Coronial

106 results for brain damage

QLDhospital2026-03-31

Inquest into the death of Robyn Ann Beale

78y · Female·Hypoxic ischaemic encephalopathy as a result of obstruction of airway caused by …

…ltimately attempted, her pupils were fixed and dilated within 5 minutes of arrest, indicating irreversible brain injury. The coroner found the complications would likely have been fatal regardless of facility, but ident…

general surgeryanaesthesiadiagnosticcommunicationoxycodone
WAhome2015-06-18

Inquest into the Death of MKP

15y · Female·Seizure Disorder in association with Long Standing Hypoxic Ischaemic Encephalopa…

MKP was a 15-year-old girl with severe cerebral palsy (GMFCS level 5) and long-standing hypoxic-ischaemic encephalopathy who died from a seizure disorder in her foster home on 26 December 2011. She had progressive respir…

neurologypaediatricsdelaydiazepam
ACThome2019-09-20

Inquest into death of Kurt Mellick Andriske

52y · Male·septicaemia caused by Streptococcus Milleri group pneumonia

Kurt Mellick Andriske, 52, died from septicaemia caused by Streptococcus Milleri pneumonia, with drug toxicity as a contributing factor. He was a complex patient with bipolar disorder, chronic pain, hepatitis B and C, an…

general practicepsychiatrydiazepam
NThospital2026-01-09

Inquest into the death of C Guyula

49y · Female·Hypoxia due to complications following incision and drainage of a right buttock …

…eostomy dislodgement causing further hypoxic events. The chain of preventable errors resulted in permanent brain damage and death. Key lessons: mandatory Train of Four calibration before blockade administration, capnogr…

anaesthesiasurgeryproceduralmedicationfentanyl
NThome2005-10-10

Inquest into the death of Kumanjay Presley, Kunmanara Coulthard and Kunmanara Brumby

Male·Suffocation as a result of acute petrol vapour inhalation

Three Aboriginal males died from acute petrol vapour inhalation while sniffing in remote Northern Territory communities. Napthan Presley (14 years, Willowra), Wallace Coulthard (21 years, Mutitjulu), and Trevor Brumby (3…

public healthaddiction medicinesystemdelaypetrol
NSW2016-09-12

Inquest into the death of M

15y · Female·hypoxic brain damage due to multiple drug toxicity

A 15-year-old girl in out-of-home residential care died from accidental overdose of heroin and methylamphetamine (speedballing) in her bedroom while a known drug user was present. She had complex trauma from childhood ab…

emergency medicinetoxicologydelaysystemheroin
TAShospital2023-11-17

Coroner's Finding: Williams, Stewart

54y · Male·Hypoxic/ischaemic brain damage caused by blood loss and airway obstruction due t…

…ad, he deteriorated into cardiac arrest requiring 97 minutes resuscitation, resulting in hypoxic-ischaemic brain injury from which he could not recover.

emergency medicineoral and maxillofacial surgerydiagnosticcommunication
WAhospital2003-08

Inquest into the Death of Richard Christopher Jankowski

39y · Male·Hypoxic brain injury due to respiratory obstruction following surgery for dental…

Richard Christopher Jankowski, a 39-year-old man, died from hypoxic brain injury due to respiratory obstruction following emergency surgery for a dental abscess with cellulitis. Af…

anaesthesiageneral surgeryproceduralcommunicationpropofol
WAcommunity2020-12-30

Inquest into the Death of Child JM (Name Subject to Suppression Order)

16y · Male·multiple injuries

A 16-year-old child in state care under a Protection Order (Until 18) was a passenger in a stolen vehicle being driven by his friend. Police attempted multiple vehicle intercepts during a series of evade police driving i…

emergency medicinetrauma surgerycannabis
WAhospital2016-02-05

Inquest into the Death of Pauline Margaret DODD

51y · Female·Ischaemic heart disease

…h long-standing bipolar affective disorder, complicated by childhood rheumatic fever causing cardiac valve damage requiring prosthetic replacement. She presented with an infected breast lesion but resisted physical exami…

psychiatrycardiologydiagnosticolanzapine
WAhome2004-10-28

Inquest into the Death of Kelly

33y · Female·Combined drug toxicity, with thioridazine as the principal component, in the con…

