Coronial

158 results for chronic pain disorder

VIC2024-12-13

Finding into death of Michael Garry Suckling

41y · Male·Cardiomegaly in a man with WHO Class III obesity

Michael Suckling, a 41-year-old Aboriginal man, died in prison from cardiomegaly secondary to morbid obesity (BMI 54.5). He gained approximately 117kg during his 3-year incarceration, with rapid initial weight gain from …

general practicepsychiatrysystemcommunicationmethadone
VIChome2016-04-22

Finding into death of Kelly Elizabeth Hall

43y · Female·mixed drug toxicity including methadone

43-year-old woman with long-standing opioid and benzodiazepine dependence died from mixed drug toxicity including methadone, amitriptyline, pregabalin, duloxetine, diazepam and paracetamol. Two GPs prescribed drugs witho…

general practiceaddiction medicinecommunicationsystemmethadone
QLDcommunity2016-12-08

Floyd, Leah Elizabeth

48y · Female·Sepsis due to pulmonary and cutaneous infections, with urinary tract infection a…

A 48-year-old tetraplegic woman died from sepsis originating from a necrotic sacral pressure wound. Multiple system failures contributed: inadequate pressure sore prevention at the disability care provider (air mattress …

neurologypsychiatrycommunicationsystemdiazepam
TASNew2026-06-03

Coroner's Finding: Brown, Nicholas, Wiki, Toni, Winwood, Matthew and Kemp, Belinda

Male, female, male, female·Nicholas Brown: combined drug (methadone and benzodiazepine) intoxication; Toni …

Joint inquest into four deaths of individuals prescribed opioid replacement therapy by Dr J. between September 2016 and August 2017: Nicholas Shane Brown (35), Toni Lee Wiki (38), Matthew Wayne Winwood (47), and Belinda …

addiction medicinegeneral practicediagnosticmedicationmethadone
ACThome2019-06-04

Inquest into the death of Lauren Maree Johnstone

48y · Female·Combined toxic effect of prescription and non-prescription medications including…

Lauren Johnstone, aged 48, died from the combined toxic effects of prescription and non-prescription sedative medications including oxycodone, tramadol, codeine, zopiclone, doxylamine and fluoxetine. She had undergone mu…

general practicesurgerycommunicationsystemdoxylamine
WAhospital2023-05-26

Inquest into the Death of Jacob George Isaac TAULELEI

28y · Male·Multiple injuries sustained when struck by a freight train

Jacob Taulelei, a 28-year-old man with long-standing depression, anxiety, and suicidal ideation, presented to St John of God Hospital on 5 February 2020 expressing intent to jump in front of a train. Despite being assess…

psychiatryemergency medicinediagnosticcommunicationduloxetine
VIChome2014-10-30

Finding into death of Anne Christine Brain

44y · Female·Intoxication by the combined effects of tramadol, methadone, diazepam, codeine, …

Anne Christine Brain, a 44-year-old woman with schizophrenia, anxiety, and depression who was opioid-dependent, died from intoxication by combined effects of tramadol, methadone, diazepam, codeine, alprazolam, risperidon…

general practiceaddiction medicinesystemcommunicationtramadol
QLDhospital2024-11-08

Non-inquest findings into the death of SD

61y · Male·Lymphoma (CD30 positive T-cell lymphoproliferative disorder), medically managed

A 61-year-old man died from CD30-positive T-cell lymphoproliferative disorder (PTCL) after being incorrectly diagnosed and treated for Hodgkin lymphoma. Critical diagnostic informatio…

haematologypathologydiagnosticcommunicationprednisolone
VIChome2025-09-02

Finding into death of Mr IKL

29y · Male·Mixed drug toxicity (gabapentin, codeine, diazepam, oxycodone, doxylamine, prome…

A 29-year-old man died from mixed drug toxicity involving multiple CNS depressants. His GP, Dr X, had maintained an inappropriate three-year sexual relationship with the patient while prescribing escalating doses of opio…

general practicepsychiatrydiagnosticmedicationgabapentin
NSWhospital2024-05-10

Inquest into the death of Finlay Browne

16y · Male·mid-gut volvulus and bowel obstruction, leading to ischaemic bowel and related c…

…-year-old with Down syndrome, presented to Bathurst Base Hospital on 30 September 2016 with acute abdominal pain and vomiting. Despite clear clinical signs—including a lactate of 7.2 mmol/L (grossly abnormal), faeculent …

emergency medicinesurgerydiagnosticcommunication
VICcommunity2026-04-15

Finding into death of LX

31y · Male·mixed drug toxicity (methadone, diazepam, pregabalin, promethazine, pizotifen)

A 31-year-old man subject to a post-sentence supervision order died from mixed drug toxicity (methadone, diazepam, pregabalin, promethazine, pizotifen) at a residential facility. He was a vulnerable person with acquired …

addiction medicinepsychiatrymedicationsystemmethadone
WAhome2016-02-10

Inquest into the Death of Daniel James HALL

26y · Male·Multiple drug toxicity and bronchopneumonia

Daniel James Hall, aged 26, died on 31 July 2010 from multiple drug toxicity and bronchopneumonia after consuming approximately 10-12 OxyContin tablets over 24 hours, vastly exceeding the prescribed dose of one tablet ev…

anaesthesiaENT surgerycommunicationsystemoxycodone
QLDcommunity2019-08-02

Ms D - Non-inquest findings

47y · Female·Overdose of hydromorphone

A 47-year-old woman died from an intentional overdose of prescribed hydromorphone while residing at a domestic violence refuge. She had a history of depression, previous suicide attempts, and was in crisis following sepa…

psychiatrygeneral practicediagnosticcommunicationhydromorphone
VIChome2021-08-26

Finding into death of Mrs A

61y · Female·Ligature neck compression in the setting of blunt force head trauma

A 61-year-old woman of Bulgarian descent was fatally assaulted by her estranged husband in a domestic violence incident. She died from ligature neck compression following blunt force head trauma. The perpetrator had mult…

general practicepsychologycommunicationsystem
NSWhome2017-10-13

Inquest into the death of D T

13y · Male·Self-inflicted (manner recorded as intentionally self-inflicted; specific method…

A 13-year-old boy with depression, migraine, school refusal and family instability died by intentional self-inflicted means. His general practitioner provided inadequate mental health assessment, initiated antidepressant…

general practicepsychiatrydiagnosticcommunicationfluoxetine
SA2019-12-20

Coroner's Finding: MORGAN Martina

60y · Female·neck compression by ligature strangulation

Martina Morgan, aged 60, died from ligature strangulation by her own leggings while in police custody at Sturt Police Station in March 2015. She was significantly intoxicated (BAC 0.23%) and taking benzodiazepines when a…

diagnosticcommunicationalcohol
VICprison2024-12-11

Finding into death of Jayke Michael Aleckson

24y · Male·Hypoxic Ischaemic Encephalopathy due to hanging

Jayke Aleckson, 24, died by hanging in a non-BDRP compliant prison health cell while on remand at Marngoneet Correctional Centre in October 2018. Key clinical lessons: (1) Multiple unmet requests for antidepressant medic…

psychiatrygeneral practicediagnosticcommunicationfluoxetine
QLDhome2015-07-27

Howman, Katie Lee

30y · Female·Fentanyl overdose caused by self-administration of intravenous Fentanyl

Katie Howman, a 30-year-old registered nurse in the Critical Care Ward at Toowoomba Base Hospital, died from an intravenous Fentanyl overdose on 21 December 2013. Autopsy findings of crystalline granulomas in the lungs i…

psychiatrypsychologydiagnosticsystemfentanyl
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