Finding into death of Alan William Worrall

47y · Male·Progressive multifocal leukoencephalopathy

Alan William Worrall, a 47-year-old man with HIV infection, poor antiretroviral adherence, hepatitis C, and epilepsy, died from progressive multifocal leukoencephalopathy (PML) caused by JC virus. He was in custody when admitted to St Vincent's Hospital on 11 August 2015 with febrile illness and neurological symptoms. His CD4 count was critically low at 30 cells/mm³, indicating advanced AIDS. MRI and lumbar puncture confirmed JC virus infection. Despite antiretroviral therapy, his condition deteriorated with dysphagia developing. Treatment was withdrawn on 5 September 2015 after multidisciplinary discussion, and he died 4 days later. The coroner found care provision while imprisoned and hospitalised was appropriate, with no causal connection between custody status and death. The death resulted from natural causes in the context of severe immunosuppression and poor prior treatment adherence.