241
Total cases
58%
Preventable or possibly preventable
63%
With coroner recommendations
30%
Escalation failure identified
Specialty tagging, error classification, and clinical flags are AI-generated and may contain inaccuracies. Always refer to the original finding.
53y · Female·Pneumonia and septic arthritis on a background of atypical parkinsonian syndrome
A 53-year-old woman with intellectual disability, schizoaffective disorder and progressive neurological decline presented to hospital with fevers and was extensively investigated over four months for septic arthritis and…
67y · Male·end-stage renal failure due to diabetic nephropathy, left lower-limb gangrene du…
This case involves a 67-year-old man with multiple serious chronic conditions (end-stage renal failure, peripheral vascular disease with gangrene, ischaemic heart disease) who presented to hospital after a fall causing s…
Male·pulmonary thromboembolism secondary to deep vein thrombosis of the right calf fo…
Kenneth Toll died from pulmonary embolism secondary to deep vein thrombosis on day four after bilateral knee replacement surgery at Albury Wodonga Private Hospital. While the surgery itself was appropriate and well-perfo…
59y · Female·Complications following a right total hip replacement for severe osteoarthritis …
Anne Margaret Chase, aged 59, had Down syndrome, dementia, and severe bilateral osteoarthritis. Despite previous medical advice against surgery, her severe hip pain and immobility led to right total hip replacement at Mu…
6y · Male·Hypoxic-ischaemic encephalopathy due to cardiac arrest following general anaesth…
Connor Dean, a 6-year-old with Down syndrome, died following cardiac arrest during an MRI under general anaesthetic. He had severe vitamin C deficiency (scurvy) which was not detected despite clinical and nutritional ris…
48y · Male·Pulmonary thromboembolism
Guy Christian Mason, 48, died from a saddle pulmonary embolism on 17 September 2023, three days after discharge from patellar tendon repair surgery. He had sustained a significant knee injury with multiple ligament ruptu…