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SAhospital2015-03-06

Coroner's Finding: SIMOS Theodoras Joannas

48y · Male·undetermined

A 48-year-old man with schizoaffective disorder, poorly controlled diabetes, sleep apnoea, obesity and cardiomegaly died unexpectedly at a rural hospital following acute psychotic agitation. He had absconded from a menta…

psychiatrygeneral practicesystemdelayhaloperidol
VICcommunity2015-03-03

Finding into death of Jahit Elliott Alieff

27y · Male·hanging

A 27-year-old man with schizo-affective disorder died by hanging on 22 April 2009 while on a Community Treatment Order (CTO). He had been discharged from psychiatric hospitalization in December 2008 and managed by an out…

psychiatrycommunicationsystemrisperidone
WAhospital2015-02-26

Inquest into the Death of John Vincent KEARNEY

49y · Male·Carbon monoxide toxicity

John Vincent Kearney, 49, with a history of depression and previous suicide attempt presented to Sir Charles Gairdner Hospital ED on 26 March 2010 with suicidal ideation triggered by work stress. Psychiatric clinicians c…

psychiatryemergency medicineantidepressant
WAhospital2015-02-26

Inquest into the Death of Peta Susan DOIG

58y · Female·pneumonia and cardiac failure complicated by hypoxic brain injury

A 58-year-old woman with autism and severe intellectual disability died from pneumonia and cardiac failure complicated by hypoxic brain injury following cardiac arrest. She had been institutionalised at Graylands Hospita…

psychiatryintensive carediagnosticdelayazithromycin
VICmental health2015-02-26

Finding into death of Paul Bernard Finck

47y · Male·pulmonary thromboembolism and deep vein thrombosis

Paul Finck, 47, an involuntary psychiatric patient with schizophrenia, died from pulmonary thromboembolism and deep vein thrombosis while admitted to the psychiatric ward. He presented with fever, tachycardia, elevated C…

psychiatryemergency medicinearipiprazole
WAmental health2015-02-26

Inquest into the Death of Tracy Margaret MARSHALL

47y · Female·Ligature compression of the neck (suicide by hanging)

Tracy Margaret Marshall, a 47-year-old woman admitted to Nickol Bay Hospital as a voluntary patient due to deteriorating mental state and suicidal ideation, left the hospital on 21 February 2011. She drove to a remote lo…

psychiatrysystemdelay
NSWcommunity2015-02-20

Inquest into the disappearance and suspected death of Margery Joyce TAYLOR

50y · Female·unascertained

Margery Joyce Taylor, aged 50, disappeared on 7 September 1978 from Warren, NSW. She had a long history of bipolar disorder and depression with prior psychiatric hospitalisations. Two months before disappearance, she was…

psychiatrygeneral practicesystemdelay
VICmental health2015-02-02

Finding into death of CB

27y · Female·hanging

A 27-year-old woman with borderline personality disorder and adjustment disorder died by hanging while voluntarily admitted to a psychiatric inpatient unit. She had presented with acute suicidality following relationship…

psychiatryemergency medicinediagnosticcommunicationquetiapine
VIC2015-01-30

Finding into death of Matthew Aaron Condie

21y · Male·upper airway obstruction and plastic bag asphyxia

Matthew Aaron Condie, a 21-year-old prisoner serving a 12-year sentence at Port Phillip Prison, died by asphyxiation using a plastic bag on 27-28 September 2007. The coroner found his death was potentially preventable du…

psychiatrypsychologycommunicationsystem
SAhome2015-01-30

Coroner's Finding: GIBSON Justin Lee

30y · Male·mixed butane, isobutane and propane toxicity

Justin Lee Gibson, a 30-year-old Indigenous man on home detention bail, died from inhalation of butane/propane causing fatal cardiac arrhythmia. He had a documented history of substance abuse (alcohol, cannabis, and buta…

emergency medicineforensic medicinecommunicationsystembutane
NSWcommunity2015-01-30

Inquest into the death of Alec Samuel MEIKLE

17y · Male·Hanging (self-inflicted)

Alec Meikle was a 17-year-old apprentice in New South Wales who experienced bullying and harassment at his workplace at Downer EDI from January to May 2008. The incidents included creation of a 'Sphincter Dilation Chart'…

psychiatrygeneral practicesystemfluoxetine
NSWcommunity2015-01-23

Inquest into the death of XY

17y · Female·multiple blunt force injuries after being struck by a train

17-year-old X died by suicide on 18 December 2012 after being struck by a train. She received multiple psychiatric admissions and CAMHS outpatient care from July-December 2012 for suicidal ideation, overdose attempts, an…

psychiatryemergency medicinefluoxetine
NTmental health2015-01-21

Inquest into the death of Anthony Faulkner

42y · Male·Sudden cardiac death in the context of schizophrenia

Anthony Graham Greig Faulkner, a 42-year-old man with longstanding schizophrenia (formerly diagnosed as bipolar disorder), died suddenly on 23 September 2013 while an involuntary psychiatric patient at Cowdy Ward, Royal …

psychiatrygeneral medicinepaliperidone
VIChome2015-01-08

Finding into death of Marzieh Rahimi

33y · Female·Compression of the neck

Ms Marzieh Rahimi, a 33-year-old Afghan refugee, died from compression of the neck following an incident with her husband. She had disclosed a history of extensive physical, verbal, financial and emotional abuse. In the …

psychiatrygynaecologycommunicationsystem
TAScommunity2015

Coroner's Finding: Youth Suicide

suicide by hanging or other means

Six young people aged 12-17 years died by suicide between 2010-2014 in Tasmania. All had significant mental health issues, trauma histories, and contact with child protection services or schools. The coroner identified s…

psychiatrypaediatricssystemcommunicationlamotrigine
WAcommunity2014-12-30

Inquest into the Death of Gyan Murray JEFFERY

31y · Male·Head and chest injury

Gyan Murray Jeffery, age 31, died from head and chest injuries sustained when struck by two motor vehicles on the South Western Highway at Argyle, Western Australia, on 30 September 2011. He had a longstanding history of…

psychiatryemergency medicinemethamphetamine
WAhospital2014-12-30

Inquest into the Death of Gheorghe Gruici

71y · Male·Organ failure in an elderly man receiving palliative medical care for renal fail…

Gheorghe Gruici, a 71-year-old life-sentenced prisoner, died of organ failure from chronic renal failure, infective endocarditis, and chest infection. Over 15 years in custody, he developed multiple comorbidities includi…

general medicinenephrologyomeprazole
VICmental health2014-12-23

Finding into death of David John McLeod

58y · Male·Cardiomegaly and severe single vessel coronary artery atherosclerosis in a man w…

David John McLeod, a 58-year-old man with schizoaffective disorder, was admitted to a psychiatric inpatient unit on 21 August 2012 following mental health deterioration. He presented with signs of infection, received app…

psychiatrygeneral medicinerisperidone
VICcommunity2014-12-22

Finding into death of Dean Alan Carlson Laycock

24y · Male·Strangulation by hanging

Dean Laycock, a 24-year-old man with intellectual disability and psychosis, died by hanging on Christmas Eve 2009, four hours after being informed that his anticipated 4-day Christmas leave from PARC (a psychiatric step-…

psychiatrypsychologycommunicationsystemclozapine
NSWhome2014-12-22

Inquest into the death of Margaret Elizabeth HILLS

60y · Female·undetermined

Margaret Elizabeth Hills, a 60-year-old woman with chronic pain and depression from a work-related spinal injury, disappeared on 2 February 2010 from her home in Katoomba, NSW. Her skeletal remains were discovered nearly…

general practicepsychiatrycommunicationdelay

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