Coronial

192 results for child abuse

VIChospital2021-12-13

Finding into death of Baby A

1y · Male·Global cerebral ischaemic injury following cardiorespiratory arrest of unknown c…

…his mother's partner. Critical clinical lessons include: incomplete family violence information sharing to Child Protection delayed appropriate risk assessment; hospital clinicians did not have access to family violence…

paediatricsemergency medicinesystemcommunicationmethamphetamine
VIChome2024-11-28

Finding into death of Child 1, Child 2, Child 3, Child 4

Multiple causes: Child 1 - blunt force trauma to chest and abdomen; Child 2 - he…

This cluster inquest examined four Victorian child deaths (2015-2017) involving parents' partners as perpetrators. Children 1-4 died from blunt force trauma,…

paediatricspsychiatrydiagnosticcommunicationmethamphetamine
SAhospital2019-04-15

Coroner's Finding: ADAMS Debra Louise

52y · Female·hepatic encephalopathy due to Child C cirrhosis of the liver on a background of …

A 52-year-old woman with chronic liver disease from alcohol abuse, diabetes and hepatitis C died from hepatic encephalopathy and cirrhosis. She presented to Port Pirie Medi…

general practicehepatology
NThome2017-06-09

Inquest into the death of Baby S

0y · Female·Hypoxic ischaemic encephalopathy complicating cardiac arrest as a consequence of…

…as in care of Territory Families after removal from her mother, Ms Charra, due to concerns about substance abuse, domestic violence, and neglect. Baby S was placed with qualified family day carers, Mr and Mrs MS, via AS…

paediatricsforensic medicine
VICcommunity2025-12-04

Finding into death of Mr PNF

60y · Male·Neck compression secondary to hanging

…with Type 2 diabetes and low mood died by hanging within 24 hours of being interviewed by police regarding child sexual abuse allegations. While police identified that suspects are at heightened suicide risk during inve…

general practicepsychiatrycommunicationsystemfluoxetine
VIC2016-11-17

Finding into death of Neil Lawrence Williamson

35y · Male·Intraoral shotgun wound

…n 4 April 2015 at Ravenswood rest stop after a lengthy police negotiation. He had a history of depression, childhood sexual abuse, and had prepared his death meticulously including creating a will and video messages. On…

psychiatryforensic medicinealcohol
QLDhospital2013-07-05

Brennan, Phil John Richard

13y · Male·Staphylococcus aureus bronchopneumonia due to perinatal hypoxic-ischaemic brain …

…owing week, and he died shortly after arriving at hospital. The coroner found no evidence of malnutrition, abuse, or neglect by his parents, who were described as loving and devoted caregivers. Key clinical lessons incl…

general practicepaediatricsdiagnosticdelay
WAcommunity2020-06-02

Inquest into the Suspected Death of Christen Lee FOGARTY

22y · Male·Unknown - Open Finding

…ly search activation in missing persons cases, and consideration of safeguarding when individuals disclose abuse.

delay
NSWcommunity2024-04-18

Inquest into the death of Baby Q

0y · Female·unascertained

A nine-month-old First Nations child (Baby Q) was killed by her psychotic father in November 2018. The family, transient and homeless, were kno…

paediatricspsychiatrysystemcommunication
QLD2023-09-19

AJO - findings

34y · Male·Hanging

…-old remand prisoner died by hanging in his cell at Arthur Gorrie Correctional Centre. He had a history of child sexual offences and mental health issues including depression and past self-harm. Initial risk assessments…

psychiatrycorrectional healthcannabis
VIChome2011-04-20

Finding into death of Brendan Glover

30y · Male·BUTANE TOXICITY

…halants; (2) professional education for health and youth workers on harm reduction strategies for inhalant abusers; (3) consideration of age-based legislative restrictions on butane sales; and (4) continued research int…

pathologypublic healthbutane
VIChospital2013-12-09

Finding into death of JM

17y · Female·Combined Drug Toxicity (heroin, alprazolam and diazepam)

… Despite extensive involvement from drug and alcohol services, mental health providers, youth justice, and child protection workers over several years, she rapidly resumed heroin use within days of release. Coordinated …

psychiatryaddiction medicinecommunicationsystemheroin
NSWhome2018-06-08

Inquest into the death of BL GN and D G

Female·Sudden Unexpected Death in Infancy (SUDI), otherwise undetermined

Two infants died suddenly and unexpectedly. The first child died at home at 3 months of age in an unsafe sleeping environment with multiple soft items in her cot; the…

paediatricsneonatologysystemdelayice/methamphetamine
VIChospital2016-03-11

Finding into death of Chloe Mary Murphy

1y · Female·head injury from non-accidental trauma

Chloe Murphy, an 11-month-old girl, died from severe head injuries on 5 December 2010 after being left in the care of a babysitter (Mrs Jenkins) on 3 December. Medical assessment revealed a skull fracture, bilateral subd…

neurosurgeryintensive care
VIChospital2010

Finding into death of Nicole Joy Millar

42y · Female·Complications of cutaneous burns

…d disclosed prior intimate partner violence to support services but remained isolated and covert about the abuse. Key lessons include: earlier intervention despite her reluctance, monitoring of high-risk prior victims, …

emergency medicineplastic and reconstructive surgerycommunicationsystemdiazepam
VIChome2018-07-17

Finding into death of James Colin Tomlinson

81y · Male·Hanging

…h depression, cardiac disease, and prior anti-depressant treatment died by hanging while awaiting trial on child sex offence charges. The coroner identified this death as part of a cluster of five cases involving suspec…

anti-depressant medication
VICcommunity2021-07-13

Finding into death of Richard Powell

32y · Male·Head injuries sustained in a motor vehicle incident (pedestrian)

…ly violence history, classifying the victim as the respondent and Mr Powell as the affected family member. Child Protection failed to provide support to the victim partner despite her homelessness, substance issues, and…

diagnosticsystemmethamphetamine
WAhome2021-04-16

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

3y · Female·tramadol toxicity

… tramadol toxicity after accessing prescribed opioid medication left unsecured in her carer's bedroom. The child was removed from her mother's care due to neglect and substance abuse and placed with her step-father. Alt…

paediatricsforensic medicinesystemdelaytramadol
VIC2015-10-30

Finding into death of Darcey Iris

4y · Female·Injuries sustained in fall from height

…uary 2009 during a parenting dispute. Her mother had disclosed to GPs fears that the father could harm the children, but these disclosures did not trigger mandatory reporting as they did not meet the threshold for signi…

general practicepaediatricscommunication
WAhome2019-06-12

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

13y · Male·Epileptic seizure with aspiration

Child L, a 13-year-old boy with autism, cognitive impairment and poorly controlled generalised epilepsy, died fr…

neurologypaediatricsmedicationcommunicationlevetiracetam
156710

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