62 results
85y · Male·systemic sepsis due to infected right perineal ulcer and associated perianal abs…
An 85-year-old man with dementia and multiple comorbidities died of sepsis caused by an infected sacral pressure ulcer that developed and deteriorated while resident at an aged care facility. Initially assessed as stage …
Male·Pulmonary thromboembolism and bronchopneumonia secondary to deep vein thrombosis
JNY, a man with metastatic small cell carcinoma, COPD, and ischaemic heart disease, died from pulmonary thromboembolism and bronchopneumonia. He received palliative care at home provided by his partner PJN, who had undis…
50y · Male·unascertained
Simon Gaskill, aged 50, was found deceased in sand dunes at Ocean Grove Beach in April 2022 after sleeping rough for months. He had been discharged from hospital in December 2021 following treatment for severe alcohol wi…
11y · Male·Bronchopneumonia and small bowel necrosis with perforation, in a boy with multic…
Child MML was an Aboriginal boy born in April 2010 who suffered catastrophic abusive head trauma at eight months old in December 2010, causing severe lifelong neurological impairment including cerebral palsy, uncontrolle…
45y · Female·Complications of sepsis secondary to sacral pressure wound in a woman with genet…
Kristy Ann Mitchener, a 45-year-old woman with severe intellectual disability, genetic developmental and epileptic encephalopathy, and oesophageal dysmotility, died from sepsis secondary to a sacral pressure ulcer despit…
42y · Female·Hypoxic brain injury due to choking on food, in a person with Cornelia de Lange …
Bridie Gilligan, aged 42 with Cornelia de Lange Syndrome, profound intellectual disability and dysphagia, died from hypoxic brain injury after choking on a Yumbo burger at her SIL home on 29 April 2021. Her support worke…
72y · Female·acute on chronic renal failure due to sepsis and chronic left leg cellulitis
Kerrie Dawn Grant, a 72-year-old woman with multiple comorbidities including pulmonary hypertension, cardiac failure, COPD, and myelofibrosis, had a well-documented history of recurrent falls with prolonged periods unabl…
66y · Male·multiple injuries sustained in motor vehicle collision
A 66-year-old cyclist was struck and killed from behind by a driver with left absolute homonymous hemianopia (left-sided visual field loss) who was not scanning to compensate for his disability. The driver had suffered a…
42y · Female·Pneumonia, underlying severe cerebral palsy
Rachel Piskun, aged 42, died from pneumonia complicated by severe cerebral palsy. She had severe disabilities requiring 24-hour care in supported accommodation. During a September 2021 hospitalization, compression stocki…
80y · Female·Fractured left neck of femur on a background of rectal carcinoma and dementia
An 80-year-old woman with dementia and undiagnosed rectal carcinoma died from complications of a fractured left neck of femur sustained during a fall in her aged care facility's memory support unit. She had sustained thr…
59y · Male·Urosepsis and aspiration pneumonia (with Trisomy 21 as underlying condition)
Donald Raymond Muir, a 59-year-old man with Trisomy 21, non-verbal autism, dementia and epilepsy living in specialist disability accommodation, died of urosepsis and aspiration pneumonia. He had experienced progressive f…
8y · Male·prematurity-associated lung and bowel disease
Daniel Wright was a premature infant (born at 24 weeks) with multiple complex medical needs including chronic lung disease, developmental delay, and failure to thrive. He died aged eight months from prematurity-associate…
83y · Male·end-stage Parkinson's disease (palliated)
Raymond John Blackney, an 83-year-old man with end-stage Parkinson's disease, died in custody at Port Phillip Prison from natural causes. He had complex medical needs including dementia, intellectual disability, and mult…
69y · Female·Effects of fire
Stephanie Rebernik, aged 69, died in a house fire in 2023. She had an acquired brain injury from 1980 with cognitive decline, poor risk identification, and a documented five-year history of unsafe fire-lighting behaviour…
90y · Male·Pneumonia complicating injuries sustained in a motor vehicle incident
A 90-year-old man died from pneumonia following injuries sustained in a motor vehicle collision. He had multiple reportable medical conditions including atrial fibrillation, coronary artery disease, chronic kidney diseas…
64y · Female·Aspiration pneumonia in a woman with multiple comorbidities
A 64-year-old woman with severe intellectual disability and multiple comorbidities died from aspiration pneumonia while in specialist disability accommodation. She had documented dysphagia and aspiration risk identified …
82y · Male·sepsis due to infected sacral ulcer with osteomyelitis and necrotising fasciitis
An 82-year-old man with multiple comorbidities developed a sacral pressure injury during admission to a private hospital for investigation of leg weakness. Despite being assessed as high-risk for pressure injury, he was …
18y · Female·Mixed drug toxicity
TK, an 18-year-old woman with borderline personality disorder, chronic suicidality, and a history of childhood trauma, died from mixed drug toxicity following intentional overdose. She had multiple psychiatric admissions…
34y · Female·Aspiration pneumonia in a woman with cerebral palsy and Lennox-Gastaut syndrome
Hannah Gray, a 34-year-old woman with cerebral palsy and Lennox-Gastaut syndrome living in specialist disability accommodation, died from aspiration pneumonia. She had experienced progressive health deterioration over th…
33y · Male·Aspiration pneumonia in the setting of recent COVID-19 infection
Russell Hewat, a 33-year-old man with autism, Down syndrome, intellectual disability, and dysphagia, died from aspiration pneumonia following COVID-19 infection. He was discharged from Frankston Hospital on 1 November 20…
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