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Findings

A written finding is a formal document handed down by a coroner following an investigation into a death or fire and is generally the final step in the coronial investigation process. A written finding is made regardless of whether an inquest is held or not.

A written finding following an investigation into a death will usually, if possible, include:

  • the identity of the person who died
  • the time, date, and location where the death occurred
  • a summary of the evidence relating to the circumstances of the death, in some cases
  • comments or recommendations made by the coroner aimed at preventing similar deaths, in some cases.

Findings are published when:

  • an inquest was held
  • recommendations have been made
  • a coroner otherwise orders they be published.

Findings handed down and published are available below.

Search older findings on the Australasian Legal Information Institute database (AustLII).

Please consider that it may be upsetting to read details about a death or fire in an inquest finding. Some information may be graphic or distressing.

Use the search field above to locate a finding. You can search for a name, a case number, type of death or location of death.

Any person may apply for some or all of a finding to be reviewed and/or appealed.

    Recommendations

    The Coroners Act 2008 allows a coroner to make recommendations as part of their finding following an investigation into a death or fire.

    Recommendations can be made to any Minister, public statutory authority or entity that may help prevent similar deaths. A public statutory authority or entity who receives a recommendation from a coroner must respond, in writing, within three months stating what action, if any, has or will be taken.

    The Court will publish inquest findings with recommendations and the subsequent responses below.

    Findings list

    Name Case ID Case type Date Sort ascending Coroner Related orders and rulings Responses to recommendations
    Katrina Mary West COR 2014 5187 Finding into death without inquest 23/05/2016 Coroner Jacqui Hawkins
    Josip Dobrovoljski COR 2014 5032 Finding into death without inquest 19/05/2016 Coroner Rosemary Carlin
    Trendafil Petrovski COR 2013 4700 Finding into death without inquest 17/05/2016 Coroner Audrey Jamieson
    Shaun Luke Beagley COR 2014 1172 Finding into death without inquest 13/05/2016 Coroner John Olle
    Kevin Stanley Margetts COR 2015 4554 Finding into death without inquest 12/05/2016 Coroner Peter White
    Nicholas Langmaid COR 2015 3119 Finding into death without inquest 11/05/2016 Coroner Rosemary Carlin
    David Scrofano COR 2013 1057 Finding into death with inquest 05/05/2016 Deputy State Coroner Paresa Spanos
    Jack Glen Irvine COR 2012 4117 Finding into death with inquest 29/04/2016 Coroner Audrey Jamieson
    Daniel Michael Miles COR 2015 0295 Finding into death without inquest 22/04/2016 Coroner Audrey Jamieson
    Kelly Elizabeth Hall COR 2013 2123 Finding into death without inquest 22/04/2016 Coroner Rosemary Carlin