Coroner's Finding: Youd, Diane Maree

MAGISTRATES COURT of TASMANIA

CORONIAL DIVISION Record of Investigation into Death (Without Inquest) Coroners Act 1995 Coroners Rules 2006 Rule 11 I, Robert Webster, Coroner, having investigated the death of Diane Maree Youd Find, pursuant to Section 28(1) of the Coroners Act 1995, that a) The identity of the deceased is Diane Maree Youd (Mrs Youd); b) Mrs Youd died in the circumstances set out below; c) The cause of Mrs Youd’s death cannot be determined; and d) Mrs Youd died between 8 and 21 November 2021 at Devonport, Tasmania.

In making the above findings, I have had regard to the evidence gained in the investigation into Mrs Youd’s death which includes:  Police Report of Death for the Coroner;  Affidavits as to identity and life extinct;  Affidavit of the Forensic Pathologist Dr Andrew Reid;  Forensic Science Service Tasmania toxicological and analytical report;  Affidavit of Mr Mark Sutton, sworn 29 March 2022;  Affidavit of Ms Melissa Hatwell, sworn 21 November 2021;  Medical records of Mrs Youd obtained from her general practitioner, Dr Fernando;  Ambulance Tasmania (AT) electronic patient care record; and  Medical records of Mrs Youd obtained from the North West Regional Hospital (NWRH) and Mersey Community Hospital (MCH).

Background Mrs Youd was 60 years of age, widowed and she lived on her own in Devonport at the date of her death. Her husband had predeceased her by approximately 6 months. Mr and Mrs Youd did not have any children.

As to her health, the records disclose she was 79.2 kg at the date of her death and she had a body mass index of 30. Her weight had fluctuated between 96 kg as at the 17 September 2019 105 kg on 22 June 2020 and 121 kg as at 28 April 2021, at which point in time her body mass index was 46.1. There is also a history of hypertension and depression. In addition, she had osteoarthritis of the lumbar spine, a deep vein thrombosis in February 2019, a left fracture of the neck of the humerus in May 2019 and an acute kidney injury in August 2021.

Mrs Youd’s brother-in-law, Mr Sutton, says up until about March 2021 Mrs Youd and her husband lived in Glenorchy. Mr Youd worked as a taxi driver however Mr Sutton says Mrs Youd “used to stay in bed all day because she was having some sort of breakdown”. He says Mrs Youd had a certificate 3 in nursing and previously worked in an aged care facility.

Mr Youd arranged for his wife to see a doctor who prescribed medication and she improved. They then moved to Devonport and both seemed very happy. Approximately 6 months after they moved, Mr Youd had a heart attack and passed away and thereafter Mr Sutton says he and his wife didn’t see her very often. Up until July 2021 they used to see Mrs Youd 3 to 4 times per week but after that point they did not see her at all. Mr Sutton was told by residents of the unit complex in which Mrs Youd’s resided that they saw little of her after that point. Mr Sutton is aware that in late August 2021, Mrs Youd was admitted to hospital and that on her release she was prescribed medication. However, Mr Sutton does not believe she took that medication because when he and his wife, Helen, went into Mrs Youd’s unit they found all the medication which was still sealed.

As to the hospital attendance the medical records disclose Mrs Youd was attended by ambulance on 18 August 2021. A male friend had called an ambulance because he was concerned about Mrs Youd’s mental health. Ambulance officers obtained a history of low mood, poor appetite, concerns about malnutrition and dehydration. She told them she had lost weight as a result of her symptoms. In addition she indicated she has had suicidal thoughts for some time but denied she had a plan. She had not been taking her antihypertensive and mood stabilising medication for weeks. A history was obtained at the hospital which included a very poor oral intake and no solid food for 14 days. A diagnosis of major depression with suicidal ideation was made. There was evidence of fluid depletion and acute kidney injury and Mrs Youd was admitted to the Mersey Community Hospital. There is a history that she ceased taking Sertraline one month before this admission. The next day she was reviewed by a psychiatrist. At a review on 26 August 2021 she was bright and reactive. She said she had good support from friends and she was discharged from psychiatric care on 27 August 2021 for GP follow-up. The Sertraline dose was increased.

Because of her improvement inpatient psychiatric treatment was not considered necessary.

