Finding into death of Micky Craig Revera

40y · Male·Unascertained; opioid withdrawal-related seizure or cardiac arrhythmia could not be excluded

Micky Craig Revera, a 40-year-old man with chronic heroin addiction, died in Melbourne Assessment Prison on 18 February 2019 from unascertained causes. He was arrested on 12 February after erratic driving, underwent police restraint with baton strikes and OC spray, then was sedated with ketamine and midazolam at Dandenong Hospital. Despite concerns about his altered consciousness, he was cleared for police custody. In prison, he presented with opioid withdrawal symptoms, minimal oral intake, drowsiness, and difficulty mobilising. Despite appropriate medical and psychiatric assessments over four days, no clear diagnosis emerged. He was found unresponsive in his cell. The autopsy excluded head injury, sepsis, and opioid toxicity but could not definitively exclude withdrawal-related seizure or cardiac arrhythmia. Clinical lessons: diagnostic uncertainty in custody settings warrants lower thresholds for hospital readmission; comprehensive documentation of injuries and mechanism is essential; mobility assessment should accompany trauma evaluation; observations of at-risk prisoners must be thorough and properly documented.