390 results for “mental health deterioration”
92y · Female·community acquired pneumonia on a background of end stage chronic obstructive ai…
…uired pneumonia on a background of end-stage COAD. She was admitted to hospital in late December 2012 with health deterioration and malnutrition (38kg). She developed acute psychiatric symptoms including paranoid delusio…
77y · Female·myocardial infarction
…nfarction following a fall and leg fracture in January 2000. She was admitted to Glenside Hospital under a Mental Health Act detention order for chronic schizophrenia. After external fixation at Royal Adelaide Hospital, …
47y · Male·abnormal heart rhythm (arrhythmia) induced by atherosclerosis, occurring in the …
Peter Shishko, a 47-year-old man with bipolar affective disorder, died in a mental health facility while in involuntary detention. He suffered a fatal cardiac arrhythmia on a background of …
47y · Female·risperidone toxicity
…eridone dose from 3mg to 6mg daily without medical advice. On 16 October 2009, her GP recognised acute deterioration and attempted urgent referral to mental health services but encountered significant system barriers: g…
34y · Female·Neck compression from ligature strangulation
…ed but cohabiting, the couple's breakdown accelerated when the female began a new relationship. The male's mental state deteriorated with depression, jealousy, and inability to accept her autonomy. On Father's Day, he at…
58y · Male·Combined drug toxicity (eucalyptus oil, alcohol, venlafaxine, quetiapine, propra…
…ing to ED with suicidal ideation and overdose. Discharged the following day despite refusal to engage with mental health services, he absconded from his supported residential service and was found deceased. The coroner f…
47y · Male·Complications of acute agitation in the setting of a prolonged struggle in an ac…
…ed for involuntary psychiatric assessment. After moving from Geelong to Ballarat in February 2017, Ricky's mental health and housing needs were not adequately coordinated across services. His placement at boarding house …
36y · Female·head injury
…chizophrenia after a chance encounter. The death resulted from a complex series of missed opportunities in mental healthcare management. Key failures included: cessation of antipsychotic depot medication in April 2017 wi…
39y · Female·Plastic bag asphyxia
… violence order against her instead of providing protection. This misidentification appeared to worsen her mental health. The coroner found police took an incident-based rather than pattern-based approach, disregarding h…
79y · Male·delirium due to aspiration pneumonia complicating advanced metastatic non-small …
…lung cancer suffered multiple strokes causing confusion and behavioural disturbance. He was detained under Mental Health Act. On the night shift, nursing staff found him unresponsive and pulseless but failed to call a Co…
59y · Male·head injuries
…ied from head injuries sustained through intentional self-harm while involuntarily detained at Nolan House mental health facility in April 2021. He developed sudden onset severe mental illness (anxiety disorder with depr…
81y · Male·myocardial infarction
An 81-year-old man with dementia died of myocardial infarction while detained under Mental Health Act orders at Glenside Hospital. He was admitted for aggression and cognitive deterioration. Over t…
64y · Male·Multiple injuries sustained after jumping from a height
… multiple injuries sustained after jumping from a cliff at the Skillion near Terrigal. Over 18 months, his mental health deteriorated with depressive symptoms, hypochondriacal beliefs about toxic exposure from home mater…
35y · Male·The medical cause of death is unknown
…nxiety, received outpatient treatment from GP Dr S. and psychologist Sandra Lundbergs throughout 2013. His mental health deteriorated significantly from September 2013, particularly due to family law custody disputes ove…
46y · Male·Methylamphetamine toxicity and coronary atherosclerosis
…int and transport. Critical clinical lessons include: (1) failure to recognise signs of rapid clinical deterioration and loss of consciousness following physical altercation; (2) officers noted concerns about his consci…
24y · Male·Multiple gunshot wounds
…k assessment tools were completed via copy-paste function without clinical review, potentially missing deterioration signs. Medication management involved switching from depot to oral formulation in 2019, aligning with …
34y · Female·Combined drug toxicity (propofol, sevoflurane and others)
… accessible to all theatre staff; (2) failure of her GP and employer to recognise her substance misuse and mental health deterioration; (3) her declining psychiatric follow-up despite referral in 2010 and advice to see a…
48y · Male·Hypovolaemic shock due to incised wounds to the arms; other significant conditio…
…arms with a prison-issue razor blade while in custody at Brisbane Correctional Centre in May 2015. Initial mental health risk assessment on admission was adequate, but critical failures occurred: the psychologist did not…
51y · Male·Unknown - no postmortem examination conducted, body not recovered
This coronial finding concerns Patrick Kear, a man reported missing in May 2016 but last seen alive on 11 January 2016. After extensive police investigation, the coroner found on the balance of probabilities that Patrick…
33y · Male·Gunshot injury to the anterior trunk (chest and upper abdomen)
…Harrison on 28 March 2019. Jack had deteriorated significantly over preceding days despite engagement with mental health services; he had refused voluntary hospital admission despite his mother's concerns. When police at…
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