Coronial

163 results for acute respiratory infection

QLDhome2014-11-26

Wallrock, William Charles - Non-inquest findings

22y · Male·mixed drug toxicity due to methadone, codeine, and morphine (metabolite), compou…

…ate) and supplied methadone from her own expired prescription (inappropriate). Methadone is unsuitable for acute ambulant pain in opioid-naïve patients due to unpredictable metabolism and overdose risk. Critical compoun…

dentistrygeneral practicemedicationcommunicationmethadone
QLDhospital2025-10-01

Non-inquest findings into the death of Mr S

26y · Male·Multi-organ failure due to pneumococcal septic shock

… an atypical blanched rash not recognised as varicella zoster (chickenpox), complicated by streptococcal infection. Critical deterioration occurred at 1:30am on 18 February when he became tachycardic and hypoxic, requir…

emergency medicineinfectious diseasesdiagnosticdelayantacid
WAhospital2024-04-04

Inquest into the Death of Karl Frederick Dominic HOLMES

66y · Male·Complications of metastatic lung adenocarcinoma, with terminal palliative care, …

Karl Frederick Dominic Holmes, a 66-year-old prisoner with metastatic lung adenocarcinoma and hepatocellular carcinoma, died from complications of his terminal cancer while serving a 7-year sentence. He received excellen…

oncologypalliative caresystemdelaymorphine
QLDhospital2018-07-30

Khazaei, Hamid

24y · Male·Hypoxic-ischaemic encephalopathy, due to or as a consequence of cardiac arrest, …

Hamid Khazaei, an Iranian asylum seeker aged 24, died on 5 September 2014 after contracting a leg infection (Chromobacterium violaceum) on Manus Island while in immigration detention. His death was preventable an…

emergency medicineinfectious diseasesdiagnosticcommunicationceftriaxone
NSWhospital2024-09-19

Inquest into the death of Denis Ives

78y · Male·COVID-19 pneumonitis on a background of ANCA nephropathy, hypertension, and diab…

Denis Ives, a 78-year-old man with type 1 diabetes, chronic kidney disease stage 4, ANCA nephropathy and hypertension, died of COVID-19 pneumonitis while in custody at Long Bay Correctional Centre. He tested positive for…

emergency medicineinfectious diseases
QLD2026-03-31

Inquest into the death of Kyle James Gallagher

22y · Male·Airway obstruction due to laryngeal abscess and laryngeal chondronecrosis due to…

…n setting where nursing staff, reassured by ENT that the airway was stable, interpreted his progressive respiratory distress as anxiety. He deteriorated overnight and died in cardiac arrest. Had appropriate ENT assessme…

ENT surgeryradiologydiagnosticcommunicationdiazepam
NSW2020-03-25

Inquest into the death of Mahmoud ALLAM

28y · Male·MRSA sepsis

…ed from MRSA sepsis whilst in custody at Parklea Correctional Centre. He initially presented with upper respiratory symptoms on 11 June 2016, followed by increasing symptoms including chest pain and facial cellulitis. N…

infectious diseasesemergency medicinecommunicationsystemflucloxacillin
VIChospital2010-03-15

Finding into death of Deborah Margaret Ricklefs

29y · Female·Invasive aspergillosis

A 29-year-old registered nurse with systemic lupus erythematosus (SLE) died from invasive aspergillosis. Dr G. prescribed lamotrigine 100 mg daily (double the recommended initial dose of 50 mg) on first consultation with…

addiction medicinegeneral practicemedicationdiagnosticlamotrigine
NTcommunity2006-05-04

Inquest into the death of Cynthia Diane Ching

29y · Female·multiple organ failure following persistent sepsis occurring as a complication o…

…y dangerous and referred the matter to prosecutors. Medical treatment at Royal Adelaide was appropriate; infections resulted from bacteria present at the time of injury, not hospital failures. Organ removal on 25 May re…

plastic and reconstructive surgeryintensive careproceduralsystemmorphine
VIChospital2017-07-18

Finding into death of Lynsie Maree Everett

36y · Female·Complications of pneumonia and pulmonary emphysema with bullae formation; respir…

