Inquest into the Death of Ibbotson, Graeme Ross

57y · Male·Ischaemic Heart Disease

A 57-year-old man with extensive medical history including ischaemic heart disease, hypertension, hypercholesterolaemia and chronic airways disease died of acute myocardial infarction whilst being transferred by ambulance from a mental health facility to hospital. He was an involuntary patient admitted for bipolar disorder management and had required multiple transfers to Royal Perth Hospital during his stay for management of acute exacerbations of chronic airways disease. The coroner found his supervision, treatment and care at the mental health facility was reasonable and appropriate, with staff appropriately recognising his deteriorating physical condition and arranging timely transfer to hospital. Death occurred during the transfer process and was deemed a natural death from ischaemic heart disease with no preventable factors identified.