Coroner's Court of Western Australia

Inquest into the Death of Ejub MEHINOVIC

Inquest into the Death of Ejub MEHINOVIC

Delivered on :29 June 2017

Delivered at : Perth

Finding of : Coroner King

Recommendations :N/A

Orders/Rules : N/A

Suppression Order : N/A

Summary : The deceased had a long history of significant mental illness for which he received ongoing treatment and care. He suffered from treatment-resistant paranoid schizophrenia for which he received depot clozapine.

On 21 September 2015 the deceased was referred by his case manager at Inner City Mental Health Service to Sir Charles Gairdner Hospital for examination by a psychiatrist because he had not been taking his medication.   He was treated and discharged on a community treatment order under the Mental Health Act 1996.

The deceased had an appointment with the treating team at Inner City Mental Health Service on 23 November 2015. On 22 November 2015 one of the deceased’s neighbours saw him cleaning his car, as he normally did on a Sunday. In the early hours of the next morning the deceased’s neighbour heard a loud bang and a sound like breaking glass coming from the deceased’s unit.  The neighbour noticed a light coming from the deceased’s kitchen window but did not see anything else.  The deceased’s car was still in his driveway the next afternoon, which was unusual.

The deceased did not attend his scheduled appointment with his treating team on 23 November 2015. Following a team meeting the next morning, the deceased’s case manager went to the deceased’s unit, but the deceased did not come to the door.  The deceased’s case manager and a senior social worker returned to the deceased’s unit the following afternoon.  The deceased’s car was in the carport, and a light was on in the kitchen despite the time of day.  They looked through a window and saw the deceased lying on the floor.  The doors and windows were locked so they called ‘000’.  Officers forced entry into the unit and confirmed that the deceased was dead.

A post mortem examination revealed that the deceased had coronary artery atherosclerosis, which caused his death. The Coroner found that death occurred by way of natural causes.

The Coroner was satisfied that the standard of supervision, treatment and care of the deceased while he was an involuntary patient was reasonable and appropriate in all of the circumstances.

Catch Words : Community Treatment Order : Clozapine : Coronary Atherosclerosis : Natural Causes.

Last updated: 30-Apr-2019

[ back to top ]