Coronial

166 results for acute traumatic death

WAcommunity2015-09-17

Inquest into the Death of MR TOBY

45y · Male·Head injury from motor vehicle rollover

…tem revealed extensive skull fractures, rib fractures, internal injuries and aspiration. The coroner found death arose by accident. Police followed procedures they believed were correct at the time, though later clarifi…

systemcommunicationalcohol
TAScommunity2022-01-28

Coroner's Finding: AZ 2022 TASCD 60

16y · Male·Multiple blunt traumatic injuries from fall from height

A 16-year-old boy with depression and suicidal ideation was discharged from an inpatient adolescent mental health facility in Victoria after 20 days. Two days later, he died by suicide at a cliff location he had previous…

psychiatrycommunicationdiagnosticfluoxetine
NSW2022-10-12

Inquest into the death of Brenden Montgomery

36y · Male·Hypoxic Ischaemic Encephalopathy

…outside his home. He had a long-standing history of depression and anxiety, previous suicide attempts, and acute distress about potential custody. Police responded to a domestic violence complaint and a suicide concern …

communicationsystemescitalopram
VIChospital2026-01-23

Finding into death of Dorothy Anne Simm

74y · Female·Non traumatic intracerebral haemorrhage with further deterioration post medical …

…e deterioration following participation in the EVACUATE trial at Monash Medical Centre. She presented with acute right parietal intracerebral haemorrhage and was consented for trial-protocol minimally invasive endoscopi…

neurosurgeryneurology
VIChospital2022-04-11

Finding into death of C J

22y · Male·Hanging

A 22-year-old man with depression, alcohol addiction, and recent significant losses (parents, sister, friend) presented to Frankston ED on 14 January 2018 with active suicidal ideation and a specific plan to hang himself…

emergency medicinepsychiatrycommunicationsystemdiazepam
NSWcommunity2016-01-29

Jimmy JAMES - Findings

44y · Male·pneumonia (with multiple left-sided rib fractures as the antecedent cause)

… of septic shock (tachypnoea, hypoxia, hypotension, hypothermia, elevated lactate 12.7 mmol/L, leukopenia, acute kidney injury) but was managed on a trauma pathway focusing on traumatic injuries rather than the underlyi…

emergency medicineintensive carediagnosticmedicationceftriaxone
VIChospital2019-02-07

Finding into death of JP

39y · Male·septicaemia following self-administered intravenous injection of faeces

A 39-year-old Aboriginal man with schizophrenia, personality disorder, and substance dependence died from septicaemia after self-injecting faeces into his vein while an involuntary mental health patient. He obtained a sy…

psychiatryinfectious diseasessystemdelaypaliperidone
NSW2017-06-22

Inquest into the death of David BROWNE

28y · Male·Brain death due to large right acute subdural haematoma sustained as a result of…

David Browne died from brain death due to a subdural haematoma sustained during a professional boxing match on 11 September 2015. The coroner…

emergency medicineneurosurgerydiagnosticcommunication
TAScommunity2024-06-13

Coroner's Finding: Xu, Robert Bo; Davies, Jarrod Robert

Male·Drowning (Dr Xu); Undetermined - accidental drowning while intoxicated (Mr Davie…

…nd post-assault care was deficient. The coroner found the excessive service of alcohol was a cause of both deaths and identified inadequate compliance monitoring by liquor licensing authorities as enabling poor practice…

diagnosticsystem
TAShome2023-08-11

Coroner's Finding: Dobson, Barbara Maree

45y · Female·mixed drug toxicity including heroin and methylamphetamine

…oroner found that an ambulance should have been called; this would more likely than not have prevented her death by removing her from the premises and ensuring medical assessment and appropriate care.

