Coronial

195 results for CT brain scan

TAShome2016-07-14

Coroner's Finding: Bedford, Sidney

83y · Male·Acute subdural haemorrhage following a fall

… on warfarin anticoagulation therapy. He was transported to Launceston General Hospital where an initial CT scan of the brain was misread as normal by radiologist Dr M., who failed to identify a small (3-4 mm) acute subd…

emergency medicineradiologydiagnosticwarfarin
TAShospital2025-03-17

Coroner's Finding: Phillips, Helen Lynette

77y · Female·intracranial haemorrhage (subdural, intraventricular and brainstem)

…ar-old woman fell from a ladder on 12 December 2022, suffering loss of consciousness and rib fractures. No brain CT scan was performed at Mersey Community Hospital despite the mechanism of injury and unconsciousness sug…

emergency medicinecardiologydiagnosticdelaythrombolytic agents
TAShospital2015-09-07

Coroner's Finding: Weir, Mary

80y · Female·subdural haematoma due to closed head injury sustained in a fall from bed in hos…

…ut a possible head injury, the House Medical Officer incorrectly concluded no injury had occurred and no CT scan was performed. Two days later, when the patient became unresponsive, she was treated with a full dose of an…

emergency medicinegeneral medicinediagnosticmedicationaspirin
VICaged care2018-10-31

Finding into death of Winifred Jean Morffew

88y · Female·Complications of a pedestrian accident including subarachnoid haemorrhage, subdu…

An 88-year-old woman with multiple comorbidities (diabetes, ischaemic heart disease, cardiomyopathy) was struck by a reversing vehicle at low speed, sustaining subarachnoid haemorrhage, subdural haemorrhage, and fracture…

emergency medicineneurosurgerysystem
VIChospital2017-07-13

Finding into death of Michelle Louise Rosevear

41y · Female·Left middle cerebral artery territory ischaemic stroke

…despite later learning she had reported weakness on her right side and suspected stroke that morning. A CT brain was not ordered initially; it was performed 8+ hours after presentation (8:21 pm), confirming a large left…

emergency medicineneurologydiagnosticdelayquetiapine
NSWhospital2014-05-09

Inquest into the death of Brendan BURNS

24y · Male·acute hydrocephalus due to undiagnosed colloid cyst of the third ventricle of th…

… concerned about possible space-occupying lesion, arranged urgent transfer to Griffith Base Hospital for CT scan. However, Drs Hall and Wark misdiagnosed alcohol withdrawal despite weak evidence (patient abstinent 2 week…

emergency medicineneurosurgerydiagnosticcommunicationmorphine
TAS2016-06-29

Coroner's Finding: McDougall, Kirsten

34y · Female·Aspiration pneumonia due to traumatic brain injury

…ugall, aged 34, died on 20 July 2015 from aspiration pneumonia, 16 months after suffering severe traumatic brain injury in a single-vehicle motor crash on 7 February 2014 on the Midland Highway in Tasmania. The crash oc…

TAShospital2017-05-17

Coroner's Finding: Woulleman-Jarvis, Anne Maree 2017 TASCD 188

62y · Female·subacute subdural haematoma due to a closed head injury sustained in a fall from…

A 62-year-old woman on warfarin for a mechanical aortic valve sustained a head injury from a fall. A CT scan on day 5 post-injury identified a small extradural haematoma, but the radiologist (Dr J.) failed to report …

general practiceemergency medicinediagnosticcommunicationwarfarin
VIC2012-02-14

Finding into death of George Iles

83y · Male·Metastatic oesophageal adenocarcinoma

…ls and deterioration during incarceration. In 2009, he was diagnosed with oesophageal adenocarcinoma and a brain tumour. He was transferred to the prison hospital ward for palliative care in September 2009 and died in O…

oncologypalliative care
TAShospital2021-05-24

Coroner's Finding: Lumley, Barry Alyn

81y · Male·acute subdural haematoma

…a cardiac cause for syncope based on chest pain, referred him for cardiology, and did not perform a head CT scan despite clear evidence of head injury. The Canadian CT Head Rule, which mandates imaging for patients over …

emergency medicinecardiologydiagnosticproceduralparacetamol
VIChospital2021-04-08

