Coronial

92 results for acute psychotic symptoms

WAhospital2025-06-30

Inquest into the death of Houston PEEL

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

Houston Peel, a 29-year-old man, presented to Fiona Stanley Hospital ED at 4:35 am on 30 March 2023 with acute psychotic symptoms including auditory and visual hallucinations, bizarre behaviour, and paranoid ideation …

emergency medicinepsychiatrycommunicationdelayolanzapine
VIC2022-04-04

Finding into death of Naser Vukovic

42y · Male·Incised injury to the neck resulting in exsanguination and air embolism

Naser Vukovic, a 42-year-old prisoner with severe psychotic symptoms and dual P1/S3 risk ratings, died by self-inflicted neck laceration in Melbourne Assessment Pri…

psychiatrycorrectional healthsystemdelayquetiapine
TAShospital1996-10-01

Coroner's Finding: Muller Shar Marie

25y · Female·injuries sustained by jumping from the Tasman Bridge

A 25-year-old woman with longstanding borderline personality disorder, chronic suicidal ideation, and substance abuse died by jumping from the Tasman Bridge on 4 January 1996. She presented to the Emergency Department on…

psychiatryemergency medicinecommunicationsystemflunitrazepam
WAmental health2000-01

Inquest into the Death of Steven Charles Indich

20y · Male·Ligature Compression of the Neck (Hanging)

Steven Charles Indich, a 20-year-old Aboriginal man with schizophrenia and a long history of psychotic symptoms, violent behaviour and substance abuse, died by suicide in Smith Ward at Graylands Hospital on …

psychiatryintensive caresystemhaloperidol
QLDhome2015-03-19

Press, Connon Kenneth

33y · Male·Gunshot wound to the head

… died from a self-inflicted gunshot wound to the head. He had been prescribed risperidone and prozac for psychotic symptoms and was experiencing significant paranoid delusions on the morning of his death. Post-mortem to…

psychiatryforensic medicinemethamphetamine
NSWcommunity2026-02-05

Inquest into the deaths at Westfield Bondi Junction Volume 1

40y · Male·Victims: fatal stab wounds from knife attack; Joel Cauchi: fatal gunshot wounds …

…ting that his treating psychiatrist Dr B.-Lavack failed to adequately monitor him after cessation of antipsychotic medications from June 2018, did not respond appropriately to early warning signs of relapse reported by …

psychiatrygeneral practicecommunicationsystemclozapine
SAhospital2019-03-25

Coroner's Finding: NICHOLSON James

65y · Male·hypoxic ischaemic encephalopathy complicating hanging

… to maintain the ITO, cessation of one-to-one nursing observation, non-implementation of recommended antipsychotic medication, and absence of proper psychiatric follow-up before discharge. Expert evidence confirmed the …

oncologypsychiatrydiagnosticcommunicationdexamethasone
WAmental health2015-11-30

Inquest into the Death of Frances May COOPER

48y · Female·Head injury

Frances May Cooper, a 48-year-old woman with chronic paranoid schizophrenia, died from head injuries after being struck by a train on 30 October 2011 while on unescorted leave from the mental health unit at Kalgoorlie Re…

psychiatryemergency medicineproceduralsystemrisperidone
QLDhome2019-11-06

Follent, Mitchell James - Non-inquest findings

22y · Male·Multiple injuries from fall from height

…e (found at scene). The coroner was unable to determine capacity to form suicidal intent given potential psychotic state from medications, cannabis, and post-ictal phenomena. Systemic improvements implemented post-death…

psychiatryneurologydiagnosticcommunicationolanzapine
VIC2020-10-29

Finding into death of Bo Zhao

31y · Male·Combined Drug Toxicity (amitriptyline and metoclopramide)

