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SAhospital2005-04-12

Coroner's Finding: KARTINYERI Richard John

60y · Male·respiratory failure and sepsis complicating acute subdural haematoma

Richard Kartinyeri died 44 days after exiting a moving vehicle during a police pursuit. He sustained a severe right-sided acute subdural haematoma, cerebral contusions and skull fractures requiring emergency neurosurgery…

neurosurgeryintensive caremorphine
SA2005-04-11

Coroner's Finding: POTTER Claire Elizabeth

26y · Female·multiple injuries sustained as a result of being struck by a motor vehicle on th…

A 26-year-old woman with schizo-affective disorder, detained under the Mental Health Act, absconded from a psychiatric hospital and was fatally struck by a vehicle on a freeway. Clinical concerns include: (1) inadequate …

psychiatryemergency medicinecommunicationsystemolanzapine
SAhospital2005-04-07

Coroner's Finding: HARRIS Margret Lillian

48y · Female·Chronic Obstructive Airway Disease

Margret Lillian Harris, aged 48, died of chronic obstructive airway disease while detained under the Mental Health Act at Royal Adelaide Hospital. She had longstanding COAD, right heart failure, chronic hypoxia and cyano…

psychiatryrespiratory medicinediuretics
SAhospital2005-04-07

Coroner's Finding: MULVINSKAS Anna

79y · Female·pulmonary oedema and electrolyte imbalance, both secondary to renal failure

Mrs Mulvinskas, a 79-year-old with end-stage renal disease, renal carcinoma, diabetes, and cardiac failure, died from pulmonary oedema and electrolyte imbalance secondary to renal failure. On 21 October 2004, she became …

general medicinenephrologycalcium
SAhospital2005-04-05

Coroner's Finding: HOLLENS Christopher

44y · Male·aspiration pneumonia

Christopher Hollens, a 44-year-old man with chronic schizophrenia, traumatic brain injury, spastic paraparesis, and epilepsy, died of aspiration pneumonia after a 15-day admission to Royal Adelaide Hospital. He was trans…

psychiatrygeneral medicinephenytoin
SA2005-03-14

Coroner's Finding: Ward Kunmanara

Unknown·Multiple causes including neck compression due to hanging (Ward, Ryan, Cooper) a…

This inquest into four deaths on the Anangu Pitjantjatjara Lands involved multiple causes including hanging (three cases) and exposure with complications. Kunmanara Ward died by hanging while intoxicated with petrol; Kun…

psychiatryemergency medicinecommunicationsystempetrol
SAcommunity2005-03-14

Coroner's Finding: Cooper Kunmanara

Male·Kunmanara Ward: neck compression due to hanging; Kunmanara Ken: exposure in cont…

Four separate inquests into the deaths of Kunmanara Ward (19), Kunmanara Ken (35), Kunmanara Ryan (25), and Kunmanara Cooper (27) on the Anangu Pitjantjatjara Lands between May 2003 and March 2004. Three deaths were by h…

psychiatrygeneral practicedelaycommunicationpetrol
SAcommunity2005-03-14

Coroner's Finding: Ryan Kunmanara

Unknown·Multiple; Kunmanara Ward: neck compression due to hanging; Kunmanara Ken: exposu…

Four Aboriginal individuals died on Anangu Pitjantjatjara Lands between May 2003 and March 2004. Ward (19) and Ryan (25) died by hanging with evidence of petrol intoxication. Ken (35) died from exposure after wandering a…

psychiatryemergency medicinedelaysystempetrol
SAcommunity2005-03-14

Coroner's Finding: Ward Kunmanara

Unknown·Multiple causes: hanging (three cases); exposure in context of organic brain dam…

Four Anangu (Aboriginal) young men died between May 2003 and March 2004 on the Anangu Pitjantjatjara Lands in South Australia. Three deaths were by hanging (ages 19, 25, 27); one by exposure (age 35). Deaths were linked …

psychiatryemergency medicinesystemdelaypetrol
SAcommunity2005-03-14

Coroner's Finding: KEN Kunmanara

19y · Male·neck compression due to hanging

Kunmanara Ward, aged 19 years, died on 22 May 2003 by hanging from playground equipment at Indulkana Community while intoxicated by petrol sniffing. He had been sniffing petrol since early adolescence and was angry and u…

petrol
SAhospital2005-02-01

Coroner's Finding: WALPOLE Gary Frederick

49y · Male·small intestinal infarction due to mesenteric and portal vein thrombosis associa…

