Coronial findings 

To access a finding not listed here, please make application (DOC , 61.5 KB) to the Court. In some inquests recommendations are made to Ministers and Government and non-government agencies.

Showing 1-10 of 57 results

  • Recommended
    Decision of Deputy State Coroner Lee
    CORONIAL LAW - manner of death
  • Recommended
    Decision of Deputy State Coroner Forbes
    CORONIAL LAW - unidentified human remains, Eastern bank of the MacDonald River, near Wrights Creek Road St Albans NSW
  • Recommended
    Decision of
    CORONIAL LAW - cause and manner of death, laryngectomy, tracheal stenosis, respiratory rate, respiratory distress, alteration of calling criteria, Clinical Emergency Response System, vital sign observations
  • Recommended
    Decision of Deputy State Coroner Forbes
    CORONIAL LAW - death in custody, mandatory inquest, cause and manner of death, natural causes
  • Recommended
    Decision of Deputy State Coroner Ryan
    CORONIAL LAW - natural causes death of a person in lawful custody - was medical care and treatment appropriate
  • Recommended
    Decision of Deputy State Coroner Grahame
    CORONIAL LAW - Self-inflicted death, Safe Driving Policy, "urgent duty driving", use of lights and sirens
  • Recommended
    Decision of Deputy State Coroner Ryan
    CORONIAL LAW - natural causes death of a person in lawful custody - whether a 'not for resuscitation' directive was in place
  • Recommended
    Decision of Deputy State Coroner Stone
    CORONIAL LAW - mandatory inquest - critical incident - police pursuit - motor vehicle accident - motorcycle - alcohol - speed - inexperienced rider - NSW Police Force - Safe Driving Policy
  • Recommended
    Decision of Deputy State Coroner Forbes
    CORONIAL LAW - self-inflicted death - mental health - s.23 Coroners Act 2009 - mandatory inquest - death as a result of police operations - high risk to public safety
  • Recommended
    Decision of Deputy State Coroner Forbes
    CORONIAL LAW - Death in custody, death at Mount Druitt Police Station, cocaine toxicity, pre-existing heart condition, police attempts to obtain medication, implementation of police policy and procedure
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Last updated:

18 Aug 2021

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