The circumstances leading to Mrs Youd’s death On 8 November 2021 Jason Dyke, who was a neighbour of Mrs Youd, contacted police because he was concerned for her welfare as he had not seen her for a month. At 5.10pm that day police attended and with the assistance of Christine Shaw, whose unit adjoins Mrs Youd’s unit, managed to have Mrs Youd come to the door and speak to police. Ms Shaw advised police Mrs Youd was a recluse by nature and would not come to the door if the person at the door was not known to her. This was the last time Mrs Youd was seen alive.

Police spoke to Mrs Youd at length and she assured them she was not suicidal and that she wished to be left alone to get over an upset stomach which was caused by the consumption of ham that was “off”.

Mr Sutton says he was aware Mrs Youd used to speak to Anne Wrankmore on the telephone each day. Around about the end of October 2021 Ms Wrankmore advised Mr Sutton she had not heard from Mrs Youd for some time. On 21 November 2021, Walter Wrankmore, who lived in the same street as Mrs Youd, advised Mr and Mrs Sutton that he had not seen or heard from her for about 3 weeks. As Mr Sutton still had not heard from her he and Mrs Sutton spoke to a neighbour, Melissa Hatwell, who advised them to call police. Mr Sutton had spoken to the crisis assessment and treatment team (CATT), AT and some doctors but he says no one would check on her. Ms Hatwell called Tasmania Police on Mrs Sutton’s behalf.

At 4.10pm police attended Mrs Youd’s address, spoke to neighbours and knocked on the door. Subsequently police forced entry and upon entering Mrs Youd’s unit police observed Mrs Youd reclining in a chair in the lounge room. She was deceased.

Investigation Christine Shaw advised police she last saw Mrs Youd when police attended on 8 November

2021. A search of the area where Mrs Youd was found did not identify any prescription medication. There was nothing suspicious about Mrs Youd’s resting position and there was no evidence of any forced entry or that she had been subject to any violence.

Dr Reid performed a post-mortem examination on 23 November 2021. He confirmed there were no signs of violence or injury. There were signs of decomposition. Internal examination showed decomposition changes, mild atherosclerosis and no evidence of an obvious natural cause of death. Equally there was no evidence of an unnatural cause or contribution to death. Dr Reid noted there was no alcohol or drugs in Mrs Youd’s blood apart from nicotine. Interpretation of the histology samples was limited by post-mortem autolysis; that is the breakdown of all or part of a cell or tissue by self produced enzymes. There was a

right supra renal mass however its nature could not be determined because of the loss of diagnostic features which was due to the autolysis. There were no macroscopic or residual microscopic features of malignancy. The possibility of a benign paraganglioma could not be excluded. In addition the possibility of an ante-mortem infarction of this benign tumour could not be excluded. The differential diagnosis for the cause of a possible sudden natural death in this case also includes pneumonia. Diagnostic features for acute pneumonia could not be seen due to decomposition associated autolysis. However there were reactive changes identified in the middle lobe which are consistent with a previous infection.

Dr Reid says despite a full external and internal post-mortem examination and histological and toxicological tests the cause of death is undetermined. However he says the possibility that death was due to natural causes could not be excluded. In addition he says there was no evidence Mrs Youd’s death was due to, or contributed to by, an unnatural cause, violence or injury. Dr Reid notes the history of the acute kidney injury that is acute renal failure which was due to dehydration. This and the history in the Police Report of Death to the Coroner suggest the possibility that the circumstances in which the cause of death arose were contributed to by self-neglect.

Given the circumstances of Mrs Youd’s death, I arranged for the coronial medical consultant, Dr Anthony Bell, to examine the file. His opinion is that Mrs Youd had depression and this led to her suicide. Whilst that certainly is a possibility I am not satisfied, on the balance of probabilities that is the cause of death.

In this case I prefer the opinion of Dr Reid. Unfortunately his post mortem examination was hampered by the presence of decomposition and accordingly, although he notes a number of potential causes of death, he ultimately could not determine Mrs Youd’s cause of death.

Comments and Recommendations The circumstances of Mrs Youd’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 Mrs Youd.

Dated: 11 August 2022 at Hobart in the State of Tasmania.

Robert Webster Coroner