96
Total cases
55%
Preventable or possibly preventable
66%
With coroner recommendations
38%
Escalation failure identified
Specialty tagging, error classification, and clinical flags are AI-generated and may contain inaccuracies. Always refer to the original finding.
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…
64y · Male·Peritonitis and ischaemic small bowel, with contributing factors of hypertensive…
A 64-year-old male with hypertension and smoking history presented to hospital with several weeks of abdominal pain, diarrhoea, and weight loss. Imaging revealed a superior mesenteric artery (SMA) occlusion deemed chroni…
54y · Male·Respiratory failure secondary to prolonged ventilation for management of sepsis …
Christopher McIntosh, a 54-year-old man with Type II diabetes and chronic foot ulcers, died from respiratory failure secondary to sepsis arising from an infected foot ulcer requiring above-knee amputation. He was incarce…
79y · Male·Complications of peripheral vascular disease with Type 2 Diabetes Mellitus, atri…
John Reginald Wright, a 79-year-old remand prisoner, died from complications of peripheral vascular disease with diabetes, atrial fibrillation, cardiomyopathy and delirium. He was transferred to Princess Alexandra Hospit…
41y · Female·multiple stab wounds to the neck
This inquest examined the death of Prabha Arunkumar, a 41-year-old computer programmer who died from multiple stab wounds to the neck sustained during an attack in Parramatta Park on 7 March 2015. She was transported to …
71y · Male·Subdural haemorrhage on a background of an unwitnessed fall and anticoagulation …
A 71-year-old man with diabetes, ischaemic heart disease and osteomyelitis presented with fever and hypoglycaemia. He met Red Zone sepsis criteria (lactate 4.5mmol/L) but antibiotics were significantly delayed—ceftriaxon…