emergency medicineforensic medicinedelaysystemheroin
QLDhome2025-10-10

Inquest into the death of AB

31y · Male·Hanging

31-year-old male with borderline personality disorder, alcohol use disorder, and history of self-harm died by hanging. He had multiple presentations to emergency services and mental health services from March to July 202…

psychiatrygeneral practicesystemcommunicationalcohol
VICaged care2026-01-19

Finding into death of Kevin Thomas Maloney

39y · Male·Mixed drug toxicity (heroin, venlafaxine, alprazolam, pregabalin) with contribut…

…ts are critical safety measures; (5) medication administration should not proceed without consideration of acute changes in resident presentation. The facility had pre-existing medication management compliance breaches …

psychiatryaddiction medicinecommunicationsystemheroin
WAhome- 15 May 2014

Inquest into the Death of Helen Barbara MINETT

55y · Female·Multiple drug toxicity in a woman with coronary artery atherosclerosis

A 55-year-old woman with complex medical history including chronic pain, previous multiple abdominal surgeries, gastrointestinal disorders, mental health issues including DID, and suicidal ideation died from multiple dru…

general practicepain medicinediagnosticcommunicationmorphine hydrochloride
NSWhospital2018-07-13

Inquest into the death of Leonard Bartholomeusz

73y · Male·Consequences of myocardial infarction with coronary artery atherosclerotic disea…

Leonard Bartholomeusz, aged 73, died of myocardial rupture on 6 May 2013, six days after hip fracture surgery. He suffered a fall on 30 April 2013 following which ECG testing revealed cardiac abnormality. A first ECG at …

emergency medicineorthopaedic surgerysystemcommunicationfentanyl
QLDhospital2025-03-31

Inquest into the death of Jamie Brian Campbell

43y · Male·Hypoxic ischaemic encephalopathy, due to or as consequence of, cardiac arrest of…

…ygen, appropriate airway support, and proper monitoring contributed to cardiac arrest and subsequent brain death. A senior paramedic's intervention to stop assessment-taking may have undermined junior team members. The …

emergency medicinetoxicologydiagnosticmedicationmethamphetamine
WA2019-05-02

Inquest into the Death of Fazel CHEGENI NEJAD

34y · Male·ligature compression of the neck

Fazel Chegeni Nejad, a 34-year-old Iranian asylum seeker, died from ligature compression of the neck in the jungle near Christmas Island immigration detention centre on 8 November 2015. He had spent 1,477 days in detenti…

psychiatrygeneral practicesystemcommunicationmirtazapine
VIChome2025-06-24

Finding into death of Jessica Geddes

27y · Female·Complications of multiple blunt force injuries

…r Robert Rickerby through multiple blunt force injuries on 6 November 2020. The autopsy revealed extensive acute, subacute and chronic injuries inconsistent with accidental trauma, indicating prolonged abuse. Jessica ha…

general practicepsychiatrydiagnosticsystemmethamphetamine
WAmental health2000-01

Inquest into the Death of Steven Charles Indich

20y · Male·Ligature Compression of the Neck (Hanging)

…Hospital on 13 November 1998. He was admitted involuntarily after assaulting his brother and father whilst acutely psychotic. Despite appropriate antipsychotic medication and close observation during his 3-day admission…

psychiatryintensive caresystemhaloperidol
VICaged care2015-05-14

Finding into death of Philip John Roberts Hewitt

64y · Male·Acute traumatic subarachnoid haemorrhage secondary to single penetrating injury …

…, documented since 2000. Staff dismissed these threats as joking despite explicit warnings on the night of death. The death was preventable had staff: (1) taken the specific threat seriously and separated the men, (2) e…

psychiatrygeneral practicediagnosticcommunicationolanzapine
SAhospital2016-08-02

Coroner's Finding: SMITH Gordon Charles

91y · Male·Multi-organ failure due to inanition complicating prolonged delirium of uncertai…

…ly 2014. He had been admitted voluntarily and subsequently placed on mental health detention orders due to acute confusion and agitated behaviour. The critical clinical lesson is the need to investigate delirium urgentl…

psychiatrygeneral medicinecommunicationsystemmirtazapine

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