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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
    Edna May Pullen COR 2012 0607 Finding into death with inquest 08/10/2015 Deputy State Coroner Paresa Spanos
    Rutiano Chong Gum COR 2014 4554 Finding into death with inquest 08/10/2015 Coroner Jacqui Hawkins
    Gregory Anderson COR 2014 0858 Finding into death with inquest 06/10/2015 State Coroner Judge Ian L Gray
    Catherine Jane Bernard COR 2012 0414 Finding into death without inquest 05/10/2015 Coroner Audrey Jamieson
    Kirat Singh COR 2013 3852 Finding into death with inquest 30/09/2015 Deputy State Coroner Paresa Spanos
    Martin Yim COR 2007 3518 Finding into death with inquest 29/09/2015 Coroner Peter White
    Leigh Trevor Davies COR 2010 4736 Finding into death with inquest 29/09/2015 State Coroner Judge Ian L Gray
    Luke Geoffrey Batty COR 2014 0855 Finding into death with inquest 28/09/2015 State Coroner Judge Ian L Gray
    GC COR 2012 0265 Finding into death with inquest 24/09/2015 Coroner John Olle
    Jason Govan COR 2012 0264 Finding into death with inquest 24/09/2015 Coroner John Olle