Coroners Court New South Wales

Coronial findings and recommendations

To access a finding not listed here, please make an application (PDF, 112.1 KB) to the Court. In some inquests recommendations - external site are made to Ministers and Government and non-government agencies.

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Showing results 1 - 10 of 973 results

Inquest into the Disappearance and Suspected Death of Ashley McKellar (218.2 KB,PDF File) - external site

Decision of Deputy State Coroner Hosking

Coronial law: missing person, whether now deceased, cause and manner of death, place of death

Inquest into the death of Colin Neil Amatto (2.6 MB,PDF File) - external site

Decision of Deputy State Coroner Forbes

CORONIAL LAW - Dog attack - Examination of the Companion Animals Act 1998 regulatory regime - Recommendations for regulatory changes

Inquest into the death of DB (847.0 KB,PDF File) - external site

Decision of Deputy State Coroner Grahame

CORONIAL LAW - infant death, homicide, non-accidental injuries, FACS, Family and Community Services, DCJ, Department of Communities and Justice, risk of seriou

Inquest into the death of Michael Sanderson (3.8 MB,PDF File) - external site

Decision of Deputy State Coroner Hosking

CORONIAL LAW - Mandatory inquest pursuant to s 23(1 )(d)(ii) of the Coroners Act 2009 (NSW)- First Nations death in custody- communication and treatment of fam

Inquest into the death of Ms K (464.4 KB,PDF File) - external site

Decision of Deputy State Coroner Ryan

CORONIAL LAW - mandatory inquest, death of a person by homicide, coercive control, was response of NSW Police Force to reports of domestic and family violence

Inquest into the death of Hayden Dawes (456.8 KB,PDF File) - external site

Decision of Deputy State Coroner Pearce

CORONIAL LAW – death in Corrective Services NSW custody – whether adequate and appropriate medical care provided

Inquest into the death of RD (324.5 KB,PDF File) - external site

Decision of Magistrate McLaughlin, Coroner

CORONIAL LAW – Group A Streptococcus pneumonia with sepsis – NSW Ambulance protocols for transportation when vital signs outside the reference range/outside th

Inquest into the Death of G.P. (392.8 KB,PDF File) - external site

Decision of Deputy State Coroner O'Neil

CORONIAL LAW – mental health – abscondment from mental health facility – hospital care and treatment – police response to abscondment – ADHD – Vyvanse – manner

Inquest into the death of NL (483.3 KB,PDF File) - external site

Decision of Deputy State Coroner Lee

CORONIAL LAW – cause and manner of death, cardiac arrythmia, QT prolongation, hypothyroidism, compliance with thyroxine medication, endocrine management, thyro

Inquest into the death of Michelle Michell (4.1 MB,PDF File) - external site

Decision of Deputy State Coroner Baptie

CORONIAL LAW - domestic violence - homicide - NSW Police Force - Domestic Violence Safety Assessment Tool (DVSAT) - Apprehended Domestic Violence Order - cross

Last updated:

02 May 2025