Gary Walpole, a 49-year-old teacher with polycythaemia rubra vera, died from small intestinal infarction due to mesenteric and portal vein thrombosis. He was admitted to Royal Adelaide Hospital with oesophageal varices f…

gastroenterologyhaematology
SAmental health2005-01-27

Coroner's Finding: ROBJOHNS Ronald Thomas

89y · Male·congestive cardiac failure due to ischaemic heart disease and aortic valve steno…

Ronald Thomas Robjohns, 89, died of congestive cardiac failure due to ischaemic heart disease and aortic valve stenosis while detained under the Mental Health Act at Glenside Hospital. He was admitted following severe de…

psychiatrygeriatric medicinesertraline
SAhospital2005-01-18

Coroner's Finding: SQUIRES Dorothy Alberta

90y · Female·incompatible blood transfusion resulting in haemolysis and multi-organ failure c…

A 90-year-old woman with acute myocardial infarction and cardiogenic shock died after receiving an incompatible blood transfusion (A- instead of O+), which caused haemolysis and multi-organ failure. The registered nurse …

cardiologyintensive careproceduralcommunication
SAhome2005-01-18

Coroner's Finding: WILSON Anthony Trent

34y · Male·multiple myeloma

Anthony Trent Wilson, aged 34, died of multiple myeloma on 18 August 2003 while on compassionate leave from prison. He was diagnosed with multiple myeloma in December 2001 while in custody at Adelaide Remand Centre await…

haematologypalliative care
SAhospital2004-12-14

Coroner's Finding: O'NEILL Louise Kay

31y · Female·mixed drug toxicity (propoxyphene, fluvoxamine, and alprazolam)

A 31-year-old woman with extensive history of deliberate self-harm and prescription drug abuse died from mixed drug toxicity (propoxyphene, fluvoxamine, and alprazolam). She presented to the emergency department with a r…

emergency medicinetoxicologydiagnosticcommunicationpropoxyphene
SAhome2004-11-18

Coroner's Finding: CUNNINGHAM Tracey-Lee

26y · Female·morphine toxicity complicated terminally by bronchopneumonia

A 26-year-old woman with chronic migraines and depression died from morphine toxicity complicated by aspiration pneumonia. She had a documented history of drug-seeking behaviour, forged prescriptions, and doctor-shopping…

general practiceneurologymedicationdiagnosticmorphine
SAhospital2004-11-18

Coroner's Finding: PEDDEY Ross Dudley

63y · Male·pneumonia complicating anoxic brain injury, due to post-operative haemorrhage as…

A 63-year-old man died from pneumonia complicating anoxic brain injury following a post-operative haemorrhage from the inferior epigastric artery during ileostomy closure surgery. The critical failure was a 2.5-hour dela…

colorectal surgerygeneral surgerydiagnosticdelaywarfarin
SA2004-10-01

Coroner's Finding: MAGEE Liam

19y · Male·traumatic rupture of the thoracic aorta with bilateral haemothoraces

A 19-year-old experienced motorcycle racer died from traumatic aortic rupture and bilateral haemothoraces after colliding with a concrete wall at 100 km/h at a racing circuit. He lost control at approximately 205 km/h an…

systemdelay
SAcommunity2004-09-10

Coroner's Finding: CORNISH Peter Henry

43y · Male·aspiration of vegetable matter with occlusion of the upper airway

Peter Cornish, a 43-year-old man with a 17-year history of bipolar disorder, died on 25 September 2001 from aspiration of vegetable matter while experiencing a severe manic episode. In the two weeks before his death, mul…

psychiatryemergency medicinediagnosticsystemcannabis
SAcommunity2004-09-03

Coroner's Finding: EUSTICE Dean Stanley

73y · Male·ischaemic heart disease due to coronary atherosclerosis

A 73-year-old man found a purse at a shopping centre and attempted to leave his details with the information desk rather than hand it in directly. A security officer, believing him suspicious, confronted, accused him of …

cardiologyemergency medicineproceduralcommunication
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