instrumentation and bag-valve-mask ventilation through a displaced tube, causing bilateral tension pneumothoraces. Delays in emergency a…
74y · Female·right lower lobe pneumonia (Staphylococcus aureus)
A 74-year-old woman admitted for depression and functional decline following aortic valve replacement received 15mg Nitrazepam instead of prescribed 15mg Mirtazapine due to drug name confusion. Th…
37y · Male·valvular and ischaemic heart disease
Eric Wumbie, a 37-year-old Aboriginal male prisoner, died from valvular and ischaemic heart disease on 13 April 2016 following intraoperative cardiac arrest during planned cardiothoracic surgery at Fiona Stanley Hospital…
12y · Male·Cardiac haemorrhage due to or as a consequence of congenital aortic stenosis (su…
… 12-year-old with complex congenital aortic stenosis, died 18 days after a redo Konno procedure and aortic valve replacement when a CardioCel patch to the right ventricular outflow tract (RVOT) ruptured, causing catastr…
55y · Male·Septicaemia due to hydronephrosis and infection
A 55-year-old man with complex medical and social problems died of septicaemia from renal infection. He had a history of cardiac disease requiring anticoagulation, alcohol dependence, depression, and chronic hoarding beh…
86y · Female·Plastic bag asphyxia
An 86-year-old woman with delirium, depression, and multiple cardiac comorbidities died by asphyxiation with a plastic bag while in a transitional care facility. She had expressed wishes to die, references to suicide, an…
85y · Female·Multiple injuries sustained as a passenger in a motor vehicle collision
Pamela Louise Elsdon, 85, died from multiple injuries sustained as a passenger in a motor vehicle collision caused by her husband's driving error. Her husband had documented progressive cognitive decline and dementia fro…
41y · Male·haemothorax due to ruptured thoracic aortic aneurysm in a man with Marfan syndro…
A 41-year-old man with Marfan syndrome and a thoracic aortic aneurysm managed conservatively with blood pressure medications died from aneurysm rupture while imprisoned. Methylamphetamine in his system significantly elev…
29y · Male·severe burns sustained in motor vehicle fire following collision
29-year-old Benjamin Wilton was killed in a horrific car fire following a rear-end collision with a vehicle driven by 67-year-old Robert Spencer on a Darwin highway. Spencer had suffered a stroke in 2003 with residual co…
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.