Lou Ann Kelly, aged 33, died on 3 April 2003 at Royal Perth Hospital ICU from combined drug toxicity, primarily thioridazine, after consuming large quantities of prescription medications with alcohol. She collapsed at he…

general practicepsychiatrysystemthioridazine
NTPodcast2025-10-24

Inquest into the death of Ebony Thompson

1y · Female·hypoxic brain injury caused by pressure to the neck from entrapment on a loop-to…

Ebony Thompson, aged 22 months, died from hypoxic brain injury caused by neck entrapment in a loop-topped chickencoop gate at a childcare centre. She became trapp…

paediatricsemergency medicinesystemcommunication
WAcommunity2002-06

Inquest into the Death of David Stanley William Poole

40y · Male·Complications following fracture of the pelvis

…pulmonary embolism and cardiac arrest. Despite emergency pulmonary embolectomy, he suffered severe hypoxic brain damage and died on 14 April 2000 after life support was withdrawn. The coroner found the death arose by ac…

emergency medicineorthopaedic surgerysystemdelaymorphine
ACThospital2023-03-08

Inquest into the death of Brontë Haskins

23y · Female·Hypoxic-ischaemic brain damage due to self-inflicted hanging with intention of t…

Brontë Haskins, aged 23, died by suicide via hanging on 18 February 2020, three days after her release from custody on bail. The inquest identified multiple systemic failures in supervision, assessment, and coordination …

psychiatryemergency medicinesystemdelayheroin
NSWhome2016-09-14

Inquest into the death of NA

0y · Male·Hypoxic ischaemic encephalopathy (brain damage) sustained during and just after …

A newborn died from hypoxic-ischaemic encephalopathy following a home birth without medical assistance. The mother had significant risk factors: hepatitis C, anaemia, and transverse fetal lie confirmed at 38+ weeks gesta…

general practiceobstetricscommunicationsystem
SAhome2004-01-29

Coroner's Finding: ARANY Eva and Jeno

Eva Arany: gunshot wound to the neck; Jeno Arany: traumatic brain damage complic…

An elderly man with severe depression, suicidal ideation, and ongoing psychiatric risk was hospitalised twice in 2000 and discharged on antidepressant medication. Despite staff identifying he owned seven firearms and pos…

psychiatrygeriatric medicinecommunicationsystemparoxetine
NSWPodcast2021-10-29

Inquest into the death of Jesse DRABSCH

31y · Male·Hypoxic brain injury caused by the exogenous administration of insulin, resultin…

…Medical evidence indicates discovery within 3-6 hours of insulin injection may have prevented irreversible brain damage. The case highlighted systematic gaps in gym safety protocols, inadequate resources for PIED users …

endocrinologytoxicologysystemproceduralinsulin
QLDhospital2025-10-24

Non-Inquest findings into the death of Ms G

76y · Female·Head injury comprised of subdural haematoma, subarachnoid haemorrhage with brain…

…consultant-to-consultant communication could have enabled timely transfer before irreversible neurological damage occurred.

neurosurgeryemergency medicinecommunicationdelay
SAhome2002-09-06

Coroner's Finding: HUNT Kunmanara

25y · Female·inhalation of petrol (hydrocarbon inhalation)

This is a complex coroner's inquest into three Aboriginal deaths from petrol inhalation on the Anangu Pitjantjatjara Lands. Kunmanara Hunt, age 25, died on 27 January 2001 after inhaling petrol fumes while lying face-dow…

toxicologyforensic medicinesystemdelaypetrol
SA2000-06-16

Coroner's Finding: CARTER Marshall Freeland

19y · Male·heroin toxicity

Marshall Carter, 19, died in custody from heroin toxicity at Yatala Labour Prison. He had a long history of drug abuse starting from age 14 and was an intravenous heroin user. Critical failures included: inadequate trans…

forensic medicineemergency medicinediagnosticcommunicationheroin

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