Coronial
TAScommunity

Coroner's Finding: McKillop, John Andrew

Deceased

John Andrew McKillop

Demographics

58y, male

Date of death

2021-12-11

Finding date

2022-07-06

Cause of death

drowning due to loss of consciousness from acute coronary event (unstable plaque in left main coronary artery)

AI-generated summary

A 58-year-old man with a 5-year history of cardiology follow-up died during a recreational canoeing expedition. Despite previous cardiology assessment detecting no ischaemic heart disease, autopsy revealed severe ischaemic heart disease with unstable plaque in the left main coronary artery. While paddling, he became dizzy and collapsed, leading to submersion and drowning. The coroner found the cardiac event could not have been foreseen and was likely fatal regardless of the aquatic setting. The rescue response was prompt and appropriate. This case highlights the unpredictable nature of acute coronary events even in apparently stable patients under cardiology care, and the importance of risk stratification in patients engaging in water-based activities.

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Specialties

cardiologyemergency medicineforensic medicine

Contributing factors

  • severe ischaemic heart disease not previously detected despite 5 years of cardiology follow-up
  • acute unstable coronary plaque causing loss of consciousness
  • submersion in water while unconscious
Full text

MAGISTRATES COURT of TASMANIA

CORONIAL DIVISION Record of Investigation into Death (Without Inquest) Coroners Act 1995 Coroners Rules 2006 Rule 11 I, Olivia McTaggart, Coroner, having investigated the death of John Andrew McKillop Find, pursuant to Section 28(1) of the Coroners Act 1995, that a) The identity of the deceased is John Andrew McKillop; b) Mr McKillop was 58 years of age, was married and lived in Margate. He worked as a naval architect. He was a member of the Tasmanian Sea Canoeing Club (the Club) and was a competent paddler. For five years before his death, he was under the care of a cardiologist. During that time, Mr McKillop was treated for palpitations, which resolved with the prescribed treatment. His cardiologist detected no evidence of ischaemic heart disease.

On Saturday 11 December 2021, Mr McKillop was one of a party of six paddlers with the Club who left Fort Beach at South Arm on a canoe trip to circumnavigate Betsy Island. The group departed the beach at approximately 9.30am on that date.

Mr McKillop had been a member of the Club for 6 months and had demonstrated that he was a competent paddler. He had previously circumnavigated Betsy Island.

The group took approximately 70 minutes to reach the North West corner of Betsy Island. There, they had a brief break before continuing on their journey.

Within 5 minutes of resuming their journey, while abeam the western side of Betsy Island, it was observed that Mr McKillop was starting to fall behind. It was unusual for him to struggle to keep up with the main group. When questioned, Mr McKillop complained of feeling unwell and 'dizzy'.

The trip coordinator was Terrence Sykes, a long-term member of the Club and a very experienced paddler. Because Mr McKillop felt unwell, Mr Sykes made the decision that the group would turn around and return to the north shore of Betsy Island. Mr McKillop struggled to turn his canoe and his strokes were weak and

ineffective. Mr McKillop was then seen to collapse and his canoe capsized sideways to the left. Mr McKillop remained attached to his canoe and was submerged in the water for approximately 30 seconds before he was rescued by Mr Sykes.

A nearby vessel was alerted of the incident and assisted. Mr McKillop was initially administered EAR (mouth-to-mouth resuscitation) due to him still being attached to the canoe and wearing a life jacket. Mr McKillop was then removed from the canoe and brought aboard the vessel where CPR was administered. Mr McKillop did not regain consciousness and it was observed that he had white foam around his mouth and nose. He was immediately conveyed to the Cremorne Jetty where Ambulance Tasmania paramedics examined him, found that there were no signs of life and determined that, unfortunately, he was deceased.

An autopsy was conducted by the forensic pathologist who observed that Mr McKillop suffered severe ischaemic heart disease and had suffered a loss of consciousness due to plaque in the left main coronary artery which had become unstable while at sea. Unable to protect himself from being submerged in the water, he drowned; c) Mr McKillop’s cause of death was drowning due to becoming unconscious as a result of the above-mentioned cardiac event; and d) Mr McKillop died on 11 December 2021 at South Arm, Tasmania.

In making the above findings, I have had regard to the evidence gained in the comprehensive investigation into Mr McKillop’s death. The evidence includes:  The Police Report of Death for the Coroner;  Affidavits confirming identification and life extinct;  Opinion of the forensic pathologist regarding cause of death;  Toxicology report regarding Mr McKillop’s post-mortem blood sample;  Affidavit of Terrence Sykes, trip coordinator;  Affidavit of Christopher Bird, driver of the boat which rescued Mr McKillop;  Affidavit of Senior Constable Eileen Langford of Tasmania Police Marine and Rescue Services;  Medical records for Mr McKillop; and  Opinion of Dr Anthony Bell, coronial medical consultant.

Comments The evidence in this investigation indicates that Mr McKillop’s cardiac event occurring before he drowned could not have been foreseen at the commencement of the trip. Given the extent of the disease in Mr McKillop’s left main coronary artery, it is quite likely that he would have died even if he was not in water.

I particularly note that the trip was well organised and Mr McKillop’s canoe was in excellent condition. The response from Mr Sykes to rescue Mr McKillop was immediate and timely steps were taken to convey him to land. I acknowledge the contribution of all of those who assisted in these efforts.

The circumstances of Mr John McKillop’s death are not such as to require me to make any comments or recommendations pursuant to Section 28 of the Coroners Act 1995.

I convey my sincere condolences to the family and loved ones of Mr McKillop.

Dated: 6 July 2022 at Hobart Coroners Court in the State of Tasmania.

Olivia McTaggart Coroner

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