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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
    John Reed COR 2015 003624 Finding into death without inquest 03/06/2021 State Coroner Judge John Cain
    Beryl Maloney COR 2018 5326 Finding into death without inquest 01/06/2021 Coroner Darren Bracken
    Darin Lyndon Wheeldon COR 2020 0929 Finding into death without inquest 31/05/2021 Coroner John Olle
    Melanie Diane Doherty COR 2018 001213 Finding into death without inquest 28/05/2021 Coroner Sarah Gebert
    David John Campbell COR 2019 003853 Finding into death without inquest 27/05/2021 Deputy State Coroner Paresa Spanos
    William Maxwell COR 2018 1430 Finding into death with inquest 21/05/2021 Coroner Jacqui Hawkins
    Brodie Moran COR 2018 1110 Finding into death without inquest 20/05/2021 State Coroner Judge John Cain
    Ms ZT COR 2016 2733 Finding into death without inquest 15/05/2021 State Coroner Judge John Cain
    Ella Felicity Hitchen COR 2020 5929 Finding into death without inquest 11/05/2021 Coroner Phillip Byrne
    Karim Aarras COR 2017 4490 Finding into death with inquest 10/05/2021 Coroner Phillip Byrne