…eval services; insufficient IV fluid resuscitation (patient encouraged to refuse); misinterpretation of respiratory distress as anxiety/alcohol withdrawal; sparse overnight vital sign monitoring despite clinical deterio…

emergency medicineinfectious diseasesdiagnosticsystemsalbutamol
VIChospital2017-12-13

Finding into death of Lachlan Black

2y · Male·Group A beta Haemolytic Streptococcal septicaemia (invasive Group A Streptococca…

…e presentations to hospital over three days. Clinical staff failed to recognise the developing bacterial infection despite objective warning signs. Key failures included: not escalating care when presented with persiste…

emergency medicinepaediatricsdiagnosticsystemparacetamol
NSWhospital2015-11-16

Inquest into the death of Ivy Dwyer

18y · Female·Severe cardiogenic shock caused by myocarditis as a consequence of an unknown vi…

Ivy Dwyer, 18, died from viral myocarditis causing cardiogenic shock. She presented over weeks with progressive non-specific symptoms (nausea, vomiting, fatigue, cough) consistent with viral illness. A locum GP diagnosed…

general practiceemergency medicinediagnosticcommunicationloperamide
VIChospital2021-03-26

Finding into death of Resel Juerchott

59y · Female·Aspiration pneumonia in the setting of Down's syndrome

…presented to hospital drowsy and unresponsive on 22 May 2019 with normal vital signs and no identifiable infection on investigation. After a decision to provide comfort measures only, she developed hypoxia thought due t…

geriatric medicineinfectious diseases
QLDhospital2019-06-20

Burrell, Michael Leslie

58y · Male·Multifocal hepatocellular carcinoma due to cirrhosis of the liver due to hepatit…

…ortcomings in diagnostic interpretation, adherence to clinical escalation protocols, and the absence of an acute resuscitation plan for a palliative patient. The hospital implemented corrective measures including dedica…

emergency medicinegastroenterologydiagnosticcommunicationmorphine
QLDhospital2015-05-08

Marr, Hunter Campbell

9y · Male·asthma - acute episode of asthma which became increasingly resistant to Ventolin

…ciencies in asthma education delivery and assessment. Hunter deteriorated at home on 6 January and died of acute asthma resistant to Ventolin. Clinical lessons include: actively assessing parental understanding (not jus…

paediatricsrespiratory medicinecommunicationsystemsalbutamol
NSW2021-03-11

Inquest into the death of Nathan REYNOLDS

36y · Male·bronchial asthma

…d rigid procedures requiring three officers before medical assistance was called, absence of specialist respiratory input, and poor clinician understanding of chronic disease management protocols.

respiratory medicineemergency medicinediagnosticsystemsalbutamol
VIChospital2015-07-01

Finding into death of Robert Charles Avery

86y · Male·Septic shock secondary to urosepsis

… Private Hospital for colonoscopy to investigate constipation. After the procedure was cancelled due to respiratory concerns, he was managed with fluid restriction, bowel preparation, and insulin adjustment. Despite ove…

surgerygastroenterologycommunicationsystemmixtard insulin
VIChospital2025-10-28

Finding into death of Christopher Gerard McIntosh

54y · Male·Respiratory failure secondary to prolonged ventilation for management of sepsis …

Christopher McIntosh, a 54-year-old man with Type II diabetes and chronic foot ulcers, died from respiratory failure secondary to sepsis arising from an infected foot ulcer requiring above-knee amputation. He was…

infectious diseasesvascular surgerydiagnosticsystemantibiotics
TAShome2022-05-27

Coroner's Finding: TS de-identified

47y · Female·Traumatic closed head injury likely sustained in a fall from standing

TS, a 47-year-old woman with a 18-year history of anorexia nervosa, bulimia, and severe alcoholism, died from a traumatic closed head injury sustained in a fall from standing. At autopsy, blood alcohol concentration was …

emergency medicinegeneral practicecommunicationsystemalcohol
QLDaged care2017-06-09

DR - Non-inquest findings

46y · Female·Dilated cardiomyopathy (acute complication with sudden cardiac arrhythmia)

…led type 2 diabetes, morbid obesity, severe obstructive sleep apnoea, and pulmonary hypertension died from acute dilated cardiomyopathy with sudden arrhythmia. She presented to hospital multiple times in January 2015 wi…

general medicineemergency medicinecommunicationsystemquetiapine

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