Coronial

304 results for chronic suicide risk

SAhome2024-09-13

Coroner's Finding: McKinley-Glen, Haydn James

22y · Male·neck compression due to hanging

…ile under guardianship with special powers of detention in supported independent living. He had attempted suicide by drinking bleach one month prior and was assessed at hospital but not detained. He experienced multiple…

psychiatryemergency medicinepaliperidone
WA2002-05-03

Inquest into the Death of Gerhardus Theron

39y · Male·Ligature Compression of the Neck (Hanging)

Gerhardus Theron, 39, died by suicide in a remand centre on 25 June 2000 by ligature compression of the neck. He had murdered his wife on 28 Ap…

psychiatrycorrectional healthsystemanti-depressants
TAShome2024-08-05

Coroner's Finding: de-identified TJ

82y · Male·Self-inflicted partial contact shotgun wound of the head

…n January, he told his GP the treatment made him feel 'terrible' and he'd 'rather be dead,' but no formal suicide risk assessment or mental health referral was documented. No communication occurred between treating onco…

oncologygeneral practicecommunicationsystem
TAShome2022-10-28

Coroner's Finding: O'Shea, Amie Maree

39y · Female·mixed prescription drug and alcohol toxicity (ethanol, tapentadol, tramadol, pro…

…on points as her death was sudden and unexpected to those around her. Key clinical lessons: Ms O'Shea had chronic complex medical conditions (breast cancer post-treatment, rheumatoid arthritis, sarcoidosis, depression, …

pathologytoxicologytapentadol
VIChome2021-03-19

Finding into death of Jessinda Kiroyan

41y · Female·Nitrate/nitrite toxicity

… requiring ongoing management. The coroner's investigation identified a marked increase in sodium nitrite suicides in Victoria since 2017, with 20 confirmed cases between 2000 and 2020. The finding highlights potential …

psychiatryforensic medicinesodium nitrite
VICcommunity2021-08-25

Finding into death of Garry Mark Wise

47y · Male·Hanging

A 47-year-old man with chronic schizophrenia and alcohol dependence died by hanging at a rooming house. He had been non-compliant with a…

psychiatrygeneral practicecommunicationsystemlurasidone
SA2004-02-13

Coroner's Finding: DEWSON Brian Keith

33y · Male·hanging

… alcohol abuse, multiple psychiatric assessments (antisocial personality disorder, depression), and prior suicide risk designations died by hanging in Port Augusta Prison in November 2000. Despite two previous suicide r…

psychiatrycorrectional healthsystemcitalopram
QLDmental health2024-09-17

Inquest into the death of Chloe Jane Campbell

32y · Female·Hypoxic-ischaemic encephalopathy due to hanging

Chloe Jane Campbell, aged 32, died by suicide while an involuntary inpatient with borderline personality disorder, complex PTSD, and chronic suicidal i…

psychiatryintensive caresystemlorazepam
VICmental health2013-06-21

Finding into death of Heather Jane Kinder

59y · Female·Toxicity to quetiapine

59-year-old woman with long-standing psychiatric illness, chronic suicidal ideation, and dependent personality disorder was admitted involuntarily to a low-dependency psyc…

psychiatryforensic medicinesystemquetiapine
ACTcommunity2019-10-14

Inquest into the death of Adrian Pitman

54y · Male·Multiple injuries due to motor vehicle collision with retaining wall caused by d…

Adrian Pitman, a 54-year-old man with treatment-resistant schizophrenia, died by suicide following a motor vehicle collision with a retaining wall. He was subject to a psychiatric treatment orde…

psychiatrycommunicationsystemolanzapine
VICcommunity2019-07-30

Finding into death of Caterina Fratto

45y · Female·Hanging

…ctive disorder, borderline personality disorder, anorexia nervosa and depression died by hanging. She had chronic suicidal ideation and was managed in the community by a mental health team despite expressing active suic…

psychiatrygeneral practicecommunicationdocumentationquetiapine
VIChome2013-07-16

Finding into death of Melanie Anne Reynolds

30y · Female·Mixed drug toxicity (propranolol, duloxetine and codeine)

…ate psychiatrist for acute suicidal ideation. Key clinical lessons include: BPD patients may not disclose suicide plans despite appearing functional; the balance between safety monitoring and therapeutic engagement is c…

psychiatryemergency medicinecommunicationsystempropranolol
VIChome2022-06-22

Finding into death of Mr Y

46y · Male·Neck compression by ligature suspension

Mr Y, a 46-year-old man with a history of alcohol use and family violence perpetration, died by suicide via neck compression by ligature suspension in May 2020. He had expressed suicidal ideation to his wife o…

general practicepsychiatrycommunicationsystem
VIChome2011-10-18

Finding into death of Peter John Griffin

54y · Male·Hanging (self-inflicted), following the death of Lynette Ann Kent from stab woun…

…ies documented neither reported domestic violence or mental health concerns despite documented threats of suicide and homicide. Lyn was advised by neighbours to contact police but declined, believing she could manage th…

general practicepsychiatrycommunicationsystem
VICmental health2026-04-27

Finding into death of GM

Female·Fulminant hepatic failure due to paracetamol toxicity

A 19-year-old female with anorexia nervosa, borderline personality disorder, and chronic suicidality was admitted to St Vincent’s psychiatric inpatient unit on 28 July 2023. She reported ongoing…

psychiatryintensive careparacetamol
NSWcommunity2022-08-02

Inquest into the disappearance and suspected death of Kenneth Klees

37y · Male·Unascertained

…venting autopsy determination of cause. The coroner could not definitively establish whether death was by suicide or accidental fall, making an open finding. Clinical lessons include the importance of ensuring mental he…

general practicepsychiatrycommunicationsystem
VICmental health2014-12-19

Finding into death of Melissa Jane Thorn

33y · Female·multiple injuries sustained in a train incident

A 33-year-old woman with schizoaffective disorder and chronic suicidality died by suicide after stepping in front of a train on 6 October 2009. She was an involuntary …

psychiatryemergency medicinesystemcommunicationclozapine
NSWcommunity2022-09-16

Inquest into the death of M G

51y · Male·multiple injuries sustained by a high velocity fall from a height

…all officers appropriately trained and well-coordinated, with no systemic failures. The tragedy underscores risks when people with severe untreated mental illness, experiencing command hallucinations and delusional belie…

psychiatryemergency medicine
VICcommunity2026-01-08

Finding into death of Dominic Joshua Clifford

23y · Male·Plastic bag asphyxia in setting of irrespirable atmosphere induced by nitrogen g…

…likely autism spectrum disorder, died by nitrogen gas inhalation in September 2024. He had multiple prior suicide attempts and was under care of various mental health services. On 9 September 2024, he consulted with Dr …

psychiatryfluoxetine
VIChome2025-10-09

Finding into death of Narelle Catherine Simmons

42y · Female·Haemothorax and pneumonia in the setting of acute and chronic chest injuries and…

…rom haemothorax and pneumonia secondary to rib fractures, with contributing factors of hepatic cirrhosis, chronic alcoholism, and multiple drugs (methadone, methylamphetamine, diazepam, sertraline). She was assaulted by…

forensic medicinegeneral practicediagnosticcommunicationmethadone
167816

AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes. Report an inaccuracy.