Finding into death of Ian Lindsay Gould

64y · Male·Complications of Creutzfeldt-Jakob Disease following a fall

…t. On 7 August, he fell backwards, hitting his head, but was assessed as orientated with no bruising. No CT scan was performed despite being on anticoagulation (rivaroxaban). Over subsequent days he deteriorated with sti…

neurologyophthalmologysystemrivaroxaban
VIC2026-01-28

Finding into death of L N

28y · Male·Traumatic intracranial haemorrhage sustained in an unwitnessed fall

…ial event and fell down stairs in the communal area around 11:15pm. He was found conscious but with severe brain injury, intubated on arrival at hospital, and declared brain dead within 48 hours. The coroner found the d…

intensive careneurosurgeryalcohol
NSWhospital2026-03-10

Inquest into the death of Mustafa Kayirici

31y · Male·metastatic alveolar soft part sarcoma

31-year-old man serving a custodial sentence died of metastatic alveolar soft part sarcoma on 25 January 2022. Diagnosed April 2020, the ultra-rare cancer (1 in 10 million incidence) had already metastasised at discovery…

oncologypalliative caredelaypazopanib
SAhospital2018-03-29

Coroner's Finding: BUTSON Graham Joseph

81y · Male·aspiration of gastric contents complicating disseminated moderately differentiat…

…on, aged 81, died from aspiration of gastric contents complicating undiagnosed metastatic lung cancer with brain metastases. He presented with confusion, agitation and atrial fibrillation; a lung mass was suspected but …

orthopaedic surgerygeneral medicinesystemwarfarin
SAhospital2012-03-26

Coroner's Finding: SWEETMAN Amber Jayne

10y · Female·congenital hydrocephalus

…ressure (ICP) but the diagnosis was significantly delayed—approximately 90-100 minutes—because previous CT brain imaging stored at another hospital could not be electronically accessed for comparison. While her clinical…

emergency medicineneurosurgerydiagnosticcommunicationmidazolam
TAShospital2019-07-25

Coroner's Finding: Horcicka, Josef Vratislav

89y · Male·fractured cervical spine (C5 inferior articular process fracture) due to unwitne…

…nt disruption and spinal cord compression, converting the injury to a C5-C6 paraplegia/quadriplegia. An MRI scan would have detected the ligamentous injury and prevented mobilisation. The patient underwent delayed neuros…

orthopaedic surgeryemergency medicinediagnosticproceduralmorphine
TAShospital2020-04-07

Coroner's Finding: Pettersson, Jan Axel

71y · Male·disseminated fungal (Cryptococcus) infection of the lungs, brain and meninges

…ated further with cardiac arrest, and died. Autopsy revealed disseminated cryptococcal infection of lungs, brain and meninges—not lung cancer. The coroner found management poor, with missed diagnostic opportunities and …

general medicinerespiratory medicinediagnosticdelay
VIChospital2023-07-14

Finding into death of Reginald Desmond Benham

85y · Male·Intracranial haemorrhage in the setting of a fall in a man with multiple comorbi…

… multiple comorbidities suffered a fall at home and was transported to hospital with stroke symptoms. A CT brain scan revealed subtle subarachnoid haemorrhage (traumatic), but the VST consultant neurologist missed this …

emergency medicineneurologydiagnosticcommunicationalteplase
VIChospital2020-10-21

Finding into death of MRS M

91y · Female·Complications of pelvic fractures sustained in a fall

A 91-year-old woman with osteoporosis and multiple comorbidities sustained pelvic fractures in a mechanical fall at home. She presented to the ED where initial hip x-ray showed no fracture. She deteriorated with hypotens…

emergency medicinegeriatric medicinediagnosticdoxycycline
WAhome2007-09-14

Inquest into the Death of Jones Coronial

9y · Male·Head injury (epidural haematoma with cerebral coning following craniotomy)

…Hospital, where resident intern Dr P. also diagnosed concussion. The following morning, Dr W. arranged a CT scan, but it could not be completed without sedation. Dr A. delayed the scan until 13 April, stating Dwayne appe…

general practiceemergency medicinediagnosticdelayparacetamol
1210

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