314
Total cases
78%
Preventable or possibly preventable
76%
With coroner recommendations
42%
Escalation failure identified
Specialty tagging, error classification, and clinical flags are AI-generated and may contain inaccuracies. Always refer to the original finding.
33y · Female·Combined drug toxicity (heroin, benzodiazepines, methylamphetamine, mirtazapine,…
BP, a 33-year-old female with longstanding opioid and polysubstance use disorder, died from accidental heroin overdose at home with concomitant CNS depressants (benzodiazepines, mirtazapine, promethazine) and stimulant (…
34y · Male·Multiple gunshot wounds
James Michael Watson, aged 34, died from multiple gunshot wounds sustained during a police altercation outside the Greek Club in South Brisbane on 11 October 2022. He had long-standing mental health issues and polysubsta…
Male·toxicity caused by a combination of methylamphetamine and morphine
Felipe Esteban Alvarez died on 30 March 2021 from toxicity caused by methylamphetamine and morphine (heroin) ingestion at his unit in Taylor, ACT. He collapsed after self-injecting heroin in the presence of others, inclu…
37y · Male·Multiple injuries sustained in a train incident
A 37-year-old Aboriginal man with chronic opioid use disorder and co-occurring mental health issues presented to Royal Melbourne Hospital's Mental Health, Alcohol and Other Drugs Hub after being found slumped in Melbourn…
44y · Male·Neck compression; Hanging
Andre Alistair Hei, a 44-year-old Māori man, died by suicide via hanging on 11 March 2025 at Fitzroy Town Hall. He had a complex psychiatric history including depression, complex PTSD, methamphetamine use disorder, and c…
62y · Male·complications of chronic alcohol misuse and olanzapine toxicity
John Aramathuparambil John, a 62-year-old with chronic alcohol dependence and depression, was arrested for trespass following a confused intrusion into a home on 6 June 2023. Police noted confusion and apparent intoxicat…