Coronial

126 results for suicidal behaviour by hanging

WAhome2005-12

Inquest into the Death of Jake Willem Dunne-Heynis

15y · Male·Ligature Compression of the Neck (Hanging)

… Exmouth District High School in rural Western Australia, died by suicide on 23 June 2004, two days after hanging himself at home. Jake had motor coordination difficulties attributed to poor eyesight, and experienced be…

communicationsystem
QLDhome2022-06-17

CJ - Non-inquest findings

14y · Male·Hanging

A 14-year-old boy died by hanging after extensive exposure to domestic and family violence and child abuse, primarily from his father. Chil…

paediatricspsychiatrydiagnosticcommunicationcannabis
VIChome2015-05-08

Finding into death of Nilesh Sharma

36y · Male·Hanging (Mr Sharma); Homicide by smothering/suffocation or chloroform exposure (…

…eetika, son Divesh (5 years old), and daughter Divya (3 years old) between 28-29 April 2012, then died by hanging. Evidence suggests he exposed them to chloroform before smothering them. The case involved a history of c…

rehabilitation medicineneurologycommunicationsystemchloroform
WA2020-11-28

Inquest into the Death of Wayne Thomas LARDER

42y · Male·ligature compression of the neck (hanging)

Wayne Larder, a 42-year-old man with depression, suicidal ideation, and substance use disorder, died by hanging in Hakea Prison on 22 February 2021. Critical failu…

psychiatrypsychologydiagnosticsystemmethamphetamine
QLD2021-05-24

Ahquee, Dylon James

19y · Male·Hanging

Dylon James Ahquee, aged 19, died by hanging in Townsville Correctional Centre on 26 December 2015. Despite documented self-harm and suicidal ideation…

correctional healthpsychologydiagnosticsystem
ACT1999-08-05

In The Matter Of An Inquest Into The Death Of Ian Glen Bransby At Canberra On 14.2.98

31y · Male·extensive global cerebral hypoxia following prolonged asphyxia following attempt…

…ear-old remandee with a history of substance abuse and depression, died from asphyxia following attempted hanging at Calvary Hospital on 14 February 1998. He had been remanded at Belconnen Remand Centre on 31 January 19…

psychiatrygeneral practicecommunicationsystemchlorpromazine
QLDmental health2005-11-09

Community Mental Health Patient

20y · Male·hanging

… though his sister noted he remained depressed. Following discharge, the patient exhibited volatile mood, suicidal ideation, overdosed on antidepressants with alcohol, threatened to drive into a tree, and abused inhalant…

psychiatrygeneral practicediagnosticcommunicationsertraline
WAhome2014-10-17

Inquest into the Death of Ethan (Subject to a Suppression Order)

15y · Male·Ligature compression of the neck (hanging)

A 15-year-old Aboriginal boy in foster care died by suicide following apparent impulsive response to adolescent boundary conflicts. Despite stable, loving foster placement since age 4, Ethan remained neurologically vulne…

psychiatrypsychologymelatonin
WAmental health2024-08-28

Inquest into the Death of Peter Jonathon Rex BOLTON

36y · Male·ligature compression of the neck (hanging)

…voluntary inpatient in a locked mental health ward. He was on hourly observations and had recently denied suicidal ideation, with risk assessments rating him at low self-harm risk. Between observations at 2pm and 3pm, he…

psychiatryemergency medicinehaloperidol
VIC2012-09-21

Timothycaseypart1 127708

29y · Male·hanging

Timothy Casey, 29, charged with murder, died by hanging in Port Phillip Prison on 28 March 2008, 12 days after arrival. His death resulted from systemic failures…

psychiatrycorrectional healthdiagnosticcommunicationheroin
WAhome2021-12-15

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

15y · Male·ligature compression of the neck (hanging)

Aboriginal child in out-of-home care died by hanging following relationship breakdown. He experienced foetal alcohol spectrum disorder, early trauma and negle…

psychiatrypaediatricssystemdelay
SAhospital2019-03-25

Coroner's Finding: NICHOLSON James

65y · Male·hypoxic ischaemic encephalopathy complicating hanging

James Nicholson, aged 65, died from hypoxic ischaemic encephalopathy following a suicide attempt by hanging while an inpatient at Noarlunga Hospital on 18 August 2015. He had undergone extensive facial cancer surg…

oncologypsychiatrydiagnosticcommunicationdexamethasone
NSWhospital2026-01-22

Inquest into the death of JC

30y · Male·hanging

…or coordination between specialties and no clear ownership of discharge planning. JC took his own life by hanging 9 hours after discharge. Clinical lessons include: recognise benzodiazepine withdrawal as a red flag requ…

emergency medicinepsychiatrydiagnosticcommunicationetizolam
WAmental health2015-12-31

Inquest into the Deaths Alma Street Centre

Female·Five separate deaths: Ruby Nicholls-Diver—ligature compression of neck (hanging)…

Five former psychiatric patients of Alma Street Centre (part of Fremantle Hospital) died between March 2011 and March 2012. Two died by suicide within 24 hours of discharge; one disappeared and was found deceased; one ab…

psychiatryemergency medicinediagnosticcommunicationantidepressants
VIC2022-07-15

Finding into death of Wiki Raymond Lowe

35y · Male·hanging

Two inmates at Karreenga Correctional Centre died by hanging within four months of each other in 2017. Mr Lowe, aged 35, died on 7 March 2017 after learning he faced …

psychiatrycorrectional healthcommunicationsystem
TAShome2013-08-09

Coroner's Finding: Miss N de-identified

20y · Female·injury caused by hanging

A 20-year-old woman with a long history of eating disorder, obsessive-compulsive behaviours, and adjustment difficulties died by suicide in October 2009. She had received treatment at the Bronte …

psychiatrypsychologysystemdelaymethylphenidate
VIChome2012-10-09

Finding into death of Li Zhen Gao

47y · Female·Neck compression subsequent upon hanging

…er GPs. After her husband left in July 2010, she showed increasing signs of distress but did not disclose suicidal ideation. Her GPs recognised mental health difficulties and attempted referrals to psychology/psychiatry …

general practicepsychiatrydiagnosticcommunication
WA2025-12-17

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

14y · Female·ligature compression of the neck (hanging)

…22. She had Complex PTSD from childhood trauma and presented multiple times to emergency departments with suicidal ideation and self-harm from December 2021. The coroner found missed opportunities in her care: inadequate…

paediatricsgeneral practicecommunicationsystemmelatonin
VICmental health2013-08-20

Finding into death of Hassan Yassin

35y · Male·Hanging

Hassen Yassin, a 35-year-old man with schizophrenia, bipolar affective disorder, and PTSD, died by hanging after absconding from an involuntary psychiatric admission. On 10 January 2011, following a clinical revi…

psychiatryemergency medicinecommunicationsystemrisperidone
VIC2022-07-15

Finding into death of Noel Thomas

42y · Male·hanging

… de-escalation of observation status in high-risk prisoners, despite explicit statements about concealing suicidal intent, may be unsafe; (4) frequent prison transfers disrupted continuity of mental health care; (5) inte…

psychiatrycorrectional healthsystemcommunication

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