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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
Clarence Tuivaiese Nicholas Leo COR 2016 5542 Finding into death with inquest 09/11/2018 Deputy State Coroner Paresa Spanos
Apollo George Papadopoulos COR 2016 5536 Finding into death with inquest 09/11/2018 Deputy State Coroner Paresa Spanos
Paul Francis O'Donnell COR 2016 2762 Finding into death without inquest 07/11/2018 Deputy State Coroner Iain West
Abuk Derder Akek COR 2016 1161 Finding into death without inquest 07/11/2018 Deputy State Coroner Iain West
Winifred Jean Morffew COR 2018 0437 Finding into death without inquest 31/10/2018 Coroner Audrey Jamieson
Baby B COR 2014 4591 Finding into death without inquest 26/10/2018 Coroner Caitlin English
John Gorman Maltman COR 2017 6579 Finding into death without inquest 26/10/2018 Coroner Caitlin English
Sydney Dale Stanfield COR 2017 5763 Finding into death without inquest 24/10/2018 Coroner Audrey Jamieson
Quoc Huong Vu COR 2016 1158 Finding into death with inquest 23/10/2018 Coroner Audrey Jamieson
Ian Cook COR 2016 1157 Finding into death with inquest 23/10/2018 Coroner Audrey Jamieson