…ting heartburn medication and mentioned to his lawyer that he had been threatened, there is no evidence of acute psychotic symptoms or significantly impaired capacity. The coroner found he intentionally took his own lif…

psychiatrygeneral practicedelayamitriptyline
QLDhospital2016-11-23

SPB - Non-inquest findings

36y · Male·hanging

…after brief assessment by junior staff who attributed his presentation to alcohol intoxication rather than acute psychosis. He died by suicide hours later. Key clinical lessons: collateral history from family and treati…

psychiatryemergency medicinediagnosticcommunicationdiazepam
VIChospital2026-05-22

Finding into death of Stratos Ioannidis

45y · Male·focal coronary artery disease and cardiomegaly

…al coronary artery disease and cardiomegaly during an involuntary psychiatric admission. He presented with acute psychosis from bipolar disorder requiring emergency response and Mental Health Act detention. During his 2…

psychiatryemergency medicinecommunicationsystemolanzapine
TAScommunity2025-06-30

Coroner's Finding: de-identified XA

41y · Male·head and chest injuries from fall from height

…. He had a 15-year history of mental illness with multiple suicide attempts, previously managed with antipsychotic injections and antidepressants. Critical clinical lessons: medication non-adherence was the key factor—t…

psychiatrygeneral practicesystemdelaypaliperidone
NSW2021-07-15

Findings into the death of MH

22y · Male·Hanging

…n changes should not be made without assessing the patient; and prison is unsuitable for managing severe psychotic illness. The coroner found the existing prison mental health model fundamentally inadequate, with expert…

psychiatrycorrectional healthdiagnosticsystemzuclopenthixol
WAmental health2024-03-07

Inquest into the Death of Petya Evgenieva PETROVA-CIZEK

41y · Female·ligature compression of the neck (hanging)

… psychiatric patient at Bentley Health Service Ward 6 on 16 December 2020. She had been admitted following acute psychotic symptoms with paranoia and suicidal ideation. The coroner found multiple inadequacies in her car…

psychiatrydiagnosticcommunicationescitalopram
QLDcommunity2025-02-11

Inquest into the death of Mohamad Ikraam Bahram

24y · Male·Multiple gunshot wounds

…ollowing an unprovoked assault on a tourist. He had presented five days prior to a psychiatrist who saw no acute psychotic symptoms and continued assertive community management. Critical systemic issues identified: exce…

psychiatryforensic medicinesystemcommunicationaripiprazole
NSWhospital2024-02-26

Inquest into the disappearance of Luke Huggard

31y · Male·Unable to be determined (uncertain whether drowning or other cause following app…

…izoaffective disorder and substance use was admitted involuntarily to the Kiloh Centre after presenting in acute psychosis with suicidal ideation on 1 April 2017. His psychotic symptoms rapidly resolved over 3 days, lea…

psychiatrydiagnosticcommunicationlisdexamfetamine
WAmental health2019-05-22

Inquest into the Death of Christopher John DEBNAM

40y · Male·Cardiomyopathy with early pneumonia in a man with reported sleep apnoea and high…

…uctive sleep apnoea. He was readmitted to Graylands Hospital's mental health ward on 20 November 2014 with acute psychiatric decompensation and received sedation (haloperidol and clonazepam) for agitation. He was observ…

psychiatryrespiratory medicinediagnosticcommunicationhaloperidol
NT2025-08-12

Inquest into the death of Didbala Anzac

17y · Female·Self-inflicted hanging in the context of known complex mental health and behavio…

…ad consumed cannabis and alcohol that evening and upon return to care at approximately 2.55am, experienced acute psychotic symptoms (hearing voices). She became aggressive, assaulted her carer, then locked herself in he…

psychiatrypsychologycommunicationsystemcannabis
WAhospital2013-02-11

Inquest into the Death of Carroll

21y · Male·Acute hypoxic ischaemic encephalopathy and pneumonia in a man with recent trauma…

Peter Martin Carroll, age 21, died on 8 June 2007 in the ICU at Royal Perth Hospital from acute hypoxic ischaemic encephalopathy and pneumonia following oxycodone overdose. He had been discharged that d…

emergency medicineorthopaedic surgerycommunicationsystemoxycodone

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