Inquest into the Death of David William Maddams
Inquest into the Death of David William MADDAMS
Delivered on : 17 September 2026
Delivered at : Perth
Finding of : Acting State Coroner Linton
Recommendations : N/A
Orders/Rules : N/A
Suppression Order : N/A
Summary :
David Maddams was a military veteran who suffered serious injuries, including a head injury, while serving in the Australian Army when he was 26 years of age. He was medically discharged a few years later and received ongoing support from the Department of Veteran Affairs including assistance with health care. David was diagnosed with a number of health conditions, one of which was paranoid schizophrenia for which he was prescribed antipsychotic medication.
David also had a history of pulmonary embolism, for which he was prescribed anti-coagulant medication.
In May of 2024 David ceased taking his prescribed medications and relapsed into psychosis. By September of 2024 David was hospitalised as an involuntary psychiatric patient. He was subsequently released on a Community Treatment Order to ensure he continued to receive his antipsychotic medications. He refused to recommence his anticoagulant, which increased his risk of having another pulmonary embolism. It was hoped as his mental health continued to improve, his GP would be able to convince him to restart the medication.
On 4 November 2024 David suddenly died at home. At the time it was said that he was doing well psychiatrically but he was still not yet taking his anticoagulant medication. David died as a result of a pulmonary thromboembolism.
The coroner found David’s health care, treatment and supervision was reasonable and appropriate.
The coroner found David died as a result of natural causes and no recommendations were made.
Catch Words : Mandatory Inquest : Death in care : Community Treatment Order : Natural Causes
Last updated: 24 September 2026